Quality Of Life

ORDERS - RECEIVED ON ADMISSION

002

F635

ADMISSION ORDERS - IMMEDIATE CARE

003

F635

ORDERS - SIGNED BY PHYSICIAN

004

F635

ADMISSION ORDERS - TRANSFER ORDERS

005

F636

483.20

RESIDENT ASSESSMENT

006

F636

483.20(b)(1)

COMPREHENSIVE ASSESSMENT

007

F636

483.20(b)(1)(i)

IDENTIFICATION AND DEMOGRAPHIC INFORMATION

008

F636

483.20(b)(1)(i)

IDENTIFICATION - LOCATION

009

F636

483.20(b)(1)(i)

COMPREHENSIVE RESIDENT ASSESSMENT

010

F636

483.20(b)(1)(ii)

CUSTOMARY ROUTINE

011

F636

483.20(b)(1)(iii)

COGNITIVE PATTERNS

012

F636

483.20(b)(1)(iii)

SAFETY AWARENESS

013

F636

483.20(b)(1)(iv)

COMMUNICATION

014

F636

483.20(b)(1)(v)

VISION

015

F636

483.20(b)(1)(vi)

MOOD AND BEHAVIOR PATTERNS

016

F636

483.20(b)(1)(vii)

PSYCHOLOGICAL WELL-BEING

017

F636

483.20(b)(1)(viii)

PHYSICAL FUNCTIONING - ADLs

018

F636

483.20(b)(1)(viii)

STRUCTURAL PROBLEMS

019

F636

483.20(b)(1)(ix)

CONTINENCE - BOWEL - BLADDER

020

F636

483.20(b)(1)(ix)

CONTINENCE - APPLIANCES

021

F636

483.20(b)(1)(x)

DISEASE DIAGNOSES & HEALTH CONDITIONS

022

F636

DENTAL CONDITION

023

F636

DENTAL CONDITION STATUS

024

F636

NUTRITIONAL STATUS - INTAKE

025

F636

NUTRITION - WEIGHT - HEIGHT

026

F636

NUTRITIONAL STATUS

027

F636

483.20(b)(1)(xii)

SKIN CONDITION - PRESSURE SORE RISK

028

F636

483.20(b)(1)(xiii)

ACTIVITY PURSUIT - ABILITY - DESIRE

029

F636

483.20(b)(1)(xiv)

MEDICATIONS - OTC

030

F636

483.20(b)(1)(xiv)

MEDICATIONS - PRESCRIPTION

031

F636

483.20(b)(1)(xv)

SPECIAL TREATMENTS AND PROCEDURES

032

F636

483.20(b)(1)(xv)

SPECIAL TREATMENTS

033

F636

483.20(b)(1)(xvi)

3 MONTH DISCHARGE POTENTIAL

034

F636

483.20(b)(1)(xvii)

MDS - TRIGGERED CARE AREAS

035

F636

DIRECT OBSERVATION - COMMUNICATION

036

F636

DOCUMENTATION PARTICIPATION

037

F636

COMMUNICATION

038

F636

DIRECT OBSERVATION

039

F636

COMMUNICATION

040

F636

OBSERVATION

041

F636

RESIDENT INTERVIEW

042

F636

LICENSED STAFF INTERVIEW

043

F636

COMMUNICATION - STAFF

044

F636

483.20(b)(2)(i)

14 DAY ASSESSMENT

045

F636

483.20(b)(2)(iii)

ANNUAL ASSESSMENT

046

F637

483.20(b)(2)(ii)

SIGNIFICANT CHANGE

047

F638

483.20(c)

QUARTERLY ASSESSMENT

048

F639

MDS - 15 MONTHS

049

F639

ASSESSMENT RETENTION

050

F639

MDS - USE OF RESULTS FOR COMPREHENSIVE CARE PLAN

051

F639

SIGNATURE PAGE

052

F640

483.20(f)(1)(i)

ENCODING DATA - ADMIT 7 DAY

053

F640

483.20(f)(1)(ii)

ENCODING DATA - ANNUAL 7 DAY

054

F640

483.20(f)(1)(iii)

ENCODING DATA - CHANGE 7 DAY

055

F640

483.20(f)(1)(iv)

ENCODING DATA - 1/4LY 7 DAY

056

F640

483.20(f)(1)(v)

