200562000212Medicare NoteAAAA128064255255255000000000000000002550001Arial140025101842150400000000020056200021200000000000000000000000000000002000000000000011011100000000000000000000000000000000200562000212000000000000000000000000000000020000000000000110111000000000000000000000000000000002005620002120000000000000000000000000000000000000000000002005620002120001000000000000000000000000000000000000000000000000801000000000000000020056200021200000000000000000000000000000002005620002357Yellow outline = REQUIREDAAAC2552552550000000000000000000000010Arial8000112655350000000002005620002357000000000000000000000000000000000000000000000200562000235700010000000000000000000000000000000000000000000000000010000000000000000200562000235700000000000000000000000000000002005620002469ABAA128128642552552550000000000000000000001Arial1400251017974574000000000200562000246900000000000000000000000000000000000000000000020056200024690001000000000000000000000000000000000000000000000000001000000000000000020056200024690000000000000000000000000000000000000000000200562000211MEDICARE NOTEABAB21220820000010100010002000001105251021000Arial800000179745740000000002005620002110000000000000000000000000000000000000000000002005620002110000010000000000000000001000000000000000000000000000001000000000000000020056200021100000000000000000000000000000002005620002111200562000216420056200021122005620002430200562000211320056200024292005620002114200562000243120056200021152005620002428200562000211620056200024682005620002117200562000259200562000211820056200021812005620002119200562000218220056200021110200562000243620056200021111200562000222220056200021112200562000212720056200021113200562000251200562000211142005620002201200562000211152005620002444200562000211162005620002446200562000211172005620002449200562000211182005620002502005620002111920056200021542005620002112020056200028520056200021121200562000220420056200021122200562000249200562000211232005620002226200562000211242005620002257200562000211252005620002139200562000211262005620002163200562000211272005620002342005620002112820056200022202005620002112920056200028420056200021130200562000210320056200021131200562000213520056200021132200562000226320056200021133200562000227120056200021134200562000270200562000211352005620002274200562000211362005620002252005620002113720056200022662005620002111200562000216420056200021122005620002430200562000211320056200024292005620002114200562000243120056200021152005620002428200562000211620056200024682005620002117200562000259200562000211820056200021812005620002119200562000218220056200021110200562000243620056200021111200562000222220056200021112200562000212720056200021113200562000251200562000211142005620002201200562000211152005620002444200562000211162005620002446200562000211172005620002449200562000211182005620002502005620002111920056200021542005620002112020056200028520056200021121200562000220420056200021122200562000249200562000211232005620002226200562000211242005620002257200562000211252005620002139200562000211262005620002163200562000211272005620002342005620002112820056200022202005620002112920056200028420056200021130200562000210320056200021131200562000213520056200021132200562000226320056200021133200562000227120056200021134200562000270200562000211352005620002274200562000211362005620002252005620002113720056200022662005620002383ACAA128128642552552550000000000000000000001Arial14002510179745740000000002005620002383000000000000000000000000000000000000000000000200562000238300010000000000000000000000000000000000000000000000000010000000000000000200562000238300000000000000000000000000000000000000000002005620002164RESIDENT IS SKILLED FOR:ACAB12806425525525510000000000000001105251021010Arial8000112655350002005620029173419992000200562000216400000000000000000000000000000000000000000000020056200021640000010000000000000000000000000000000000000000000000001000000000000000020056200021640000000000000000000000000000000200562000246(populates from assignmentACAC25525525500000000000000000001105251020000Arial80001017974574000000000200562000246000000000000000000000000000000000000000000000200562000246000100000000000000000000000000000000000000000000000000100000000000000002005620002460000000000000000000000000000000200562000290on Nursing To Do List)ACAD25525525500000000000000000001105251020000Arial800010179745740000000002005620002900000000000000000000000000000000000000000000002005620002900001000000000000000000000000000000000000000000000000001000000000000000020056200029000000000000000000000000000000002005620002427Vital