Completing a Service Plan is the critical second step in defining a resident's documented care services within ALIS. This guide walks you through the process of turning the evaluation triggers into actionable schedules, ensuring you accurately capture specific resident needs for daily Care Tracking.
About the Evaluation Cycle
The ALIS team works with your leadership to build an integrated tool used to evaluate residents and determine their care needs. When you complete a Service Plan in ALIS, you are finalizing the second piece of a standardized three-part process.
The three components of this process are:
The Evaluation: The set of questions and answers that comprehensively assess a resident's health and acuity.
The Service Plan (the topic of this article): A document generated from the evaluation answer choices that outlines specific resident needs. This is where a clinical team member schedules the specific services that will ultimately appear on the Care Plan. The completed document, including the set schedule, serves as the contractual agreement between the community and the resident, responsible party, or other required signers.
The Care Plan: The actionable schedule used for daily Care Tracking by direct care staff.
All three parts can be generated as PDFs for printing or signing. While the specific questions in your Evaluation are customizable to your organization, the steps to complete the evaluation cycle remain consistent.
Service Plan Overview
The process of completing a Service Plan consists of two main steps:
Review Needs & Set Schedules: Review the "Need" details and set the schedule for each intervention triggered by the evaluation.
Review Care Level: Confirm the resident's final acuity score and associated fees.
Access the Service Plan
Typically, you will proceed to the Service Plan immediately after completing an Evaluation and wait to collect signatures once both documents are complete.
Immediate Access: Click the Go to Service Plan button immediately upon finishing an evaluation.
Later Access: If you did not proceed to the Service Plan immediately, you can find the Continue button in the "In Progress" tab of the Evaluation Center or on the resident's Profile.
For more information about completing an Evaluation, read this How to complete an Evaluation guide.
Navigate Review Service Plan page
Before adding information for the Needs, Goals, and Interventions, it is important to understand the main components and navigational tools of this page to help you track progress and identify requirements.
Finish Later vs. Discard Draft
Finish Later: Allows you to save the in-progress Service Plan draft. Clicking Finish Later keeps the Service Plan in the "In Progress" tab of the Evaluation Center for you to return to later.
Discard Draft: Allows you to delete the in-progress Service Plan. Review the Service Plan in full first. If any answer choices in the Evaluation were made in error, click this button to return to the Evaluation and fix any mistakes.
Document Preview Options
View Evaluation (Left): Opens a reference PDF of the completed evaluation.
View Service Plan (Right): Opens a preview of the document you are currently building, including schedules.
Status Indicators (Top Right)
Percentage Bar: Shows completion progress.
Red Box: Indicates the number of Required Needs that still require attention. You cannot complete the Service Plan until this box shows '0'.
Yellow Box: Indicates the number of needs requiring review of the previously set Care Plan schedules. This would only apply if you just reassessed a resident.
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Care Points/Level: Displays the current calculated points total and resulting Care Level (if applicable to your custom evaluation tool). Points are calculated based on evaluation answers.
Note: Authorized users can only change points for specific needs by discarding the Service Plan draft and going back and edit the Evaluation. They can also edit the overall points total in the Review Care Level step. Click here to go to the Review Care Level section of this guide.
Care Packages details also display here if any packages were triggered by the evaluation. For more information on how to add Care Packages to an evaluation, read this Care Packages in the Evaluation guide.
Edit Needs
If a section is red, it contains at least one Need that requires further configuration.
Most often, needs will automatically populate with a Goal, Intervention, Staff Role, and Location. Occasionally, the Frequency and Schedule will also be pre-selected. Depending on what items appear, you may choose to not edit the need and only the Set Schedule.
If there are not pre-selected options below the listed Need, this typically means there are multiple possibilities to choose from (e.g., specific Fall Interventions, potential Third Party roles).
Click the Edit button on a specific Need to open the Set Goals and Interventions configuration pane.
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Notes: Review notes carried over from the evaluation and add new notes if necessary.
