27th Case of the Week Due 8/9/19, by 1pm EST

**Use the 2019 GLs** HF Medicare SNF, Reviewed 7/30/19

CCR3. Brief Clinical Course: Admit 6/11/19 managed for sepsis 2/2 to UTI & Ecoli Bacteremia; IV ABX. Brought to ER after HHA noted him to be confused, disoriented and very lethargic with labored breathing; required intubation. Physical Findings: Head CT with marked cerebral atrophy, old infarct. Septic shock with severe lacticemia, likely from UTI. Target LOS NA days provided to facility based on NA. Treatment Goal Date: 07/31/2019. Expected DCP: TBD Expected; DC date: TBD. Number of Skill Days used prior to current review/100 days: 19. PMH: HTN; BPH; Systolic CHF (LVEF 25-30%); CVA w/ no residual, Kidney stones, Dysphagia, Dementia. PLOF/Living Situation: Lives w/ son, HHA daily for 5 hrs to assist w/ADLs. Pt was Modified I with wheeled walker. Home Setup: 2nd floor apartment w/elevator access. Behavioral Health: Dementia. Advanced Directive/Living Will: Not provided. Service requested for: SNF2. *Skilled Medical Needs: Medical and Medication Management. *Current Mental Status: AAOx3 Dementia Score: NA *Bed Mobility: MinA (No Update). *Ambulation: 30 feet ft ModA w/ 2-wheeled walker --> 20 ft ModA w/ 2-wheeled walker (Declined). *Transfers: MinA --> ModA (Declined). *Stairs: Not Provided. *Bathing UB: Not Provided; LB: Not Provided. *Dressing UB: CGA (No Update); *LB: MinA --> MaxA (Declined). *Toileting: MinA --> MaxA (Declined). *Toilet transfers: ModA (No Update). *Speech Tx: Swallowing strategies. Pt participating in at least 1.5 hours of therapy 5 days a week but is more weak at this time.



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