CARING NURSES, INC.
SOC HHRG
Patient: PICKARD, ALECIA- MR# 900004280
Chart: 3 Episode: 1
Patient Care Assistant: father is assisting with care.
Visit Date: 09/09/2024
Problems:
Pressure ulcer stage 4 sacral, Left posterior thigh moisture damage wound, Paraplegic, Bedbound, HTN, Chronic pain, Colostomy, Neurostomy

Tests
CLOX:
pass

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

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

(M1620) Bowel Incontinence Frequency:
NA - Patient has ostomy for bowel elimination

(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?
2 - The ostomy was related to an inpatient stay or did necessitate 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).
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:
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).
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.
3 - Unable to transfer self and is unable to bear weight or pivot when transferred by another person.

(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.
NA - No injectable medications prescribed.

Home Health Certification and Plan of Care
09/09/2024
Skilled Nursing Jeanne Javinar
Added by: Ron 09/10/24 10:50 AM
1Week9
09/09/24 - 11/07/24
9
PRN
09/09/24 - 11/07/24
2
Primary Care Physician DR. GOPALAKRISHNA LEELA
PECOS Enrolled
Physician Scheduled Visit 04/23/2020: DR. KRISTINA JONES
04/30/2020: DR. KRISTINA JONES
05/14/2020: DR. KRISTINA JONES
05/20/2020: DR. BROCK WENTZ
05/28/2020: DR. KRISTINA JONES
06/04/2020: DR. KRISTINA JONES
06/11/2020: DR. KRISTINA JONES
06/18/2020: DR. KRISTINA JONES
06/25/2020: DR. KRISTINA JONES
07/02/2020: DR. KRISTINA JONES
07/09/2020: DR. KRISTINA JONES
07/15/2020: DR. KRISTINA JONES
07/23/2020: DR. KRISTINA JONES
07/30/2020: DR. KRISTINA JONES
08/06/2020: DR. KRISTINA JONES
08/13/2020: DR. KRISTINA JONES
08/20/2020: DR. KRISTINA JONES
08/27/2020: DR. KRISTINA JONES
09/03/2020: DR. KRISTINA JONES
09/10/2020: DR. KRISTINA JONES
09/17/2020: DR. KRISTINA JONES
09/24/2020: DR. KRISTINA JONES
10/01/2020: DR. KRISTINA JONES
10/08/2020: DR. KRISTINA JONES
10/15/2020: DR. KRISTINA JONES
10/22/2020: DR. KRISTINA JONES
10/29/2020: DR. KRISTINA JONES
11/12/2020: DR. KRISTINA JONES
12/03/2020: DR. KRISTINA JONES
12/10/2020: DR. KRISTINA JONES
12/17/2020: DR. KRISTINA JONES
12/24/2020: DR. KRISTINA JONES
12/31/2020: DR. KRISTINA JONES
02/18/2021: DR. KRISTINA JONES
02/25/2021: DR. KRISTINA JONES
03/04/2021: DR. KRISTINA JONES
03/11/2021: DR. KRISTINA JONES
03/18/2021: DR. KRISTINA JONES
03/25/2021: DR. KRISTINA JONES
04/01/2021: DR. KRISTINA JONES
04/08/2021: DR. KRISTINA JONES
04/22/2021: DR. KRISTINA JONES
04/29/2021: DR. KRISTINA JONES
05/06/2021: DR. KRISTINA JONES
05/13/2021: DR. KRISTINA JONES
05/20/2021: DR. KRISTINA JONES
05/27/2021: DR. KRISTINA JONES
06/10/2021: DR. KRISTINA JONES
06/24/2021: DR. KRISTINA JONES
07/01/2021: DR. KRISTINA JONES
07/15/2021: DR. KRISTINA JONES
07/22/2021: DR. KRISTINA JONES
07/29/2021: DR. KRISTINA JONES
08/12/2021: DR. KRISTINA JONES
08/19/2021: DR. KRISTINA JONES
08/26/2021: DR. KRISTINA JONES
09/02/2021: DR. KRISTINA JONES
09/09/2021: DR. KRISTINA JONES
10/21/2021: DR. KRISTINA JONES
10/28/2021: DR. KRISTINA JONES
11/04/2021: DR. KRISTINA JONES
11/11/2021: DR. KRISTINA JONES
10/19/2021: DR. GOPALAKRISHNA LEELA
11/18/2021: DR. KRISTINA JONES
12/02/2021: DR. KRISTINA JONES
12/09/2021: DR. KRISTINA JONES
12/16/2021: DR. KRISTINA JONES
12/23/2021: DR. KRISTINA JONES
12/30/2021: DR. KRISTINA JONES
01/06/2022: DR. KRISTINA JONES
01/13/2022: DR. KRISTINA JONES
01/20/2022: DR. KRISTINA JONES
01/27/2022: DR. KRISTINA JONES
02/03/2022: DR. KRISTINA JONES
02/10/2022: DR. KRISTINA JONES
02/17/2022: DR. KRISTINA JONES
02/24/2022: DR. KRISTINA JONES
03/03/2022: DR. KRISTINA JONES
03/10/2022: DR. KRISTINA JONES
09/04/2024: DR. GOPALAKRISHNA LEELA
Reported to: Ron 09/10/2024 10:50 AM
Printed By/Date/Time: 07/05/2025 04:41 PM