CARING NURSES, INC.
SOC HHRG
Patient: METZBOWER, BARBARA- MR# 900010826
Chart: 1 Episode: 1
Patient Care Assistant: RENT A ROOM
Visit Date: 01/20/2026
Problems:
FALL WITH INJURY, OTH FRACTURE OF UPPER AND LOWER END OF LEFT FIBULA, CONTUSION OF UNSPECIFIED PART OF HEAD,, HYPOTHYROIDISM, CIRRHOSIS, NASH, MIGRAINES, DEPRESSION, ACUTE HYPOXIC RESPIRATORY FAILURE,, HX PNEUMONIA,, ACUTE TRAUMATIC COMMINUTED FRACTURE OF THE DISTAL FIBULA WITH EXTENSION INTO THE TALOFIBULAR AND TIBIOTALAR JOINTS, LIVER CIRRHOSIS, OXYGEN 2 L CONT.

Tests
CLOX:
pass

01/20/2026
OASIS-D
Maricel Echague
Assessor
(M0030) Start of Care Date:
01/20/2026

(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)
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?
3 - With minimal exertion (e.g., while eating, talking, or performing other ADLs) or with agitation

(M1610) Urinary Incontinence or Urinary Catheter Presence:
1 - Patient is incontinent

(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:
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).
5 - Unable to use the shower or tub, but able to participate in bathing self in bed, at the sink, in bedside chair, or on commode, with the assistance or supervision of another person throughout the bath.

(M1840) Toilet Transferring: Current ability to get to and from the toilet or bedside commode safely and transfer on and off toilet/commode.
1 - When reminded, assisted, or supervised by another person, able to get to and from the toilet and transfer.

(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.
2 - Able to take medication(s) at the correct times if given reminders by another person based on the frequency of the injection

Home Health Certification and Plan of Care
01/20/2026
Skilled Nursing Veltra Metts-Cannon
Added by: Veltra 01/21/26 02:18 PM
Maricel Echague
Added by: Veltra 01/20/26 12:04 PM
2Week1
01/20/26 - 01/23/26
2
1Week8
01/24/26 - 03/20/26
8
Physical Therapy
CONSULT SAFETY, TRANSFER AND HEP 2 WK 2 		Annie Copeland
Added by: Veltra 01/20/26 01:44 PM
Maria Consolo
Added by: Veltra 01/20/26 04:53 PM
Primary Care Physician DR. EVANGELINE DE GUZMAN-DELALUZ
PECOS Enrolled
Physician Scheduled Visit 01/16/2026: DR. TRENT RICHARDSON
Reported to: Veltra 01/20/2026 12:04 PM
Printed By/Date/Time: 02/07/2026 03:47 AM