This document contains forms and information for a new patient visit at 501 Pain and Rehab. It includes sections for the patient's contact information, insurance details, accident details, medical history, consent forms, and other paperwork related to their treatment. The patient provides personal details, describes their accident and symptoms, and signs forms giving consent for treatment and assigning certain rights to their medical billing to a third party for collection.
The document discusses various legal aspects of emergency room nursing including federal and state regulations, HIPAA privacy rules, requirements for obtaining consent from patients or their guardians, and implications of the Emergency Medical Treatment and Active Labor Act (EMTALA) which prohibits patient dumping and requires hospitals to provide screening and stabilization to anyone seeking emergency care. It also outlines elements that must be proven in medical malpractice and negligence cases against healthcare providers.
Federal laws such as EMTALA and HIPAA regulate emergency care and patient privacy. EMTALA requires hospitals to provide medical screening exams and stabilizing treatment to anyone regardless of ability to pay. It also sets rules for appropriate patient transfers. HIPAA protects personal health information and sets penalties for violations like improper access or disclosure of patient records. Consent is also important legally and varies for situations like treatment of minors, incapacitated adults, and refusals of care. Proper documentation in medical records is essential.
The document discusses various legal aspects relevant to emergency room nursing practice, including federal and state regulations, HIPAA privacy rules, requirements for medical record documentation and obtaining patient consent, EMTALA guidelines for screening and stabilizing patients, and elements of potential negligence or malpractice claims. It provides an overview of key compliance considerations and potential penalties for violations in these important legal areas.
This document discusses various legal and ethical issues in nursing. It begins by outlining objectives related to describing how healthcare trends impact legal/ethical issues and examining best practices. It then covers topics like medication administration, DNR orders, patient confidentiality, falls, documentation, abandonment, controlled substances, social media, and more. Key points emphasized include following policies/procedures, documenting thoroughly and accurately, maintaining patient privacy/confidentiality, and understanding nurses' legal duties and how to avoid negligence.
This document authorizes Tristate Opiate Recovery Health Center to release a patient's medical records to and receive records from another specified person or organization. It lists the types of medical records that may be disclosed, including treatment plans, progress notes, lab reports, and diagnoses. The purpose of the disclosure is to coordinate the patient's care. The patient consents to the release of any substance abuse, HIV/AIDS, or mental health information contained in the records. The consent will automatically expire one year from the date signed unless revoked earlier in writing.
This document is an authorization form for Winn Family Dentistry to release a patient's health information. It allows the dental office to disclose x-rays and chart notes relating to the patient's treatment to any person or entity upon legal request or referral. The purpose is for continuity of care, further dental care, or legal proceedings. The patient signature acknowledges they understand and voluntarily sign the form, and can revoke authorization at any time except if the office has already acted upon it.
This document contains forms and information for a new patient visit at 501 Pain and Rehab. It includes sections for the patient's contact information, insurance details, accident details, medical history, consent forms, and other paperwork related to their treatment. The patient provides personal details, describes their accident and symptoms, and signs forms giving consent for treatment and assigning certain rights to their medical billing to a third party for collection.
The document discusses various legal aspects of emergency room nursing including federal and state regulations, HIPAA privacy rules, requirements for obtaining consent from patients or their guardians, and implications of the Emergency Medical Treatment and Active Labor Act (EMTALA) which prohibits patient dumping and requires hospitals to provide screening and stabilization to anyone seeking emergency care. It also outlines elements that must be proven in medical malpractice and negligence cases against healthcare providers.
Federal laws such as EMTALA and HIPAA regulate emergency care and patient privacy. EMTALA requires hospitals to provide medical screening exams and stabilizing treatment to anyone regardless of ability to pay. It also sets rules for appropriate patient transfers. HIPAA protects personal health information and sets penalties for violations like improper access or disclosure of patient records. Consent is also important legally and varies for situations like treatment of minors, incapacitated adults, and refusals of care. Proper documentation in medical records is essential.
The document discusses various legal aspects relevant to emergency room nursing practice, including federal and state regulations, HIPAA privacy rules, requirements for medical record documentation and obtaining patient consent, EMTALA guidelines for screening and stabilizing patients, and elements of potential negligence or malpractice claims. It provides an overview of key compliance considerations and potential penalties for violations in these important legal areas.
This document discusses various legal and ethical issues in nursing. It begins by outlining objectives related to describing how healthcare trends impact legal/ethical issues and examining best practices. It then covers topics like medication administration, DNR orders, patient confidentiality, falls, documentation, abandonment, controlled substances, social media, and more. Key points emphasized include following policies/procedures, documenting thoroughly and accurately, maintaining patient privacy/confidentiality, and understanding nurses' legal duties and how to avoid negligence.
