According to the Administration for Community Living (ACL), nearly 40 percent of seniors will require nursing home care at some point in their lives. Given the likelihood of long-term care needs—especially for individuals with complex medical conditions—it is essential to create a well-structured, individualized nursing home care plan. At Keystone Elder Law P.C., our Mechanicsburg life care planning attorney provides guidance to help families navigate this process with confidence. Below, we offer an overview and example of a nursing home care plan used in Pennsylvania.
What is a Nursing Home Care Plan?
A nursing home care plan is a detailed, personalized document created for each resident of a long-term care facility. Its primary goal is to outline the specific medical, emotional, and daily living needs of the resident, along with the strategies and resources that will be used to meet those needs. These plans are developed collaboratively by nursing home staff, healthcare providers, the resident, their family members, and legal representatives. A nursing home care plan acts as a roadmap to ensure the delivery of high-quality, consistent, and person-centered care.
Note: In Pennsylvania, personal care homes frequently use a standardized tool known as the Resident Assessment Support Plan (RASP). The RASP is designed to evaluate a resident’s needs and document the support methods that will be used to meet them.
Sample Nursing Home Care Plan Structure
A comprehensive nursing home care plan typically includes the following key sections:
1. Personal Information
This section captures the essential details of the resident:
- Full Name
- Date of Birth
- Medical Record Number
- Date of Admission
- Next Scheduled Review Date
- Summary of Current Health Assessment
- Diagnosed Medical Conditions
- Known Allergies
- Dietary Restrictions or Preferences
- Mobility Status
2. Care Plan Objectives and Interventions
This section outlines care goals and how they will be achieved:
- Individualized Objectives (e.g., manage chronic conditions, prevent falls)
- Specific Interventions or Services
- Responsible Staff or Providers
- Frequency of Monitoring and Updates
3. Nutritional Support
- Nutritional Goals (e.g., maintain weight, manage diabetes)
- Meal Planning and Dietary Modifications
- Assigned Dietary Staff
- Monitoring Schedule
4. Mobility and Physical Activity
- Mobility Improvement or Maintenance Goals
- Use of Assistive Devices (e.g., walkers, wheelchairs)
- Physical Therapy or Exercise Programs
- Staff Roles and Monitoring
5. Personal Hygiene
- Daily Hygiene Routines (e.g., bathing, grooming)
- Assistance Required (if any)
- Assigned Care Aides or Nursing Staff
- Monitoring Frequency
6. Cognitive Support
- Support for Memory, Dementia, or Cognitive Decline
- Mental Health Strategies or Therapies
- Responsible Providers (e.g., social workers, therapists)
- Monitoring and Progress Review
7. Social Engagement
- Opportunities for Social Interaction (e.g., group activities, visits)
- Emotional Support Goals
- Assigned Staff for Engagement Coordination
- Activity Frequency and Participation Tracking
Why Customization is Critical in Nursing Home Care Planning
No two residents have the same medical history, care needs, or personal preferences. A nursing home care plan must be tailored to reflect the individual’s unique health conditions, values, routines, and desired quality of life. Generic or cookie-cutter plans can lead to gaps in care, dissatisfaction, and increased risks. By creating a personalized care plan, families and providers can work together to promote dignity, comfort, safety, and improved health outcomes for the resident.
- Life Care Planning Tip: Involving both the resident and their family in developing the care plan ensures it aligns with the individual’s wishes and provides a stronger foundation for consistent, high-quality care.
Contact Our Pennsylvania Life Care Planning Attorney Today
At Keystone Elder Law P.C., we are dedicated to helping families prepare for long-term care with thoughtful, personalized legal and care planning solutions. If you have questions about creating or reviewing a nursing home care plan, our experienced Mechanicsburg life care planning attorney is here to help. Call today or contact us online to schedule a fully confidential consultation. We proudly serve clients throughout Central Pennsylvania from our Mechanicsburg office, including Gettysburg and surrounding communities.