Documentation5 minPublished By Curtis, RN

Writing Resumption of Care Narratives That Justify Services

What Makes ROC Documentation Different

Resumption of Care visits occur when a patient returns home after an inpatient stay. Unlike routine visits, ROC documentation must establish a clear link between the hospitalization event and the continued need for skilled home health services. This connection is what Medicare reviewers scrutinize most heavily.

The Hospitalization Bridge

Start your ROC narrative by documenting the reason for hospitalization, length of stay, and any new diagnoses or medication changes that resulted. Then bridge to the current assessment: 'Patient discharged from [facility] on [date] following [reason]. New orders include [changes]. SN assessment today reveals [current status].'

Reassessment Is Key

A ROC visit is essentially a mini-SOC. Document a comprehensive reassessment including functional status changes, new fall risk factors, medication reconciliation, and updated care needs. Compare the patient's current status to their pre-hospitalization baseline to demonstrate the impact of the acute event.

Justifying Continued Services

End your ROC narrative with a clear statement of why continued skilled nursing is required: new medications to monitor, wound care needs, post-surgical assessment, disease management education, and coordination with new specialists. Each justification should link directly to an assessment finding from your visit.

Written by

Curtis, RN

Registered Nurse, active multistate compact license, home health case management

I am a home health registered nurse and case manager with an active multistate compact license. I carry a case load, see patients in their homes, and write the visit documentation afterward. MyPrechart grew out of that daily practice.

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