CARING NURSES, INC.
SOC HHRG
Patient: MOHN, KATHLEEN- MR# 900010749
Chart: 2 Episode: 1
Patient Care Assistant:
Visit Date: 03/31/2026
Problems:
ENCOUNTER FOR SURGICAL AFTERCARE FOLLOWING SURGERY ON THE DIGESTIVE SYSTEM,, MALIGNANT NEOPLASM OF ILL-DEFINED SITES WITHIN THE DIGESTIV, ENCOUNTER FOR ATTENTION TO COLOSTOMY,, ACUTE RESPIRATORY FAILURE WITH HYPOXIA, NEW COLOSTOMY

Tests
CLOX:
pass

03/31/2026
OASIS-D
Kira Irenze
Assessor
(M0030) Start of Care Date:
03/31/2026

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

(M1033) Therapies the patient receives at home: (Mark all that apply.).
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:
0 - No incontinence or catheter (includes anuria or ostomy for urinary drainage) [ Go to M1620 ]

(M1620) Bowel Incontinence Frequency:

(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?
2 - The ostomy was related to an inpatient stay or did necessitate change in medical or treatment regimen.
(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.
4 - Chairfast, unable to ambulate but is able to wheel self independently.

(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
03/31/2026
Skilled Nursing Mary Wagner
Added by: Veltra 04/01/26 04:57 PM
Veltra Metts-Cannon
Added by: Veltra 04/02/26 10:56 AM
Kira Irenze
Added by: Veltra 04/01/26 02:07 PM
1Week9
03/31/26 - 05/29/26
9
PRN
03/31/26 - 05/29/26
2
Physical Therapy
CONSULT SAFETY, TRANSFER AND HEP 1 WK 1 		Clydelle Higgs
Added by: Veltra 04/01/26 04:06 PM
Home Health Aide
ADL SAFETY 		Blanca Luz Mendizabal
Added by: Veltra 04/01/26 04:06 PM
1Week4
03/31/26 - 04/24/26
4
Social Work
TRANSPORTATION OTHER RESOURCE 		Karen Davis
Added by: Veltra 04/01/26 04:07 PM
Primary Care Physician DR. ERIC WOLFSON
PECOS Enrolled
Reported to: Veltra 04/01/2026 02:07 PM
Printed By/Date/Time: 04/06/2026 09:05 AM