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[PDF File]Adult Care Home FL2 Form
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injurious to others speech non-verbally other injurious to property contractures does not communicate 02 prn cont other: activities/social skin nutrition status personal care assistance . passive normal diet bathing active other: supplemental ... speech therapy range of motion exercises restraints . 18. medications/name & strength, dosage ...
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[PDF File]Sport concussion assessment tool - 5th edition
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Eye opening to speech 3 3 3 Eyes opening spontaneously 4 4 4 Best verbal response (V) No verbal response 1 1 1 Incomprehensible sounds 2 2 2 Inappropriate words 3 3 3 ... Does the athlete report that their neck is pain free at rest? Y N If there is NO neck pain at rest, does the athlete have a full range of ACTIVE pain free movement? Y N
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[PDF File]Mini-Mental State Examination
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Mini-Mental State Examination (MMSE) Patient’s Name: Date: Instructions: Ask the questions in the order listed. Score one point for each correct response within each question or activity. Maximum Score Patient’s Score Questions 5 “What is the year? Season? Date? Day of the week? Month?” 5 “Where are we now: State? County?
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[PDF File]RESIDENT CENSUS AND CONDITIONS OF RESIDENTS
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nutrition or hydration). Facilities may provide “setup” activities, such as opening containers, buttering bread, and organizing the tray; if this is the case and is the only assistance a resident needs, count this resident as independent. G0110H1 = 0 for F91 OR G0110H1 = 1, 2, or 3 for F92 OR G0110H1 = 4 for F93.
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[PDF File]PDPM Calculation Worksheet for SNFs
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In the PDPM, there are five case-mix adjusted components: Physical Therapy (PT), Occupational Therapy (OT), Speech-Language Pathology (SLP), Non-Therapy Ancillary (NTA), and Nursing. Each resident is to be classified into one and only one group for each of the five case-mix adjusted components. In other words, each resident is classified into a PT
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[PDF File]MISSOURI DEPARTMENT OF HEALTH AND SENIOR SERVICES …
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LEVEL ONE NURSING FACILITY PRE-ADMISSION SCREENING FOR MENTAL ILLNESS/MENTAL RETARDATION OR RELATED CONDITION Completion of this form is mandatory for all persons applying for admission to a Medicaid certified bed to determine appropriateness of the nursing facility placement. SECTION A. IDENTIFYING INFORMATION
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[DOC File]Aid Codes Master Chart (aid codes) - Medi-Cal
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The Aid Codes Master Chart was developed for use in conjunction with the Medi-Cal Automated Eligibility Verification System (AEVS). Providers must submit …
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[PDF File]From Business Profit or Loss
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your loss from passive activities. • Form 8594 to report certain purchases or sales of groups of assets that constitute a trade or business. • Form 8824 to report like-kind exchanges. • Form 8829 to claim actual expenses for business use of your home. • Form 8990 to determine whether your business interest deduction is limited.
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[DOC File]LEAVE REQUEST FORM/AUTHORIZATION - United States Navy
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navcompt form 3065 (3pt) (rev. 2-83) 1. date of request. 2. for . admin. use only. approval of this leave is . not valid . without control no,
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[PDF File]INSTRUCTIONS FOR COMPLETING MA-51 MEDICAL …
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INSTRUCTIONS FOR COMPLETING MA-51 MEDICAL EVALUATION NOTE: THE MA-51 IS VALID AS LONG AS IT REFLECTS THE CURRENT CONDITIONS FOR THE APPLICANT At the top of the page, mark if this is a new or updated MA-51.
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Free printable speech therapy activities