CARING NURSES, INC.
SOC HHRG
Patient: ANTEE, ALEXIS- MR# 900010339
Chart: 1 Episode: 1
Patient Care Assistant: mother is assisting with care.
Visit Date: 07/02/2025
Problems:
Foley catheter, DM1, Tube Feeding, Cholecystitis, Gastroparesis, Severe Hypokalemia, Chronic Liver disease

Tests
CLOX:
fail

07/02/2025
OASIS-D
Joan Leyderos
Assessor
(M0030) Start of Care Date:
07/02/2025

(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)
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:
2 - One to three times weekly

(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.
3 - Unable to take injectable medication unless administered by another person.

Home Health Certification and Plan of Care
07/02/2025
Skilled Nursing Jeanne Javinar
Added by: Teena 07/07/25 11:51 AM
Joan Leyderos
Added by: Ron 07/02/25 02:13 PM
1Week1
07/02/25 - 07/04/25
1
2Week1
07/05/25 - 07/11/25
2
1Week8
07/12/25 - 08/30/25
8
PRN
07/02/25 - 08/30/25
2
Physical Therapy
1/WK X 2WKS - eval, safety transfer, and hep. 		Conrad Chi
Added by: Julia 07/02/25 05:04 PM
Eval
07/02/25 - 08/30/25
1
Primary Care Physician DR. ANGELICA VILLAHERMOSA
PECOS Enrolled
Physician Scheduled Visit 07/09/2025: DR. EDWARD MAKAREWICZ
Reported to: Ron 07/02/2025 02:13 PM
Printed By/Date/Time: 02/07/2026 03:51 AM