This document authorizes Tristate Opiate Recovery Health Center to release a patient's medical records to and receive records from another specified person or organization. It lists the types of medical records that may be disclosed, including treatment plans, progress notes, lab reports, and diagnoses. The purpose of the disclosure is to coordinate the patient's care. The patient consents to the release of any substance abuse, HIV/AIDS, or mental health information contained in the records. The consent will automatically expire one year from the date signed unless revoked earlier in writing.
This document is an authorization form for Winn Family Dentistry to release a patient's health information. It allows the dental office to disclose x-rays and chart notes relating to the patient's treatment to any person or entity upon legal request or referral. The purpose is for continuity of care, further dental care, or legal proceedings. The patient signature acknowledges they understand and voluntarily sign the form, and can revoke authorization at any time except if the office has already acted upon it.
This document discusses several important aspects of medical documentation and potential medico-legal issues. It addresses:
1) The importance of maintaining thorough and accurate medical records to document patient care and protect against legal claims of negligence or malpractice.
2) Key elements that must be included in valid consent forms, such as ensuring the patient has the capacity to consent, providing information on risks and alternatives, and obtaining written or witnessed consent when appropriate.
3) Guidelines for properly completing certificates, including death certificates, and ensuring the accuracy and legitimacy of any medical documents issued.
This document is an application for the ATRIPLA Patient Assistance Program. It requests personal information about the patient such as name, address, income sources, insurance status, and medical information including diagnosis codes. If approved, the program will provide ATRIPLA medication at no cost. The applicant and prescriber must sign to authorize the disclosure and use of the patient's information for determining eligibility and program support.
this is a discussion not a paper I need a paragraph under each quest.docxabhi353063
this is a discussion not a paper I need a paragraph under each question. each paragraph need to be at least 250 words with up to date references.
HAS 515 Week 8 Lecture:
Patient Rights and Responsibilities and Acquired Immunodeficiency Syndrome
Slide #
Scene/Interaction
Narration
Slide 1
Intro Slide
Slide 2
Scene 1
Professor Charles enters classroom and introduces the topics for today’s lesson and begins the lecture.
Prof Charles
: Hello everyone….welcome back to class. Today, we are going to discuss patient rights and responsibilities and acquired immunodeficiency syndrome.
The Patient Self-Determination Act of 1990 (PSDA) made a significant advance in the protection of the rights of patients to make decisions regarding their own health care. Healthcare organizations may no longer passively permit patients to exercise their rights but must protect and promote such rights. The PSDA provides that each individual has a right under state law to make decisions concerning his or her medical care, including the right to accept or refuse medical or surgical treatment and the right to formulate advance directives.
Let’s first discuss the rights of the patient. How are patient rights classified?
Casey:
Patient rights may be classified as either legal (those emanating from law) or human statements of desirable ethical principles (such as the right to healthcare or the right to be treated with human dignity). Both staff and patients should be aware and understand not only their own rights and responsibilities, but also the rights and responsibilities of each other.
Donald
: Patients also have a right to receive a clear explanation of tests, diagnoses, treatment options, prescribed medications, and prognosis; participate in healthcare decisions; understand treatment options; and discontinue or refuse treatment options. It is recognized that the relationship between the physician and the patient is essential for the provision of proper care.
Casey
: In addition to what has already been noted, I would say that legal precedent has established that not only does the institution have responsibility to the patient, but also the patient has responsibility to the institution.
Prof. Charles
: Absolutely… What does the federal and state law and the Constitution have to say about discriminatory practices?
Casey
: Most federal, state and local programs specifically require, as a condition for receiving funds under such programs, an affirmative statement on the part of the organization that it will not discriminate. For example, Medicare and Medicaid programs specifically require affirmative assurances by healthcare organizations that no discrimination will be practiced. Healthcare organizations who do not comply may lose Medicare and Medicaid certification and reimbursement.
Prof. Charles
: Excellent. What is an example of discrimination by a hospital?
Donald:
There was a case,
Stoick v. Caro Community Hospital
, where the patient brought a medical ...
This document provides an overview of the health assessment process, including the purpose, components, and guidelines for taking a patient's health history. The main points are:
- The purpose of a health assessment is to collect physical, mental, and social data about a client to identify problems, make clinical decisions, and evaluate outcomes of care.
- Taking a health history is a key part of the assessment process and involves systematically gathering both subjective data from the client and objective data observed by the nurse.
