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US · guidance

CMS SOM App. B, Tag G590

§484.60(c)(1)

activein force · 2026-07-22 – presentas-observed

. . . The HHA must promptly alert the relevant physician(s) or allowed practitioner(s)

to any changes in the patient's condition or needs that suggest that outcomes are not

being achieved and/or that the plan of care should be altered.

Interpretive Guidelines §484.60(c)(1) (Tags G588 and G590)

For “responsible physician” see §484.60(a)(1).

The signature and date of the review by the responsible physician or allowed practitioner

verifies the interval between plan of care reviews.

In the event of a change in patient condition or needs that suggest outcomes are not being

achieved and/or that the patient’s plan of care should be altered, the HHA should notify

both the responsible physician or allowed practitioner and the physician(s) or allowed

practitioner(s) associated with the relevant aspect of care.

Changes in physician or allowed practitioner orders during the plan of care certification

period do not automatically restart the timeframe for physician or allowed practitioner

review of the plan of care.

History

Rev. 219; Issued: 04-12-24; Effective: 04-12-24; Implementation: 04-12-24

Provenance

Source
cms.gov
Retrieved
2026-07-22
Edition
som-2026-07-22
Content hash
80f2b1d0814a03836c8863f900c5293b96e0d12a309285bb966415835c0da711
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