CARING NURSES, INC.
SOC HHRG
Patient: LAUVAO JR, FILIFAIESEA- MR# 900009417
Chart: 1 Episode: 1
Patient Care Assistant:
Visit Date: 07/14/2024
Problems:
S/P INCISION AND DRAINAGE OF THE SCROTUM AND PERINEUM, WOUND VAC, IV ABT, CELLULITIS/SEPSIS, DM, HTN, POSSIBLE FOURNIER'S GANGRENE,, AKI, LEFT FOREARM PERIPHERAL LINE

Tests
CLOX:
pass

07/14/2024
OASIS-D
Joshua Clark
Assessor
(M0030) Start of Care Date:
07/14/2024

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

(M1033) Therapies the patient receives at home: (Mark all that apply.).
5 - Decline in mental, emotional, or behavioral status in the past 3 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
8 - Currently reports exhaustion

(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:
1 - Patient is incontinent

(M1620) Bowel Incontinence Frequency:
2 - One to three times weekly

(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).
2 - Someone must assist the patient to groom self.

(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).
4 - Unable to use the shower or tub, but able to bathe self independently with or without the use of devices at the sink, in chair, or on commode.

(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.
1 - Able to transfer with minimal human assistance or with use of an assistive device.

(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.
NA - No injectable medications prescribed.

Home Health Certification and Plan of Care
07/14/2024
Skilled Nursing Jeanne Javinar
Case Manager
Added by: Veltra 07/16/24 01:43 PM
Joan Leyderos
Added by: Veltra 07/16/24 01:52 PM
Joshua Clark
Added by: Veltra 07/15/24 05:31 AM
2Day1
07/14/24 - 07/14/24
2
2Week1
07/15/24 - 07/19/24
2
3Week7
07/20/24 - 09/06/24
21
PRN
07/14/24 - 09/11/24
2
3Week8
07/20/24 - 09/11/24
24
Primary Care Physician DR. SCOTT LAMPRECHT
PECOS Enrolled
Physician Scheduled Visit 07/13/2024: DR. JEFFERY OLSEN
Reported to: Veltra 07/15/2024 05:31 AM
Printed By/Date/Time: 07/06/2025 04:45 PM