Social Service Care Plans for Long Term Care 

Psychosocial Care Plans ~ Cognitive ~ Mood ~ Behavior ~ Medications 

2026 Book and Flash Drive for MDS v1.19.1

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Table of Contents

39 Customizable Care Plans cover cognitive, mood, behavior, psychosocial well-being, and discharge planning.

11 Monitoring & Tracking Forms

7 CAAs & MDS Assessment Calendar: Simplify Care Area Assessments and stay on schedule.

 Compliance Standards: F-Tags, Psychosocial Outcome Severity Guide, Resident Rights, and PDPM.

Medication & Safety: Psychotropic drug guidance (Antidepressants, Anxiety, Lithium, MAO Inhibitors, Tricyclics), alternatives to restraint use, and a modified AIMS (Abnormal Involuntary Movement Scale).

Specialized Training: Dementia in-service materials and skilled charting guidelines.

Cognitive & Mood Challenges: Depression, memory problems, disordered thinking, paranoia, and trauma.

Behavioral Care: Abusive behavior, anger, manipulative tendencies, rejecting care, and wandering.

Adjustment & Coping: Family conflict, grief over lost status, room changes, and unhappy with roommate.

Daily Care Interventions: Refusing to eat, sleep pattern disturbances, social isolation, and withdrawal from care.

The Flash Drive contains all of the forms and care plans from the book, and these can easily be made resident and facility specific using a word processor.

39 Psychosocial Care Plans

Abusive

Anger

Antidepressant

Anxiety

Conflict with Family

Decision-making

Depression

Disordered Thinking

Family Coping

Fear

Grief Over Lost Status

Hypnotic

Lithium

Manipulative Behaviors

MAO Inhibitor

Memory Problem

Non-compliance

Paranoia

Prefers Own Routine

Psychotropic Drug Use

Refuses to Eat

Rejects Care

Restraint

Room Change

Sensory Deprivation

Sensory Perception

Sleep Pattern Disturbance

Smoking

Social Isolation

Socially Inappropriate

Strengths

Terminal Prognosis

Trauma

Tricyclic

Unhappy with Roommate

Wandering

Withdrawal from Care 

When the Psychosocial Outcome Severity Guide became effective in 2006, it became apparent that CMS expected Social Services to be much more involved in the care planning process. The Social Service care plans in this manual cover the possible psychosocial needs residents may have in response to issues, illnesses, medications, and/or other factors.

Text, care plans, and forms specific to certain medications in the Psychotropic Medication section reflect changes to the State Operations Manual, Appendix P, Medication Pass and Pharmacy Services.