SignsADAA128128642552552550000000000000000000001Arial14002510179745740000000002005620002427000000000000000000000000000000000000000000000200562000242700010000000000000000000000000000000000000000000000000010000000000000000200562000242700000000000000000000000000000000000000000002005620002430TEMPERATURE:ADAB12806425525525510000100000000001105251021010Arial8000112655350000000002005620002430000000000000000000000000000000020000000000000110111000000000000000000000000000000002005620002430000000000000000000000000000000020000000000000110111000000000000000000000000000000002005620002430000000000000000000000000000000000000000000000200562000243001-1VGVtcGVyYXR1cmU6001000100000000000001000000000000001000000010000080100000200562000038000000002005620002430000000000000000000000000000000020056200024301Temp > 10100001Change in Status: Please notify physician of temperature higher than 101.07011003251517020056200024302Fever (2 deg. > baseline)00201Change in Status: Please notify physician of temperature 2 degress over baseline (fever).038000003251517020056200024303Temp < 9500011Change in Status: Please notify physician of temperature lower than 95.080110032515170200562000243010120002200217-1200562000243010220002200703-1200562000243010320002200953-12005620002430104200582001522-12005620002430105200562000038-12005620002430106200562000123-120056200024301072005620002430-120056200024301082005620017196-120056200024301092005620018225-1200562000243010102005620021740-120056200024301011200562002676-1200562000243010122005620020920-12005620002430111320015200222902005620002430201200562000130-120056200024302122001520022310200562000243030120002200217-1200562000243030220002200703-1200562000243030320002200953-12005620002430304200582001522-12005620002430305200562000038-12005620002430306200562000123-120056200024303072005620002430-120056200024303082005620017196-120056200024303092005620018225-1200562000243030102005620021740-120056200024303011200562002676-120056200024303112200152002230020056200024301200562000258012005620002430220056200024291200562000243012005620002580120056200024302200562000242912005620002430701-1-11012005620002430801-1-1952005620002429PULSE:ADAC12806425525525510000100000000001105251021010Arial80001126553500000000020056200024290000000000000000000000000000000200000000000001101110000000000000000000000000000000020056200024290000000000000000000000000000000200000000000001101110000000000000000000000000000000020056200024290000000000000000000000000000000000000000000002005620002429014UHVsc2U6001000100000000000001000000000000001000000010000090100000200562000036000000002005620002429000000000000000000000000000000020056200024291High Pulse00901Pulse is 10 bpm above baseline.038000003251617020056200024292Low Pulse00911Pulse is 10 bpm below baseline.038000003251617020056200024293Pulse > 13000001Change in Status: Please notify physician of resting pulse higher than 130.07011003251517020056200024294Pulse < 5500011Change in Status: Please notify physician of resting pulse lower than 55.0801100325151702005620002429101200562000121-120056200024291122001520022902005620002429201200562000121-120056200024292122001520022100200562000242930120002200709-1200562000242930220002200959-1200562000242930320002200218-12005620002429304200582001512-12005620002429305200562000036-12005620002429306200562000112-120056200024293072005620002429-120056200024293082005620017194-120056200024293092005620018223-1200562000242930102005620021738-120056200024293011200562002674-1200562000242931122001520022210200562000242940120002200218-1200562000242940220002200709-1200562000242940320002200959-12005620002429404200582001512-12005620002429405200562000036-12005620002429406200562000112-120056200024294072005620002429-120056200024294082005620017194-120056200024294092005620018223-1200562000242940102005620020918-1200562000242940112005620021738-120056200024294012200562002674-1200562000242941132001520022220200562000242912005620002431120056200024291200562000243112005620002429101-1-11102005620002429201-1-11302005620002429301-1-1552005620002431RESPIRATORY RATE:ADAD12806425525525510000100000000001105251021010Arial8000112655350000000002005620002431000000000000000000000000000000020000000000000110111000000000000000000000000000000002005620002431000000000000000000000000000000020000000000000110111000000000000000000000000000000002005620002431000000000000000000000000000000000000000000000200562000243101-1UmVzcGlyYXRvcnkgUmF0ZTo=001000100000000000001000000000000001000000010000080100000200562000037000000002005620002431000000000000000000000000000000020056200024311Resp > 2800001Change in Status: Please notify physician of respirations higher than 28.07011003251517020056200024312Resp < 1000011Change in Status: Please notify physician of respirations lower than 10.080110032515170200562000243110120002200219-12005620002431102200022007016-12005620002431103200022009516-12005620002431104200582001530-12005620002431105200562000037-12005620002431106200562000122-120056200024311072005620002431-120056200024311082005620017195-120056200024311092005620018224-1200562000243110102005620020919-1200562000243110112005620021739-120056200024311012200562002675-1200562000243111132001520022240200562000243120120002200219-12005620002431202200022007016-12005620002431203200022009516-12005620002431204200582001530-12005620002431205200562000037-12005620002431206200562000122-120056200024312072005620002431-120056200024312082005620017195-120056200024312092005620018224-1200562000243120102005620020919-1200562000243120112005620021739-120056200024312012200562002675-1200562000243121132001520022250200562000243112005620002428120056200024311200562000242812005620002431701-1-1282005620002431801-1-1102005620002428BLOOD PRESSURE: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 > 21000001Change in Status: Please notify physician of SBP higher than 210.01011003251517020056200024282SBP below parameter00011SBP is below parameter.038000003251517020056200024283SBP < 9000011Change in Status: Please notify physician of SBP lower than 90.02011003251517020056200024284DBP > 11500001Change in Status: Please notify physician of DBP higher than 115.03011003251517020056200024285DBP below parameter00011DBP is below parameter.0380000032515170200562000242810120002200216-12005620002428102200022007018-12005620002428103200022009518-12005620002428104200562000111-120056200024281052005620002428-12005620002428106200562000035-120056200024281072005620017193-120056200024281082005620018222-120056200024281092005620020917-1200562000242810102005620021737-120056200024281011200562002673-12005620002428101220058200152-120056200024281113200152002226020056200024282012001620011113-120056200024282122001520022120200562000242830120002200216-12005620002428302200022007018-12005620002428303200022009518-12005620002428304200562000035-12005620002428305200562000111-120056200024283062005620002428-120056200024283072005620017193-120056200024283082005620018222-120056200024283092005620020917-1200562000242830102005620021737-120056200024283011200562002673-12005620002428301220058200152-1200562000242831132001520022270200562000242840120002200216-12005620002428402200022007018-12005620002428403200022009518-12005620002428404200562000035-12005620002428405200562000111-120056200024284062005620002428-120056200024284072005620017193-120056200024284082005620018222-120056200024284092005620020917-1200562000242840102005620021737-120056200024284011200562002673-12005620002428401220058200152-120056200024284113200152002228020056200024285012001620011114-120056200024285122001520022130200562000242812005620002468120056200024281200562000246812005620002428101-1-12102005620002428201-1-1902005620002428301-1-11152005620002468PULSE OXIMETRY:ADAF12806425525525510000100000000001105251021010Arial80001126553500000000020056200024680000000000000000000000000000000200000000000001101110000000000000000000000000000000020056200024680000000000000000000000000000000200000000000001101110000000000000000000000000000000020056200024680000000000000000000000000000000000000000000002005620002468014UHVsc2UgT3g6001000100000000000001000000000000001000000010000080100000200562000040000000002005620002468000000000000000000000000000000020056200024681Low Saturation00011O2 Saturation below 90, follow facility protocol.0101100325151702005620002468101200022002138-12005620002468102200022007026-12005620002468103200022009526-12005620002468104200562000040-1200562000246810520056200011010-120056200024681062005620002468-120056200024681072005620017198-120056200024681082005620018226-120056200024681092005620020921-1200562000246810102005620021741-120056200024681011200582001531-1200562000246811122001520022230200562000246812005620002581120056200024681200562000258112005620002468101-1-1902005620002468101153902005620002468101159902005620002580°ADBH02552550000010000000000000000000Arial800000179745740000000002005620002580000000000000000000000000000000000000000000000200562000258000000000000000000000000000000000000000000000000000000010000000000000000200562000258000000000000000000000000000