CARING NURSES, INC.
SOC HHRG
Patient: DINGLE, JOHN- MR# 900009319
Chart: 1 Episode: 1
Patient Care Assistant: wife is assisting with care.
Visit Date: 06/06/2024
Problems:
Right foot amputation, DM2 w/ insulin, Wound infection w/ oral Abx

Tests
CLOX:
pass

06/06/2024
OASIS-D
Mary Gurrola
Assessor
(M0030) Start of Care Date:
06/06/2024

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

(M1033) Therapies the patient receives at home: (Mark all that apply.).
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?
1 - When walking more than 20 feet, climbing stairs

(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:
1 - Able to dress upper body without assistance if clothing is laid out or handed to the patient.

(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.
2 - Requires use of a two-handed device (e.g., walker or crutches) to walk alone on a level surface and/or requires human supervision or assistance to negotiate stairs or steps or uneven 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.
2 - Able to take medication(s) at the correct times if given reminders by another person based on the frequency of the injection

Home Health Certification and Plan of Care
06/06/2024
Skilled Nursing Mary Gurrola
Added by: Ron 06/06/24 01:33 PM
2Week1
06/06/24 - 06/07/24
2
3Week2
06/08/24 - 06/21/24
6
2Week1
06/22/24 - 06/28/24
2
Primary Care Physician DR. SCOTT LAMPRECHT
PECOS Enrolled
Physician Scheduled Visit 06/05/2024: DR. BRIAN CHANG
Reported to: Ron 06/06/2024 01:33 PM
Printed By/Date/Time: 07/06/2025 05:12 PM