| 93209-5 |
Functional Abilities and Goals |
|
|
|
| Indent85665-8 |
Self-Care - Discharge Performance |
|
|
|
| Indent Indent83232-9 |
Eating |
|
|
|
| Indent Indent83230-3 |
Oral hygiene |
|
|
|
| Indent Indent83228-7 |
Toileting hygiene |
|
|
|
| Indent Indent85652-6 |
Wash upper body |
|
|
|
| Indent88331-4 |
Mobility - Discharge Performance |
|
|
|
| Indent Indent83218-8 |
Roll left and right |
|
|
|
| Indent Indent83216-2 |
Sit to lying |
|
|
|
| Indent Indent83214-7 |
Lying to sitting on side of bed |
|
|
|
| Indent Indent83212-1 |
Sit to stand |
|
|
|
| Indent Indent83210-5 |
Chair/bed-to-chair transfer |
|
|
|
| Indent Indent83208-9 |
Toilet transfer |
|
|
|
| Indent Indent83206-3 |
Car transfer |
|
|
|
| Indent Indent83204-8 |
Walk 10 feet |
|
|
|
| Indent Indent83202-2 |
Walk 50 feet with two turns |
|
|
|
| Indent Indent83200-6 |
Walk 150 feet |
|
|
|
| Indent Indent83198-2 |
Walking 10 feet on uneven surfaces |
|
|
|
| Indent Indent83196-6 |
1 step (curb) |
|
|
|
| Indent Indent83194-1 |
4 steps |
|
|
|
| Indent Indent83192-5 |
12 steps |
|
|
|
| Indent Indent83190-9 |
Picking up object |
|
|
|
| Indent Indent83271-7 |
Does the resident use a wheelchair and/or scooter? |
|
|
|
| Indent Indent83188-3 |
Wheel 50 feet with two turns |
|
|
|
| Indent Indent83272-5 |
Indicate the type of wheelchair or scooter used |
|
|
|
| Indent Indent83235-2 |
Wheel 150 feet |
|
|
|
| Indent Indent83272-5 |
Indicate the type of wheelchair or scooter used |
|
|
|