ENCODING DATA - D/C 7 DAY

057

F640

483.20(f)(1)(vi)

ENCODING DATA - ENTRY 7 DAY

058

F640

483.20(f)(2)

TRANSMITTING DATA - 7 DAYS

059

F640

483.20(f)(2)

TRANSMITTING DATA - COMPLIANCE

060

F640

483.20(f)(3)(i)

MONTHLY TRANSMITTAL REQ'T - ADMISSION

061

F640

483.20(f)(3)(ii)

MONTHLY TRANSMITTAL REQ'T - ANNUAL

062

F640

483.20(f)(3)(iii)

MONTHLY TRANSMITTAL REQ'T - CHANGE

063

F640

483.20(f)(3)(iv)

MONTHLY TRANSMITTAL REQ'T - CORRECTION - FULL

064

F640

483.20(f)(3)(v)

MONTHLY TRANSMITTAL REQ'T - CORRECTION - QUARTERLY

065

F640

483.20(f)(3)(vii)

MONTHLY TRANSMITTAL REQ'T - CORRECTION

066

F640

483.20(f)(3)(vi)

MONTHLY TRANSMITTAL REQ'T - 1/4LY

067

F640

483.20(f)(4)

MONTHLY TRANSMISSION - APPROVED FORMAT

068

F641

ASSESSMENT BY PROFESSIONALS

069

F641

RESIDENT PROBLEMS

070

F641

RESIDENT STATUS

071

F641

RESIDENT STRENGTHS

072

F641

PROFESSIONALS

073

F642

483.20(h)

COORDINATION - RN

074

F642

483.20(i)(1)

CERTIFICATION - RN SIGNED

075

F642

483.20(i)(2)

CERTIFICATION - OTHERS SIGNED

076

F642

483.20(j)(1)(i)

FALSIFICATION

077

F642

483.20(j)(1)(ii)

MDS - FALSIFICATION - CAUSES ANOTHER

078

F642

483.20(j)(2)

CLINICAL DISAGREEMENT

079

F644

483.20(e)

COORDINATION - PASARR

080

F644

483.20(e)

COORDINATION - PASARR - COMPLETION ON DAY OF ADMISSION

081

F644

483.20(e)(1)

COORDINATION - PASARR - LEVEL II

082

F644

483.20(e)(2)

COORDINATION - PASARR LEVEL II REFERRAL

083

F645

483.20(k)(1)(i)(A)

PASARR - PREADMISSION SCREENING - MENTAL DISORDER

084

F645

483.20(k)(1)(i)(B)

PASARR - SPECIALIZED SERVICES - MENTAL DISORDER

085

F645

483.20(k)(1)(ii)(A)

PASRR - PREADMISSION SCREENING - INTELLECTUAL DISABILITY

086

F645

483.20(k)(1)(ii)(B)

PASARR - SPECIALIZED SERVICES - INTELLECTUAL DISABILITY

087

F645

483.20(k)(2)(i)

PREADMISSION SCREENING - NOT REQUIRED

088

F645

483.20(k)(2)(ii)(A)

PASARR - ADMITTED AFTER INPATIENT CARE

089

F645

483.20(k)(2)(ii)(B)

PASARR - SAME CARE AT HOSPITAL

090

F645

483.20(k)(2)(ii)(C)

PASARR - PHYSICIAN CERTIFICATION

091

F646

483.20(k)(4)

PASARR - NOTIFY STATE MENTAL HEALTH/INTELLECTUAL DISABILITY AUTHORITY

483.21 Comprehensive Resident Centered Care Plans

092

F655

483.21(a)(1)(i)

BASELINE CARE PLANS - 48 HOURS

093

F655

483.21(a)(1)(ii)(A)

BASELINE CARE PLANS - INITIAL GOALS

094

F655

483.21(a)(1)(ii)(B)

BASELINE CARE PLANS - PHYSICIAN'S ORDERS

095

F655

483.21(a)(1)(ii)(C)

BASELINE CARE PLANS - DIETARY ORDERS

096

F655

483.21(a)(1)(ii)(D)

BASELINE CARE PLANS - THERAPY SERVICES

097

F655

483.21(a)(1)(ii)(E)

BASELINE CARE PLANS - SOCIAL SERVICES

098

F655

483.21(a)(1)(ii)(F)

