CARING NURSES, INC.
Recert HHRG
Patient: CHISM-SWEET, JACKIE- MR# 900001950
Chart: 6 Episode: 3
Patient Care Assistant: Lives home alone
Visit Date: 09/01/2024
Problems:
PRESSURE ULCER OF SACRAL REGION ,STAGE 3, CALCULUS OF URETER, ENCOUNTER FOR FITTING AND ADJUSTING OF URINARY DEVICE, ACUTE EMBOLISM AND THROMBOSIS OF LEFT FEMORAL VEIN, ACITE EMBOLISM AND THROMBOSIS OF DEEP VEINS OF LEFT UPPER EXTREMITIES, MULTIPLE SCLEROSIS, PARAPLEGIA, ENLARGED LYMPNODES, HTN, DMII, HX OF UTI, L.T. USE OF ANTICOAGULANTS, L.T. USE OF IMMUNOMODULATOR AND IMMUNOSUPPRESSANT

Tests
CLOX:

09/01/2024
OASIS-D
Jeanne Javinar
Assessor
(M0030) Start of Care Date:
05/09/2024

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

(M1033) Therapies the patient receives at home: (Mark all that apply.).
2 - Unintentional weight loss of a total of 10 pounds or more 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
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:
2 - Patient requires a urinary catheter (i.e., external, indwelling, intermittent, suprapubic) [ Go to M1620 ]

(M1620) Bowel Incontinence Frequency:
4 - On a daily basis

(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).
3 - Patient depends entirely upon someone else for grooming needs.

(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:
3 - Patient depends entirely upon another person to dress the upper body.

(M1820) Current Ability to Dress Lower Body safely (with or without dressing aids) including undergarments, slacks, socks or nylons, shoes:
3 - Patient depends entirely upon another person to dress lower body.

(M1830) Bathing: Current ability to wash entire body safely. Excludes grooming (washing face, washing hands, and shampooing hair).
6 - Unable to participate effectively in bathing and is bathed totally by another person.

(M1840) Toilet Transferring: Current ability to get to and from the toilet or bedside commode safely and transfer on and off toilet/commode.
4 - Is totally dependent in toileting.

(M1850) Transferring: Current ability to move safely from bed to chair, or ability to turn and position self in bed if patient is bedfast.
4 - Bedfast, unable to transfer but is able to turn and position self in bed.

(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.
6 - Bedfast, unable to ambulate or be up in a chair.

(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
09/06/2024
Skilled Nursing Jeanne Javinar
Case Manager
Added by: Marlo 09/03/24 02:18 PM
1Week9
09/07/24 - 11/04/24
9
PRN
09/06/24 - 11/04/24
2
Primary Care Physician DR. STANLEY KIDIAVAYI
PECOS Enrolled
Physician Scheduled Visit 09/12/2018: DR. DEBORAH MYERS
01/08/2019: DR. DEBORAH MYERS
01/15/2019: DR. DEBORAH MYERS
11/23/2018: DR. RACHEL SAENZ
08/27/2018: DR. RACHEL SAENZ
03/16/2023: DR. DAO HUYNH
08/24/2023: DR. GARY SKANKEY
08/31/2023: DR. JULIE MARIE TIMPLE
05/08/2024: DR. KATRINA LOPEZ
Reported to: Marlo 09/03/2024 02:18 PM
Printed By/Date/Time: 09/17/2024 05:53 PM