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MED-PASS - Forms
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| HC1307H | | | Comprehensive Adult Physical Therapy Assessment, 485 P.O. C. Worksheet, and OASIS Outcome and Assessment Information Set – START OF CARE VERSION & Resumption of Care | | A CMS clarification released December 17, 2009, indicates that the fall risk assessment used in this form does not fully meet the requirement for a standardized and validated tool.
MED-PASS is providing a supplement and instructions to help ensure that your agency meets the requirements of a multi-factorial standardized validated falls risk assessment. To learn more and access the supplement – click here.
This OASIS-C 1/2010 version 14-page booklet form fully integrates and color-codes Comprehensive Adult Physical Therapy Assessment, all required OASIS elements and 485 P.O.C. elements with locator numbers into one form.
Easy Order Option - Print and Fax Order Form | | | Features: | - Color-coding allows for four forms in one
- BLACK/GRAY items on the form are part of the Comprehensive Adult Physical Therapy Assessment
- GREEN items represent mandated OASIS items
- RED items complete the 485 (Plan of Care)
- Items SHADED in GREEN are tied to reimbursement (PPS)
- Additional features include:
- PT indicator symbol next to related items
- Nutritional Risk factors
- Generous narrative area
- Expanded musculoskeletal/PT assessment section
- Fall Risk Assessment
- Non-routine Supply Indicators (marked with symbol)
- Outcome Measure Indicators (marked with symbol)
- Home Health Compare Quality Indicators (marked with symbol)
- Patient Tracking Sheet and Discharge Summary
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| Specifications: | | 8-5/8 x 11, 14 pages, handwritten, 100 per package | | | Related Products: | | |
| Click for information about our custom forms service | |
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