000000000000000002005620002581%ADBI02552550000010000000000000000000Arial8000001797457400000000020056200025810000000000000000000000000000000000000000000002005620002581000000000000000000000000000000000000000000000000000000100000000000000002005620002581000000000000000000000000000000000000000000020056200029ADLsAFAA128128642552552550000000000000000000001Arial140001017974574000000000200562000290000000000000000000000000000000000000000000002005620002900010000000000000000000000000000000000000000000000000010000000000000000200562000290000000000000000000000000000000000000000000200562000259ADLS:AFAB12806425525525510000000000000001105251021010Arial80001126553500000000020056200025900000000000000000000000000000000000000000000020056200025900000100000000000000000000000000000000000000000000008010000000000000000200562000259000000000000000000000000000000020056200025930115-1020056200025930116-10200562000292requiresAFAC025525500000100100000000001105251020000Arial80000018421504000000000200562000292000000000000000000000000000000000000000000000200562000292000000000000000000000001000000000000000000000000000000100000000000000002005620002920000000000000000000000000000000000000000000200562000292120056200025932005620002921200562000259320056200029230115-1020056200029230116-1020056200022872 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REHAB:AIAB12806425525525510000000000000001105251021010Arial8000112655350000000002005620002181000000000000000000000000000000000000000000000200562000218100000100000000000000000000000000000000000000000000008010000000000000000200562000218100000000000000000000000000000002005620002582does not receiveAIAC025525500000100100000000001105251020000Arial8000001842150400000000020056200025820000000000000000000000000000000000000000000002005620002582000000000000000000000001000000000000000000000000000000100000000000000002005620002582000000000000000000000000000000020056200025821200562000218132005620002582120056200021813200562000258230115-10200562000258230116-10200562000281receivesAIAD025525500000100100000000001105251020000Arial8000001842150400000000020056200028100000000000000000000000000000000000000000000020056200028100000000000000000000000100000000000000000000000000000010000000000000000200562000281000000000000000000000000000000020056200028112005620002181320056200028112005620002181320056200028130115-1020056200028130116-10200562000214PT,AIAE025525500000100100000000001105251020000Arial800000179745740000000002005620002140000000000000000000000000000000000000000000002005620002140000000000000000000000010000000000000000000000000000001000000000000000020056200021400000000000000000000000000000002005620002141200562000218132005620002141200562000218132005620002311OT,AIAF025525500000100100000000001105251020000Arial80000017974574000000000200562000231100000000000000000000000000000000000000000000020056200023110000000000000000000000010000000000000000000000000000001000000000000000020056200023110000000000000000000000000000000200562000231112005620002181320056200023111200562000218132005620002236ST,AIAG025525500000100100000000001105251020000Arial8000001797457400000000020056200022361200122002816002005620002236220012200458800200562000223600000000000000000000000000000000000000000000020056200022360000000000000010000000010001000000000000000000000000001000000000000000020056200022360000000000000000000000000000000200562000223612005620002181320056200022361200562000218132005620002432(state 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NURSING:AJAB12806425525525510000000000000001105251021010Arial8000112655350000000002005620002182000000000000000000000000000000000000000000000200562000218200000100000000000000000000000000000000000000000000008010000000000000000200562000218200000000000000000000000000000002005620002583does not receiveAJAC025525500000100100000000001105251020010Arial8000111419443200000000020056200025831200122002816002005620002583220012200451600200562000258300000000000000000000000000000000000000000000020056200025830000000000000010000000010101000000001000000000000000001000000000010000020056200025830000000000000000000000000000000200562000258312005620002182320056200025831200562000218232005620002173active ROM,AJAD22122120000000000100000000001105251020010Arial800011141944320000000002005620002173120012200281600200562000217322001220045160020056200021730000000000000000000000000000000000000000000002005620002173014//5TAHQAYQB0AGUAIAB3AGgAeQAgAHQAaABpAHMAIABpAHMAIABuAGUAZQBkAGUAZAAgAGEAbgBk 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