BASELINE CARE PLANS - PASARR

099

F655

483.21(a)(2)(i)

COMPREHENSIVE CARE PLAN IN PLACE OF BASELINE CARE PLAN

100

F655

483.21(a)(2)(ii)

COMPREHENSIVE CARE PLAN IN PLACE OF BASELINE CARE PLAN - MEET NEEDS

101

F655

483.21(a)(3)(i)

SUMMARY - BASELINE CARE PLAN - INITIAL GOALS

102

F655

483.21(a)(3)(ii)

SUMMARY - BASELINE CARE PLAN - MEDICATION AND DIETARY INSTRUCTION

103

F655

483.21(a)(3)(iii)

SUMMARY - BASELINE CARE PLAN - SERVICES AND TREATMENTS

104

F655

483.21(a)(3)(iv)

SUMMARY - BASELINE CARE PLAN - UPDATED INFORMATION

105

F656

CARE PLANS - MEDICAL NEEDS

106

F656

CARE PLANS - NURSING NEEDS

107

F656

CARE PLANS - MENTAL - PSYCHOSOCIAL NEEDS

108

F656

CARE PLANS - PROFESSIONALS

109

F656

483.21(c)(3)(i)

CARE PLANS - PHYSICAL WELL-BEING

110

F656

483.21(c)(3)(i)

CARE PLANS - PSYCHSOCIAL WELL-BEING

111

F656

483.21(c)(3)(i)

CARE PLANS - MENTAL WELL-BEING

112

F656

483.21(c)(3)(ii)

CARE PLANS - PROVIDED SERVICES

113

F656

483.21(c)(3)(iii)

CARE PLANS - PASARR RECOMMENDATIONS

114

F656

483.21(c)(3)(iv)(A)

CARE PLANS - GOALS - OUTCOMES

115

F656

483.21(C)(3)(iv)(B)

CARE PLANS - DISCHARGE PREFERENCE

116

F656

483.21(C)(3)(iv)(C)

CARE PLANS - DISCHARGE PLANS

117

F657

483.21(b)(2)(i)

COMPREHENSIVE CARE PLANS - 7 DAYS

118

F657

483.21(b)(2)(ii)

CARE PLAN - PREPARATION BY IDT

119

F657

483.21(b)(2)(ii)

CARE PLANS - RESIDENT AND REPRESENTATIVE NOT A PARTICIPANT

120

F657

483.21(b)(2)(iii)

CARE PLANS - IDT REVIEW AND UPDATE

121

F658

483.21(b)(3)

PROFESSIONAL STANDARDS

122

F658

PROFESSIONAL STANDARDS OF QUALITY - MD NOTIFICATION

123

F658

PROFESSIONAL STANDARD OF QUALITY - MD ORDERS - CARRIED OUT

124

F658

PROFESSIONAL STANDARDS OF QUALITY - PROMPT HOSPITALIZATION

125

F658

PROFESSIONAL STANDARDS OF QUALITY - CARE PLAN - NEEDS MET

126

F658

PROFESSIONAL STANDARDS OF QUALITY - MEDICATIONS AVAILABLE

127

F659

QUALIFIED PERSONS - CARE AND SERVICES

128

F659

QUALIFIED PERSONS - CARE & SERVICES PROVIDED BY OTHERS

129

F659

QUALIFIED PERSONS - EXPECTED OUTCOMES

130

F659

QUALIFIED PERSONS - LN - EXPECTED OUTCOMES - CARE PROVIDED

131

F659

483.21(b)(3)(iii)

QUALIFIED PERSONS - CULTURALLY COMPETENT AND TRAUMA INFORMED

132

F660

483.21(c)(1)

DISCHARGE PLANNING PROCESS - GOALS

133

F660

483.21(c)(1)

DISCHARGE PLANNING PROCESS - ACTIVE PARTNER

134

F660

483.21(c)(1)

DISCHARGE PLANNING PROCESS - READMISSIONS

135

F660

483.21(c)(1)(i)

DISCHARGE PLANNING PROCESS - DISCHARGE NEEDS

136

F660

483.21(c)(1)(ii)

DISCHARGE PLANNING PROCESS - RE-EVALUATION

137

F660

483.21(c)(1)(iii)

