CARING NURSES, INC.
SOC HHRG
Patient: GRAFFEO, PATRICIA- MR# 900011036
Chart: 1 Episode: 1
Patient Care Assistant: HUSBAND
Visit Date: 04/13/2026
Problems:
DYSLIPIDEMIA, ACUTE ON CHRONIC LOW BACK PAIN, RECENT FALL TODAY, RIGHT SCIATICA, RIGHT GLUETAL PAIN, LUMBAR STENOSIS/LUMBAR DEGENERATIVE DISC DISEASE, HYPOTHYROIDISM, RENAL INSUFFICIENCY, GAIT DISTURBANCE, IMPAIRED ADLS, IMPAIRED BALANCE, FATIGUE, POOR APPETITE, UNDERWEIGHT, BILATERAL FORAMINAL STENOSIS AT LEVEL L3-L4, L4-L5, DIFFUSE POSTERIOR DISC OSTEOPHYTE COMPLEX L3-L4,L4-L5

Tests
CLOX:
fail

04/13/2026
OASIS-D
Joshua Clark
Assessor
(M0030) Start of Care Date:
04/13/2026

(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
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:
1 - Patient is incontinent

(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).
4 - Unable to use the shower or tub, but able to bathe self independently with or without the use of devices at the sink, in chair, or on commode.

(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.
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.
5 - Chairfast, unable to ambulate and is unable to wheel self.

(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
04/13/2026
Skilled Nursing Joshua Clark
Added by: Veltra 04/13/26 04:47 PM
2Week1
04/13/26 - 04/17/26
2
1Week8
04/18/26 - 06/11/26
8
Physical Therapy
CONSULT SAFETY, TRANSFER AND HEP 1 WK 1 		Maria Consolo
Added by: Cremson 04/14/26 12:25 PM
Home Health Aide
ADL SAFETY 		April King
Added by: Cremson 04/14/26 02:21 PM
1Week4
04/13/26 - 05/08/26
4
Primary Care Physician DR. GAUTHAM REDDY
PECOS Enrolled
Physician Scheduled Visit 04/13/2026: DR. MINH NGUYEN
Reported to: Veltra 04/13/2026 04:47 PM
Printed By/Date/Time: 06/06/2026 10:48 AM