CARING NURSES, INC.
SOC HHRG
Patient: AZZARELLO, FRANK- MR# 900010291
Chart: 1 Episode: 1
Patient Care Assistant: ROOM MATE
Visit Date: 05/31/2025
Problems:
MONOCLONAL GAMMOPATHY, CARDIAC ARREST, VENTRICULAR TACHYCARDIA,, LYTIC BONE LESIONS ON XRAY, MULTIPLE MYELOMA, LYTIC LESION NOTICE ON C2, C3, C5, ENHANCING LESION AT THE LEVEL OF L5,, BILATERAL FORAMINAL NARROWING AT L5 AND S1,, CHRONIC BACK PAIN, CAD S/P STENTS X4 IN 2013 AND 2015 IN NY, HEART FAILURE WITH LIKELY IMPROVED EJECTION FRACTION 45 50 %, LEFT ATRIUM DILATION,, HTN, LYMPHOMA, DM

Tests
CLOX:
pass

05/31/2025
OASIS-D
Aster Davis
Assessor
(M0030) Start of Care Date:
05/31/2025

(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)
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:
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).
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).
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.
3 - Able to walk only with the supervision or assistance of another person at all times.

(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
05/31/2025
Skilled Nursing Aster Davis
Added by: Veltra 06/02/25 05:12 PM
2Week1
05/31/25 - 06/06/25
2
1Week8
06/07/25 - 07/29/25
8
Physical Therapy
CONSULT SAFETY ,TRANSFER AND HEP 1 WK 1 		Arvin Loquinario
Added by: Ron 06/03/25 04:03 PM
Eval
05/31/25 - 07/29/25
1
Primary Care Physician DR. STANLEY KIDIAVAYI
PECOS Enrolled
Reported to: Veltra 06/02/2025 05:12 PM
Printed By/Date/Time: 07/06/2025 04:50 PM