Tip: The "Use as Care Item Instructions" box is checked by default. Keep this checked to ensure your notes appear as instructions for caregivers.
Triggered By: Click the Show Answers button to see exactly which evaluation question triggered this Need.
Goals (and Interventions): These may be pre-selected based on your evaluation tool configuration. If multiple options exist, select the most appropriate ones. If you need different language or options, contact your Account Manager or our ALIS Customer Success Team.
Click Save Need.
Set Schedule
Even if a Need has a Goal and Intervention selected, it may still appear red if the schedule is not yet configured. If this Need is linked to an existing care item on the resident's published Care Plan, you will see the "Review Care Plan Schedule" notification.
Click Set Schedule to open the Set Roles and Frequency pane. If applicable, the current schedule will show here to help you avoid accidental changes.
Delivered By: Review and/or select the Role (who provides the care) and Location (where it happens). If applicable, you can select multiple roles (e.g., if community staff handle the day shift and third-party providers handle the night shift). You will need to set the Frequency and Care Shift/List per role selected.
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Frequency: Set the frequency (e.g., Daily, Days of the Week)
Times: Unless "Hide Care Times" is enabled, you can set specific times. If left blank, the task defaults to the start of the shift.
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Shift/ Care List: Set the specific Shift and Care List from the dropdown menu. For the Need (or Care Item) to appear in Care Tracking for multiple shifts, click the +Add button and continue to add applicable Shifts and Care Lists.
- Depending on your Care Settings, you may or may not have the option to add a specific Time once the shift and list are selected. If you have turned on the setting to Hide Care Times, the Times menu will not be available at all. For more information about hiding care times, read this How to Hide Care Times guide.
- Click Save Roles and Frequency.
Complete Service Plan
Once all Needs are configured, click Complete Service Plan to proceed to the final review page.
Review Care Level
As soon as you Complete Service Plan, you are directed to this page. Use the Review Care Level page to conduct a high-level review before finalizing the Service Plan document.
Care Levels
This section displays the Current Care Level (what is currently active) versus the Evaluated Care Level (the new result). If you are evaluating a resident for the first time, only the Evaluated Care Level will display here.
Authorized users will also have access to two buttons:
Override Care Level allows for manual adjustments to Care Points, Care Level, and Fee. There is also a field for adding internal notes.
View All Care Levels shows the current Care Levels, point ranges per care level, and associated fee for each. These are based on your Resident Evaluation Tool Settings.
Care Packages
Care Packages are services associated with fees that can be triggered in the Evaluation regardless of accumulated points. If any were triggered in the Evaluation, they will appear in this section.
Authorized users will also have access to this button:
- Override Care Packages allows for manual adjustment of the package rate.
Comments & Notes
The bottom section of the page allows you to add text to two more sections:
Comments (Service Plan): Add details here that should appear on the printable Service Plan PDF.
Internal Notes for Billing: Add notes for your billing team (visible in the Billing Center). These are useful for explaining changes in level or fees.
Complete Review
Click the green Complete Review button. It is recommended to then click Commit & Sign in order to navigate to the Evaluation & Service Plan Details page where you can begin the signatures capture process.
Note: If you select Commit & Review Care Plan, you will be directed to the Care Plan section of the resident profile where you will review and publish the Care Plan. For more information on how to review and publish the Care Plan, refer to this How to Add or Review a Care Plan guide.
Signatures
Signatures are managed centrally on the Evaluation & Service Plan Details page. It is recommended practice to wait until the Service Plan is finalized to capture signatures on both documents.
The specific number and role of required signers (e.g., Nurse, Administrator, Resident) are customizable based on your organization's settings.
You can access the signing page by clicking Sign or Manage Details next to any completed document in the Evaluation Center.
For more details on managing signatures, refer to the Evaluation Center Reference Guide and E-Sign Evaluations and Service Plans articles.
Related Articles:
- Evaluation Center Reference Guide
- How to complete a Service Plan
- E-sign Evaluations and Service Plans
- Care Packages in the Evaluation
- How to Hide Care Times
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