New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 54 - PHYSICIAN SERVICES
Subchapter 6 - HEALTHSTART-MATERNITY AND PEDIATRIC CARE SERVICES
Section 10:54-6.8 - Plan of care

(a) Definition: A Plan of Care is a written document available to and used by all providers for the purpose of assuring the provision of comprehensive and coordinated care. The Plan of Care documents: the identified patient needs for medical, nutritional, social/psychological services (including financial assessment/Medicaid eligibility status); and health education services. It also shall document what services are to be provided and by whom; when the services are to be provided; and document when the services are completed.

(b) A Plan of Care shall be initiated during the first visit. The initial Plan of Care shall be completed after a case conference by the case coordinator and no later than one month after the initial maternity medical care visit.

(c) A Plan of Care shall include but not be limited to: identification of risk conditions and/or problems; prioritization of needs; outcome objectives; planned interventions; time frames; referrals and follow-up activities; and the identification of staff persons responsible for the services and for executing the Plan of Care.

(d) The Plan of Care shall be developed and maintained by the case coordinator for each patient in consultation with the patient and staff providing services.

(e) The Plan of Care shall be reviewed, updated and revised throughout the pregnancy, but at least once during each trimester and in the postpartum period.