Closing a Member Profile & Episodes of Care
Table of Contents
Overview
Closing a member’s profile is a required step for all PCHI organizations once a member’s engagement in the program ends. The closure process captures how the member exited the program, why they exited, and completes the Episode of Care associated with their time in the program. Episodes of Care allow PCHI orgs to maintain clean, audit-ready records that group all work performed from enrollment through discharge.
Member Closure Requirements
When a member is discharged, the user must close the profile by selecting one of three main closure statuses. These statuses define the overall outcome of the member’s time in the program and are required for compliance and reporting.
Selecting a PCHI Closure Reason
After a closure status is selected, a secondary list of closure reasons will show. One of these must be chosen to describe why the member is being discharged. These reasons are specific to reporting for PCHI.
How Episodes of Care Work
Once a member is closed, all encounters, Activities, Pathways, and supervisor reviews completed during that enrollment period are grouped into a single Episode of Care. Episodes of Care allow PCHI orgs to track the full arc of work done with the member from start to finish, including all Pathway activity tied to the CHW Visit that initiated the episode.
Reopenings and New Episodes
If a closed member needs services again, their profile can be reopened. A reopening always starts a new Episode of Care. The first required step in the new episode is a CHW Visit, which establishes updated risks, fires new Recommendations, and drives the new Pathway work for that episode.
How Closure Data Impacts Reporting
Member closure status and reason selections feed directly into the Quarterly Benchmark Report. Episodes of Care structure ensures that all completed work, supervisor reviews, and successfully closed Pathways are captured accurately in the report without additional manual effort.