CARING NURSES, INC.
SOC HHRG
Patient: TILLAR, JOCELYN- MR# 900010343
Chart: 1 Episode: 1
Patient Care Assistant: family is assisting with care.
Visit Date: 06/28/2025
Problems:
S/P L3-5 extreme lateral interbody fusion, Lumbar stenosis, Chronic lower back pain

Tests
CLOX:
fail

06/28/2025
OASIS-D
Justin Foley
Assessor
(M0030) Start of Care Date:
06/28/2025

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

(M1033) Therapies the patient receives at home: (Mark all that apply.).
6 - Reported or observed history of difficulty complying with any medical instructions (for example, medications, diet, exercise) in the past 3 months
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).
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).
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.
3 - Unable to get to and from the toilet or bedside commode but is able to use a bedpan/urinal independently.

(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.
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
06/28/2025
Skilled Nursing Justin Foley
Added by: Ron 06/30/25 02:59 PM
1Week25
06/30/25 - 12/19/25
25
Physical Therapy Joseph Tanaquin
Added by: Daniel 07/01/25 10:40 AM
Maria Consolo
Added by: 06/30/25 03:08 PM
Occupational Therapy Arissa Lynam
Added by: 06/30/25 04:35 PM
Reported to: Ron 06/30/2025 02:59 PM
Printed By/Date/Time: 07/06/2025 04:47 PM