- There are several components that should be covered during a health history, including biographical data, chief complaints, history of present illness, past medical history, and family, social, and occupational information.
-
The document summarizes preliminary results from a survey on New Zealanders' views about sharing their electronic patient health records. Some key findings from the survey include:
- Respondents expressed the highest levels of comfort and agreement with sharing their health records for purposes of clinical care from hospital doctors and nurses.
- Sharing health records for non-clinical purposes like research saw higher rates of agreement if the records did not contain the respondent's name and address.
- Having a chronic disease or sensitive health condition had a minimal effect on comfort levels with sharing.
- Older age groups, especially those aged 35-64, were more willing to overcome discomfort to agree to share records compared to younger respondents.
The document outlines the rights and responsibilities of patients receiving care at Agnesian HealthCare, including the right to privacy, informed consent, and participation in treatment decisions, as well as the responsibility to provide accurate medical information and fulfill financial obligations. It also provides information on patient safety, communicating with healthcare providers, and how to voice any concerns about the quality of care received.
A medical certificate, sometimes called a doctor's certificate, is a statement from a healthcare provider that describes the results of a medical examination of a patient. It can serve as a sick note or evidence of a health condition. Medical certificates are used for various purposes, such as indicating eligibility for activities or benefits, making insurance claims, describing a medical condition, obtaining jobs or services, certifying freedom from contagious diseases, and issuing death certificates. They provide legally valid documentation of a person's health status or cause of death.
This document provides an overview of the Agnesian Cancer Center staff. It lists the physicians, nurses, therapists, and other associates who provide cancer care services at the center, including medical oncology, radiation oncology, chemotherapy, pharmacy, and navigation support. Contact information is provided for the center's multiple locations. The goal of the cancer care team is to provide high quality, compassionate care to all patients.
This document outlines the rights and responsibilities of patients receiving care at Agnesian HealthCare. It details individuals' rights to receive care based on their needs, to be informed of their treatment plan, and to have their privacy and confidentiality protected. It also lists individuals' responsibilities, which include providing accurate medical information and fulfilling financial obligations. The document emphasizes that patient safety is a top priority, and encourages patients to be active members of their care team by asking questions and speaking up about any concerns.
Deanna J. Viliamu is a medical assistant and customer service representative with over 5 years of experience in various medical settings including clinics, pediatric offices, and hospitals. She has strong skills in patient care, administrative duties, and electronic medical record systems. Her objective is to obtain a position that allows her to utilize her organizational abilities, people skills, and expand her knowledge and experience in the medical field.
Patients have several important legal rights regarding their healthcare. These rights stem from human rights, constitutional rights, consumer protection laws, and medical ethics codes. Some key rights include the right to confidentiality, informed consent, and consideration and respect during treatment. Patients should take steps to protect their rights such as understanding consent forms, requesting medical records, and addressing any complaints at the hospital level before pursuing legal action. Special protections also exist for patients related to HIV/AIDS status, clinical trials participation, and examinations by doctors of a different gender.
1) The document describes a research study that aims to improve quality of life for spinal cord injury patients with recurring pressure sores.
2) The study involves performing nerve transfer surgery from intercostal nerves in the lower back to nerves in the area of the pressure sore to restore protective sensation.
3) Risks of the surgery include bleeding, infection, scarring, nerve injury, lack of improvement or recurrence, pain, and muscle weakness. The goal is to close wounds and improve quality of life by reducing recurrences.
This document discusses medical records, including their components, importance, confidentiality, and proper documentation. It notes that a medical record contains a patient's key clinical data and consists of identification information, medical history, examination findings, test results, treatment, and progress. Medical records are important for monitoring treatment, referrals, and satisfying legal and insurance requirements. Clinical information in records is confidential, but identification data can generally be released with a legitimate request. Records must be properly maintained, with accurate documentation of any changes, and retained for appropriate time periods depending on the type of case.
- Physicians are obligated to fully communicate with patients and surrogates about diagnoses, prognoses, treatment options and risks in a timely manner to allow for informed medical decision making. However, studies show physicians often fail to discuss end of life care preferences with patients.
- Determinations of medical futility can be difficult due to uncertainties in prognosis and a lack of understanding of patient values. Physicians are encouraged to have open discussions with patients and surrogates about medical futility and end of life options.
- If a surrogate cannot understand the patient's medical situation or make decisions that reflect the patient's wishes, the physician may need to seek a new surrogate or consider the patient's best interests in
The emergency room is staffed 24 hours a day by emergency physicians and nurses to provide urgent medical care outside regular clinic hours. The pre-admission screening process includes a full history, physical exam, nursing assessment, and diagnostic testing. Patients in the emergency room have rights to treatment, informed consent, privacy, confidentiality, involvement in care decisions, and access to protective services.
