Patient:
ITKIS, YURI- MR# 900007106 Chart: 4 Episode: 1 Patient Care Assistant: wife is assisting with care. |
Visit Date:
09/11/2024
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Problems: |
Fall, Confusion, UTI |
Tests |
CLOX:
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09/11/2024
OASIS-D |
Karen Sevoian
Assessor |
(M0030) Start of Care Date:
07/31/2024
(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) 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:
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ROC Verbal Orders for Modification |
09/11/2024
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Skilled Nursing |
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Primary Care Physician |
DR. INNA ZDOROVYAK |
PECOS Enrolled | ||||
Physician Scheduled Visit |
07/08/2022: DR. FARZIN FARHANG 07/28/2024: DR. ELIZABETH BEUTLER |
Reported to: Ron 09/13/2024 08:14 AM |
Printed By/Date/Time:
09/19/2024 02:12 AM
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