Learn how home health RNs use risk screens for falls, depression, nutrition, pain, and skin during the Start of Care (SOC) visit to improve patient safety and ensure compliance.
Introduction: More Than Just Boxes to Check
During the Start of Care (SOC) visit, RNs often feel overwhelmed by the sheer number of assessments. But the risk screens—for falls, depression, nutrition, pain, and skin—aren’t just paperwork. They’re essential tools that identify problems early, prevent complications, and guide the plan of care. Done right, these screens can literally keep patients out of the hospital.
Falls Risk: Preventing the #1 Home Hazard
Falls are one of the leading causes of hospital readmissions for home health patients.
- Use tools like the Timed Up and Go (TUG) test or fall history questions.
- Look for environmental risks: loose rugs, poor lighting, or clutter.
- Tie findings to interventions: balance training, home safety teaching, or PT referral.
👉 For more on functional mobility tests, see my post on Comprehensive Assessment & Functional Testing.
Depression Screening: Seeing the Unseen
Emotional health is just as important as physical health. Tools like the PHQ-2 or PHQ-9 help identify depression risk.
- Listen for changes in sleep, appetite, or interest in activities.
- Report concerns promptly to the practitioner for follow-up care.
- Remember: untreated depression can impact med compliance, nutrition, and healing.
👉 Curious about the early steps of SOC? Read my post on Arrival, Safety, Identity & Consent.
Nutrition Risk: Fuel for Healing
Poor nutrition can delay wound healing, worsen frailty, and increase fall risk.
- Use tools like the Mini Nutritional Assessment (MNA).
- Ask about appetite, unplanned weight loss, and financial barriers to food.
- Coordinate with providers for supplements, dietitian referrals, or Meals on Wheels.
👉 For medication-related nutrition concerns, see Medication Reconciliation That Sticks.
Pain Screening: More Than a Number
Pain impacts everything—mobility, mood, and quality of life.
- Use standardized scales (0–10 numeric, Wong-Baker faces, or verbal descriptors).
- Ask about pain patterns, triggers, and medication effectiveness.
- Document both the patient’s report and your clinical observations.
Pain screening isn’t about checking a box—it’s about validating the patient’s experience and creating a plan that helps them thrive.
Skin Risk: Protecting the Body’s First Line of Defense
Skin breakdown is costly, painful, and often preventable.
- Use tools like the Braden and Norton Scale for pressure ulcer risk.
- Pay attention to bony prominences, heels, and skin folds.
- Reinforce repositioning, skin hygiene, and caregiver teaching.
👉 Want a deeper dive into wound-related SOCs? Check out my post on Timelines, Roles, and Required Elements for SOC.
Why Risk Screens Matter
- For Patients: Early detection means fewer complications.
- For Families: Provides peace of mind and a plan for prevention.
- For Agencies: Meets Medicare compliance and reduces costly hospitalizations.
- For RNs: Builds confidence and documents skilled need clearly.
👉 To see how these screens fit into the bigger picture, don’t miss Intake Triage: The RN’s Secret Superpower.
Final Thoughts: Turning Screens Into Safety Nets
Risk screens may feel routine, but they’re the safety nets that keep patients safe at home. When RNs take the time to assess falls, depression, nutrition, pain, and skin risk, they’re not just filling out forms—they’re protecting lives, one SOC visit at a time.
✨ Want step-by-step strategies for SOC visits, including risk screens that matter?
Check out my RN Home Health SOC Guidebook on Kindle. It’s packed with real-world tips, checklists, and documentation strategies to make SOC visits smoother, faster, and more effective.
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