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Interdisciplinary Discharge Summary

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$28.30
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SKU: CFS5-17P
$28.30

UPDATED 2022
Provides the information needed to be compliant with the elements required (F661) for the Discharge Summary when a resident is discharged from an LTC facility.
This updated version also contains medication reconciliation items that are included in the MDS 3.0 v1.18.11 effective October 1, 2023, as well as other items such as risk factors, BIMS, mood scores, pain, etc.


F661:Recapitulation of the resident’s stay that includes, but is not limited to:

Diagnoses
Course of illness/treatment or therapy
Pertinent lab, radiology, and consultation results
Reconciliation of all discharge medications, both prescribed and OTC
A post-discharge plan of care that is developed with the participation of the resident that will assist in adjusting to his/her new living environment. This post-discharge plan of care must indicate:
• Where the resident plans to reside
• Any arrangements made for follow-up care and
• Any post-discharge medical and non-medical services

Download a sample today!


  • Finished size 8-1/2" x 11" (four pages, 11" x 17" folded)
  • White paper with black ink
  • Printed two sides different
  • Swiss punch - punched top and side
  • 100/pk

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