plan-of-care-management

name	plan-of-care-management
description	Manage the PT/rehab plan of care end to end — goals, frequency/duration, certification, and the recertification clock — so the POC stays signed and current, visits trace to goals, and a lapsing certification is re-booked before it invalidates visits.

Plan-of-Care Management

The plan of care is a living, signed instrument with a certification clock. A lapsed cert can invalidate the visits under it.

What a POC must carry

1. Diagnosis + functional deficits the therapy addresses.
2. Measurable goals (short- and long-term) with functional outcomes.
3. Frequency × duration (e.g. 2×/week × 6 weeks) — this is also the cadence operations must staff.
4. Certification — the required signature establishing the plan.
5. A recertification clock — the window after which the plan must be re-certified to keep billing valid.

Certification vs recertification timing

• Initial certification establishes the plan within its required window.
• Recertification renews it before the certification period lapses or the plan changes materially.
• Own the deadline here; the re-book is operations' (../schedule-and-capacity-planning/SKILL.md). Recertify before it lapses — a late recert is a denial waiting to happen.

Verify-at-use

• Certification windows, signature requirements, and recertification timing vary by payor and by CMS/Medicare rules and change — confirm the current window against the specific payor/CMS source; cite + date, or mark [unverified — training knowledge]. No patient PII.

Traverse the certification-vs-recertification timing tree in ../../knowledge/pt-clinic-decision-trees.md; template at ../../templates/plan-of-care.md.