Pa Dx include: Kidney failure, CRF, Diabetes, Edema, Anemia, and HTN. The reported effects includes: severe weakness, swelling and fluid retention in her extremities and in her abdomen. Pa receives ESRD - dialysis 3 days a week. Pa reports that she is no longer on the kidney transplant list due to risk factors associated with age. Pa has an hx of R great toe amputation in 5/5/2005 d/t osteomyelitis. Hx of L little toe amputation in October 2011 d/t osteomyelitis. Pa was admitted to Penn Presbyterian Medical Center on 11/19/2015.Pa was admitted on 11/15/2015 and discharged 11/16/2016.The purpose of the stay was to surgically flush out Pa's dialysis port and remove the blood clots. However no falls change …show more content…
Per SPMSQ, Pa scored intact cognitive functioning.
2. Skilled medical care/services – Currently receiving (Medicare – Medicaid – Hospice – Private Insurance):
PCP and Specialist monitor dx of CRF, diabetes, anemia, and HTN. Pa has dialysis 3 x weekly.
3. Skilled medical care/services – Required:
PCP and Specialist monitor dx of CRF, diabetes, anemia, and HTN. Pa has dialysis 3 x weekly.
4. Consumer’s Special Medical Considerations:
Due to dx of Kidney failure, CRF, diabetes, edama, anemia, and HTN. Pa requires assistance with ADL/IADL’s. Pa needs hands on help with bathing, dressing, grooming, ambulating and toileting. Pa requires assistance with bathing helping to get in/out of the shower as she is too weak and is unable to stand long enough to wash properly. Pa requires hands on assistance for safety with dressing and grooming due to weakness and …show more content…
5. Consumer’s Physical Environment:
Pa resides in a two story home. Pa‘s bedroom and bathroom are located on the second floor. Pa is unable to climb the stairs. Pa has a stair glide to provide assistance with navigating the home. Pa ambulates w/ use of cane and supervision of PAS.
6. Consumer’s Informal Support Structure:
Pa has limited informal supports. Pa’s resides with her partner. Pa’s partner and granddaughter provide socialization and emotional support. Pa's extended family visits for holidays & provides phone support.
SC reviewed: Provider Choice, 10 item ISP checklist including rights and responsibilities and right to appeal. SC reviewed Participant Information Packet including: Your rights as a Participant, Your responsibilities as Participant, Participant choice, Applying for HCBS programs, Role of the Service Coordinator, Participant Complaints, How can I find other resources in my Community?, Medicaid (MA) Fraud and Abuse, Who do I contact If…, Abuse, neglect and exploitation, Self -directed services, and Your Appeal and Fair Hearing Rights. Pa reviewed and signed the following forms: ISP signature page, Consent for a Level of Care (LCD) Assessment Form, Provider Choice Form, Voter Registration Opportunity Preference Form, Freedom of Choice and Authorization for Use and Disclosure of