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Patient:
NAVARRA, RICHARD- MR# 900002895 Chart: 2 Episode: 1 Patient Care Assistant: WIFE |
Visit Date:
07/11/2026
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| Problems: |
| Post op infection Left ankle |
| Tests |
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CLOX:
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07/11/2026
OASIS-D |
Debbie Dios
Assessor |
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(M0030) Start of Care Date:
05/23/2026
(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) 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:
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| ROC Verbal Orders for Modification |
07/11/2026
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Veltra Metts-Cannon Added by: Veltra 07/14/26 10:08 AM Debbie Dios Added by: Veltra 07/14/26 10:08 AM Doris Bowman Added by: Veltra 07/16/26 04:23 PM |
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| Primary Care Physician |
DR. NOUHAD DAMAJ |
PECOS Enrolled | ||||||
| Physician Scheduled Visit |
09/18/2018: DR. JENNIFER WALSH 05/05/2026: DR. DAVID ENG |
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| Reported to: Ron 07/13/2026 09:13 AM |
Printed By/Date/Time:
08/05/2026 11:23 AM
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