DISCHARGE PLANNING PROCESS - IDT

138

F660

483.21(c)(1)(iv)

DISCHARGE PLANNING PROCESS - CAREGIVER SUPPORT

139

F660

483.21(c)(1)(v)

DISCHARGE PLANNING PROCESS - RESIDENT INVOLVEMENT

140

F660

483.21(c)(1)(vi)

DISCHARGE PLANNING PROCESS - GOALS OF CARE

141

F660

483.21(c)(1)(vii)

DISCHARGE PLANNING PROCESS - RESIDENT INTEREST

142

F660

483.21(c)(1)(vii)(A)

DISCHARGE PLANNING PROCESS - REFERRALS

143

F660

483.21(c)(1)(vii)(B)

DISCHARGE PLANNING PROCESS - CARE PLAN

144

F660

483.21(c)(1)(vii)(C)

DISCHARGE PLANNING PROCESS - NOT FEASIBLE

145

F660

483.21(c)(1)(viii)

DISCHARGE PLANNING PROCESS - STANDARDIZED ASSESSMENT DATA

146

F660

483.21(c)(1)(ix)

DISCHARGE PLANNING PROCESS - EVALUATION OF DISCHARGE NEEDS

147

F661

483.21(c)(2)(i)

DISCHARGE SUMMARY - RECAP OF STAY

148

F661

483.21(c)(2)(ii)

DISCHARGE SUMMARY - CONSENT

149

F661

483.21(c)(2)(iii)

DISCHARGE - RECONCILIATION OF MEDICATIONS

150

F661

DISCHARGE - PARTICIPATION AND CONSENT

151

F661

DISCHARGE - FOLLOW-UP CARE

152

F661

DISCHARGE SUMMARY - POST DISCHARGE PLAN OF CARE

153

F661

DISCHARGE - FOLLOW-UP CARE

154

F661

DISCHARGE SUMMARY - PLAN OF CARE REQUIREMENTS

483.24 Quality of Life

155

F675

CARE AND SERVICES TO ATTAIN OR MAINTAIN

156

F675

HIGHEST PRACTICABLE MENTAL WELL-BEING

157

F675

HIGHEST PSYCHOSOCIAL WELL-BEING

158

F675

HIGHEST PRACTICABLE PHYSICAL WELL BEING

159

F676

483.24(a)

ADL DECLINE - UNAVOIDABLE

160

F676

483.24(b)(1)

ADLs - ABILITY - BATHING -GROOMING

161

F676

483.24(b)(1)

ADLs - BATHING - GROOMING - DRESSING

162

F676

483.24(b)(2)

ADLs - TRANSFER - AMBULATION

163

F676

483.24(b)(2)

ADLs - DIMINISHED ABILITIES

164

F676

483.24(b)(3)

ADLs - TOILET USE ABILITY

165

F676

483.24(b)(3)

ADLS - TOILETING - DIMINISHED ABILITIES

166

F676

483.24(b)(4)

ADLs - DIMINISHED EATING ABILITY

167

F676

483.24(b)(4)

ADLs - EATING ABILITY IDENTIFICATION

168

F676

483.24(b)(5)(i)

ADLs - DIMINISHED SPEECH

169

F676

483.24(b)(5)(iii)

ADLs - DIMINISHED FUNCTIONAL COMMUNICATION SYSTEM

170

F676

483.24(a)(1)

ADLs - MAINTAIN - IMPROVE FUNCTIONAL ADLs

171

F676

483.24(b)(5)(ii)

ADLs - DIMINISHED LANGUAGE

172

F677

ADLs - MAINTAIN - IMPROVE GROOMING

173

F677

ADLs - MAINTAIN - IMPROVE ORAL CARE

174

F677

ADLs - MAINTAIN, IMPROVE NUTRITIONAL

175

F677

ADLs - MAINTAIN - IMPROVE PERSONAL CARE

176

F678

483.24(a)(3)

CPR

177

F678

483.24(a)(3)

CPR CERTIFIED STAFF

178

F679

ACTIVITY CALENDARS

179

F679

ENCOURAGEMENT TO ATTEND ACTIVITIES

180

F679

MOTIVATION

181

F679

ACTIVITY SUPPLIES

182

F679

SUPERVISION DURING ACTIVITIES

183

F679

ACTIVITIES CARE PLAN UPDATE

184

F679