CARING NURSES, INC.
SOC HHRG
Patient: PAGE, TROY- MR# 900009142
Chart: 1 Episode: 1
Patient Care Assistant: patient lives alone.
Visit Date: 04/10/2024
Problems:
Falls, Recent BKA, Compartment Syndrome, AKI, DVT, DM w/ DKA

Tests
CLOX:
pass

04/10/2024
OASIS-D
Joan Leyderos
Assessor
(M0030) Start of Care Date:
04/10/2024

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

(M1033) Therapies the patient receives at home: (Mark all that apply.).
1 - History of falls (2 or more falls - or any fall with an injury - in the past 12 months)
3 - Multiple hospitalizations (2 or more) in the past 6 months
4 - Multiple emergency department visits (2 or more) in the past 6 months
6 - Reported or observed history of difficulty complying with any medical instructions (for example, medications, diet, exercise) in the past 3 months
7 - Currently taking 5 or more medications

(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?
2 - With moderate exertion (e.g., while dressing, using commode or bedpan, walking distances less than 20 feet)

(M1610) Urinary Incontinence or Urinary Catheter Presence:
0 - No incontinence or catheter (includes anuria or ostomy for urinary drainage) [ Go to M1620 ]

(M1620) Bowel Incontinence Frequency:
0 - Very rarely or never has bowel incontinence

(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?
0 - Patient does not have an ostomy for bowel elimination.
(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).
1 - Grooming utensils must be placed within reach before able to complete grooming activities.

(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:
2 - Someone must help the patient put on upper body clothing.

(M1820) Current Ability to Dress Lower Body safely (with or without dressing aids) including undergarments, slacks, socks or nylons, shoes:
2 - Someone must help the patient put on undergarments, slacks, socks or nylons, and shoes.

(M1830) Bathing: Current ability to wash entire body safely. Excludes grooming (washing face, washing hands, and shampooing hair).
3 - Able to participate in bathing self in shower or tub, but requires presence of another person throughout the bath for assistance or supervision.

(M1840) Toilet Transferring: Current ability to get to and from the toilet or bedside commode safely and transfer on and off toilet/commode.
2 - Unable to get to and from the toilet but is able to use a bedside commode (with or without assistance).

(M1850) Transferring: Current ability to move safely from bed to chair, or ability to turn and position self in bed if patient is bedfast.
2 - Able to bear weight and pivot during the transfer process but unable to transfer self.

(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.
4 - Chairfast, unable to ambulate but is able to wheel self independently.

(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.
1 - Able to take injectable medication(s) at the correct times if:
(a) individual syringes are prepared in advance by another person; OR
(b) another person develops a drug diary or chart.

Home Health Certification and Plan of Care
04/10/2024
Skilled Nursing Joan Leyderos
Added by: Ron 04/10/24 02:53 PM
2Week2
04/10/24 - 04/19/24
4
Physical Therapy
1/WK X 4WKS - eval and to improve coordination, sitting and standing balance. 		Daniel Garcia
Added by: Daniel 04/14/24 04:08 PM
Conrad Chi
Added by: 05/07/24 06:00 AM
Joshua Jung
Added by: Vj 04/10/24 05:06 PM
Eval
04/10/24 - 06/08/24
1
1Week4
04/10/24 - 05/03/24
4
Occupational Therapy
1/WK X 2WKS - to improve the level of independence in the ADL 		Chad Duke
Added by: Vj 04/10/24 05:07 PM
Eval
04/10/24 - 06/08/24
1
1Week2
04/10/24 - 04/19/24
2
Primary Care Physician DR. SCOTT LAMPRECHT
PECOS Enrolled
Physician Scheduled Visit 04/09/2024: DR. SAREL ISKENDER
Reported to: Ron 04/10/2024 02:53 PM
Printed By/Date/Time: 07/06/2025 05:12 PM