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MED-PASS - Forms
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| HC1306H | | | Physical Therapy Discharge from Agency Version | | This new addition to the OASIS line was created for the specific needs of the physical therapist. An in-depth musculoskeletal assessment has been incorporated in this form to assist the physical therapist in documenting range of motion, posture, balance and other elements of a musculoskeletal assessment required at discharge. The form meets the new OASIS-C and the Medicare CoPs requirements for Discharge Summary.
Easy Order Option - Print and Fax Order Form | | | Features: | - Documents Discharge from Agency
- Incorporates an in-depth musculoskeletal assessment required by the physical therapist at discharge
- Page 8 documents the Discharge Summary on a two-part carbonless form (original for the physician and a copy to remain attached to the Discharge from Agency)
- Patient Tracking Sheet Update
- Outcome Measures Indicator (marked with symbol)
- Home Health Compare Quality Indicators (marked with symbol)
- Exclusive MED-PASS two-forms-in-one color-coding to document Discharge from Agency and Discharge Summary.
- Nurse version of this form – see HC1305H in Related Products below
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| Specifications: | | 8-5/8 x 11, 8 pages, handwritten, 100 per package | | | Related Products: | | |
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