Abbreviations — Home Health Training

Home health runs on abbreviations, and a new clinician spends their first month quietly decoding them. This is the list.

Check your agency's approved abbreviation list before using any of these in a chart. Some organisations prohibit specific abbreviations for safety reasons, and an abbreviation that is fine in conversation may not be acceptable in documentation.

Home health and regulatory


ADR	Additional Documentation Request
CoPs	Conditions of Participation
DC / D/C	Discharge (also discontinue — context matters, and this is one worth writing out)
F2F / FTF	Face-to-Face encounter
HHA	Home Health Agency, or Home Health Aide — context matters
HHCCN	Home Health Change of Care Notice
HHRG	Home Health Resource Group
LUPA	Low Utilization Payment Adjustment
MAC	Medicare Administrative Contractor
NOA	Notice of Admission
NOMNC	Notice of Medicare Non-Coverage
OASIS	Outcome and Assessment Information Set
PDGM	Patient-Driven Groupings Model
POC	Plan of Care
RCD	Review Choice Demonstration
ROC	Resumption of Care
SOC	Start of Care
TIF	Transfer

Disciplines and roles


COTA	Certified Occupational Therapy Assistant
CNA	Certified Nursing Assistant
DON	Director of Nursing
LPN / LVN	Licensed Practical / Vocational Nurse
MSW	Medical Social Worker
NPP	Non-Physician Practitioner
OT	Occupational Therapist / Therapy
PCP	Primary Care Provider
PT	Physical Therapist / Therapy
PTA	Physical Therapist Assistant
RN	Registered Nurse
RNCM	RN Case Manager
SLP / ST	Speech-Language Pathologist / Speech Therapy
SN	Skilled Nursing

Visit and scheduling


HEP	Home Exercise Program
PRN	As needed
q	Every (q4h = every 4 hours)
qd / qod	Daily / every other day — spell these out; they are commonly on do-not-use lists
2w1, 3w2	Visits per week for a number of weeks (2 visits × 1 week)
WNL	Within normal limits

Assessment


A&O / AOx3, AOx4	Alert and oriented (to person, place, time, situation)
ADLs / IADLs	Activities of Daily Living / Instrumental ADLs
BP	Blood pressure
BS	Breath sounds, bowel sounds, or blood sugar — write this one out
CGA	Contact guard assist
HOH	Hard of hearing
LOC	Level of consciousness
MAE	Moves all extremities
Min A / Mod A / Max A	Minimum / moderate / maximum assist
NAD	No acute distress
PERRLA	Pupils equal, round, reactive to light and accommodation
ROM / AROM / PROM	Range of motion / active / passive
SOB	Shortness of breath
SpO2	Peripheral oxygen saturation
S/S or s/sx	Signs and symptoms
VS	Vital signs
WB / NWB / PWB / TDWB / WBAT / FWB	Weight bearing / non- / partial / touch-down / as tolerated / full

Conditions


AFib	Atrial fibrillation
CAD	Coronary artery disease
CHF / HF	Congestive heart failure / heart failure
CKD / ESRD	Chronic kidney disease / end-stage renal disease
COPD	Chronic obstructive pulmonary disease
CVA / TIA	Cerebrovascular accident / transient ischemic attack
DJD / OA / RA	Degenerative joint disease / osteoarthritis / rheumatoid arthritis
DM / DM2	Diabetes mellitus / type 2
DVT / PE	Deep vein thrombosis / pulmonary embolism
DKA	Diabetic ketoacidosis
GERD	Gastroesophageal reflux disease
HTN	Hypertension
MI	Myocardial infarction
PAD / PVD	Peripheral arterial / vascular disease
PNA	Pneumonia
THA / TKA	Total hip / knee arthroplasty
UTI	Urinary tract infection

Wounds and skin


DTI	Deep tissue injury
I&D	Incision and drainage
IAD	Incontinence-associated dermatitis
MASD	Moisture-associated skin damage
NPWT	Negative pressure wound therapy (wound VAC)
PI / PU	Pressure injury / pressure ulcer
S/D/D	Staging, depth, drainage

Treatments and devices


ABT / ABX	Antibiotic
AC / PC	Before meals / after meals
BID / TID / QID	Twice / three times / four times daily
CBG / FSBG	Capillary / fingerstick blood glucose
DME	Durable medical equipment
Foley	Indwelling urinary catheter
INT	Intermittent needle therapy (saline lock)
IV / SQ / IM / PO	Intravenous / subcutaneous / intramuscular / by mouth
MDI / DPI	Metered dose inhaler / dry powder inhaler
NPO	Nothing by mouth
O2	Oxygen
PEG	Percutaneous endoscopic gastrostomy
PICC	Peripherally inserted central catheter
RW / FWW	Rolling walker / front-wheeled walker
TPN	Total parenteral nutrition
W/C	Wheelchair

Labs


BMP / CMP	Basic / comprehensive metabolic panel
BUN	Blood urea nitrogen
CBC w/ diff	Complete blood count with differential
ESR	Erythrocyte sedimentation rate (sed rate)
HgbA1c	Glycated hemoglobin
INR / PT / PTT	International normalised ratio / prothrombin time / partial thromboplastin time
LFT	Liver function tests

See Lab Tube Cheat Sheet for which tube each of these needs.

Charting shorthand


c̄ / s̄	With / without
d/t	Due to
Hx / Dx / Tx / Rx	History / diagnosis / treatment / prescription
pt / cg / PCG	Patient / caregiver / primary caregiver
r/t	Related to
↑ ↓	Increased / decreased

Ones to write out rather than abbreviate

These appear on most do-not-use lists because they are misread in ways that hurt people:

U for units — write units
IU for international units — write international units
qd, qod — write daily, every other day
MS, MSO4, MgSO4 — write morphine sulfate or magnesium sulfate
Trailing zeros (1.0 mg) and missing leading zeros (.5 mg) — write 1 mg and 0.5 mg