CARING NURSES, INC.
PDGM HHRG
Patient: CANAPA, SU - MR# 900011176
Chart: 1 Episode: 2
Patient Care Assistant: spouse
08/06/2026 - 10/04/2026
Home Health 60-Day Episode
Problems:
OBSTRUCTIVE DEFECATION, S/P ROBOTIC LYSIS OF ADHESIONS AND END COLOSTOMY CREATION, NEW COLOSTOMY, SEVER CHRONIC RECTAL PAIN RELATED TO DEFECATION, DM, HTN, SHINGLES INFECTION

08/06/2026 - 09/04/2026
30-Day Service Period
Jennifer Abordo
Assessor
(M0030) Start of Care Date:
06/07/2026

(M1030) Therapies the patient receives at home: (Mark all that apply.)

(M1033) Risk for Hospitalization: Which of the following signs or symptoms characterize this patient as at risk for hospitalization? (Mark all that apply.)

(M1200) Vision (with corrective lenses if the patient usually wears them):

(M1242) Frequency of Pain Interfering with patient's activity or movement:

(M1400) When is the patient dyspneic or noticeably Short of Breath?

(M1610) Urinary Incontinence or Urinary Catheter Presence:

(M1620) Bowel Incontinence Frequency:

(M1630) Ostomy for Bowel Elimination: Does this patient have an ostomy for bowel elimination that (within the last 14 days): a) was related to an inpatient facility stay, or b) necessitated a change in medical or treatment regimen?
(M1800) Grooming: Current ability to tend safely to personal hygiene needs (specifically: washing face and hands, hair care, shaving or make up, teeth or denture care, or fingernail care).

(M1810) Current Ability to Dress Upper Body safely (with or without dressing aids) including undergarments, pullovers, front-opening shirts and blouses, managing zippers, buttons, and snaps:

(M1820) Current Ability to Dress Lower Body safely (with or without dressing aids) including undergarments, slacks, socks or nylons, shoes:

(M1830) Bathing: Current ability to wash entire body safely. Excludes grooming (washing face, washing hands, and shampooing hair).

(M1840) Toilet Transferring: Current ability to get to and from the toilet or bedside commode safely and transfer on and off toilet/commode.

(M1850) Transferring: Current ability to move safely from bed to chair, or ability to turn and position self in bed if patient is bedfast.

(M1860) Ambulation/Locomotion: Current ability to walk safely, once in a standing position, or use a wheelchair, once in a seated position, on a variety of surfaces.

(M2030) Management of Injectable Medications: Patient's current ability to prepare and take all prescribed injectable medications reliably and safely, including administration of correct dosage at the appropriate times/intervals. Excludes IV medications.

Home Health Certification and Plan of Care
08/06/2026
Skilled Nursing Jennifer Abordo
Case Manager
Added by: Ronald 08/05/26 11:04 AM
1Week1
08/06/26 - 08/07/26
1
2Week2
08/08/26 - 08/21/26
4
1Week7
08/22/26 - 10/04/26
7
PRN
08/06/26 - 10/04/26
2
Primary Care Physician DR. KEVIN DUNSMOOR
Not PECOS Enrolled
Reported to: Ronald 08/05/2026
Printed By/Date/Time: 08/06/2026 12:37 PM