Care Plan vs Service Plan
Understanding the key differences and when you need each type of plan.
Case managers often work with both care plans and service plans, but the terms aren't interchangeable. Understanding the difference matters for compliance, billing, and providing the right support to participants.
What Is a Care Plan?
A care plan is a clinical document that outlines a person's health needs and how those needs will be addressed. Care plans are typically developed by healthcare professionals and focus on:
- Medical diagnoses and health conditions
- Clinical goals and outcomes
- Nursing interventions and treatments
- Medication management
- Health monitoring requirements
Care plans are common in nursing facilities, hospitals, and programs with significant clinical components like Adult Day Health Care (ADHC).
What Is a Service Plan?
A service plan (also called a person-centered service plan or PCSP) documents the services and supports a person will receive to live in the community. Service plans are required for Medicaid waiver programs and focus on:
- Participant goals and preferences
- Authorized services and units
- Provider assignments
- How services support community living
- Risk mitigation strategies
- Backup plans for essential services
Key Differences
| Aspect | Care Plan | Service Plan |
|---|---|---|
| Primary Focus | Clinical/medical needs | Services and supports |
| Developed By | Nurses, clinicians | Case managers with participant |
| Required For | Clinical programs, nursing | Medicaid waiver programs |
| Person-Centered | May or may not be | Required to be |
| Includes Authorization | Sometimes | Yes, always |
When You Need Both
Some programs require both a care plan and a service plan. For example:
- ADHC programs: Need a clinical care plan for nursing services AND a service plan for waiver documentation
- Participants with complex medical needs: May have a nursing care plan in addition to their HCBS service plan
- Transition from facility: May carry forward a care plan while developing a community service plan
Best Practices
- Use consistent terminology in your organization
- Know which type your program requires
- Ensure plans reference each other when both exist
- Update both plans on the same schedule when possible
- Train staff on the differences
Manage Both Plan Types Easily
One Care Portal supports both care plans and service plans with templates designed for each type. Keep all documentation in one system.
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