Home Health Timeline Reconstruction Tool
A structured template for rebuilding the patient’s home‑health timeline, identifying delays, and highlighting deviations from expected standards of care.
Home‑health cases often hinge on when symptoms changed, when the agency responded, and how quickly communication or escalation occurred. Because visits are intermittent, delays are common — and often preventable.
This tool helps attorneys reconstruct the patient’s clinical and communication timeline with clarity, identify delays, and expose deviations from home‑health standards.
Use this tool during case screening, breach analysis, expert review preparation, and deposition strategy.
BASELINE TIMELINE
✔ Establish Baseline
• Admission date and time
• Setting (private home, ALF, family home)
• Primary diagnosis
• Baseline vitals
• Baseline symptom profil
• Baseline functional status
• Baseline cognitive status
• Medication list
• Safety risks identified
• Caregiver capacity
✔ Identify Initial Red Flags
• High‑risk medications
• Fall risk
• Wound care needs
• Respiratory or cardiac instability
• Caregiver limitations
ADMISSION & INITIAL VISIT TIMELINE
✔ Document Key Events
• Admission assessment
• Medication reconciliation
• Safety evaluation
• Caregiver education
• Initial plan of care
• Physician orders confirmed
✔ Identify Delays
• Late admission visit
• Missing assessment components
• No medication reconciliation
• No documented caregiver education
ROUTINE VISIT TIMELINE
✔ Nursing Visits
• Visit dates and times
• Vitals documented
• Symptom assessments
• Medication administration
• Wound care
• Safety checks
• Caregiver education
✔ Therapy Visits (PT/OT/ST)
• Visit dates
• Functional assessments
• Safety recommendations
• Communication with nursing
✔ Identify Gaps
• Missed or shortened visits
• No vitals documented
• No reassessment after interventions
• Contradictory documentation
CHANGE IN CONDITION TIMELINE
✔ Reconstruct the Event
• Time symptoms worsened
• Who noticed the change
• When the agency was notified
• Time of nurse response
• Interventions performed
• Medication adjustments
• Caregiver instructions
• Physician notificatio
These delays are often the strongest breach indicators.
✔ Identify Delays
• Delayed recognition of deterioration
• Delayed nurse response
• Delayed provider notification
• No reassessment after interventions
FALLS, INJURIES & INCIDENT TIMELINE
✔ Required Documentation
• Time of fall or injury
• Who witnessed or discovered it
• Assessment performed
• Physician notification
• Caregiver instructions
• Follow‑up visits
• Safety interventions
✔ Identify Red Flags
• No documentation of fall
• No provider notification
• No follow‑up assessment
• No safety plan update
HOSPITALIZATION OR EMERGENCY TRANSFER TIMELINE
✔ Document Key Events
• Symptoms leading to transfer
• Time caregiver called the agency
• Time nurse responded
• Time 911 was called (if applicable)
• Hospital findings
• Communication with physician
• Post‑hospitalization plan
✔ Identify Delays
• Failure to escalate to 911
• Delayed provider notification
• No documentation of communication
COMMUNICATION TIMELINE
✔ Document All Communication
• Caregiver calls to agency
• Nurse responses
• Physician updates
• Therapy communication
• IDT communication
• Education provided
• Missed visit notification
✔ Identify Failures
• Delayed callbacks
• No documentation of communication
• Physician unaware of deterioration
• Caregiver unaware of instructions
TIMELINE RED FLAGS (BREACH INDICATORS)
• Missed or shortened visits
• Abnormal vitals not addressed
• Delayed provider notification
• No reassessment after interventions
• Medication errors
• Unsafe home environment not addressed
• No caregiver education
• Documentation gaps or contradictions
• Failure to escalate to 911
• Care plan not updated despite changes
These are the most common breach themes in home‑health litigation.