The document discusses various laws and issues related to end-of-life medical decisions and patient autonomy. It outlines the Patient Self-Determination Act, which aims to ensure patients' advance medical directives are followed. It also describes the Virginia Health Care Decisions Act and key concepts like terminal conditions and persistent vegetative states. It notes issues courts have addressed around patient and surrogate refusal of treatments, as well as state interests that can limit patient autonomy.
1 P a g e Permission to reuse granted by Alfred State Col.docxhoney725342
1 | P a g e
Permission to reuse granted by Alfred State College and Michelle A. Green.
Global Care Medical Center
100 Main St, Alfred NY 14802
(607) 555-1234
Hospital No. 999
: Bed rest Light Usual Unlimited Other:
Regular Low Cholesterol Low Salt ADA _____ Calorie
Follow-Up: Call for appointment Office appointment on Other:
:
2 | P a g e
Permission to reuse granted by Alfred State College and Michelle A. Green.
I, hereby consent to admission to the Global Care Medical Center (ASMC) , and I further consent to
such
routine hospital care, diagnostic procedures, and medical treatment that the medical and professional staff of ASMC may
deem necessary or advisable. I authorize the use of medical information obtained about me as specified above and the
disclosure of such information to my referring physician(s). This form has been fully explained to me, and I understand its
contents. I further understand that no guarantees have been made to me as to the results of treatments or examinations
done at the ASMC.
Signature of Patient
Signature of Parent/Legal Guardian for Minor
Relationship to Minor
WITNESS: Global Care Medical Center Staff Member
CONSENT TO RELEASE INFORMATION FOR REIMBURSEMENT PURPOSES
In order to permit reimbursement, upon request, the Global Care Medical Center (ASMC) may disclose such treatment
information pertaining to my hospitalization to any corporation, organization, or agent thereof, which is, or may be liable
under contract to the ASMC or to me, or to any of my family members or other person, for payment of all or part of the
any release of information is to facilitate reimbursement for services rendered. In addition, in the event that my health
insurance program includes utilization review of services provided during this admission, I authorize ASMC to release
information as is necessary to permit the review. This authorization will expire once the reimbursement for services
rendered is complete.
Signature of Patient
Signature of Parent/Legal Guardian for Minor
Relationship to Minor
WITNESS: Global Care Medical Center Staff Member
3 | P a g e
Permission to reuse granted by Alfred State College and Michelle A. Green.
GLOBAL CARE MEDICAL CENTER 100 MAIN ST, ALFRED NY 14802 (607) 555-1234
Your answers to the following questions will assist your Physician and the Hospital to respect your wishes regarding your
medical care. This information will become a part of your medical record.
YES NO PATIENT S INITIALS
1. Have you been provided with a copy of the information called
2. Have you
Hospital with a copy for your medical record.
3. Have you prepared a Durable Power of Attorney for Health
Care? If yes, please provide the Hospital with a copy for your
medical record.
4. Have you provided this facility with an Advance Directive on
a prior admission and is it still in effect? If yes, Admitti ...
Healthcare Power of Attorney Living WillRob Robertson
This document appoints an agent to make health care decisions if the individual becomes unable. It allows the agent broad authority but prohibits consent for mental health services, experimental treatments, or abortion. The individual can revoke the document orally or by appointing a new agent. Witnesses to the signing cannot be involved in the individual's care or inherit from their estate.
Write a 5-7 page paper describing the historical development of info.docxherbertwilson5999
Healthcare informatics has evolved over time with different types of systems emerging to manage health information. Properly handling personal health data requires ethical expertise. Today's integrated delivery systems rely on informatics to coordinate complex care across settings while protecting privacy.
Write a 5 paragraph essay related to the healthcare fieldthree.docxherbertwilson5999
Write a 5 paragraph essay related to the healthcare field/three major points are required
Use a variety of sentences
Use transitional words
Use in-text citations to avoid plagiarism
Remember to hand it in with a cover and a reference page
.
More Related Content
Similar to Patients NameBirth Date AgeStreet AddressPhone Nu.docx
This document discusses several important aspects of medical documentation and potential medico-legal issues. It addresses:
1) The importance of maintaining thorough and accurate medical records to document patient care and protect against legal claims of negligence or malpractice.
2) Key elements that must be included in valid consent forms, such as ensuring the patient has the capacity to consent, providing information on risks and alternatives, and obtaining written or witnessed consent when appropriate.
3) Guidelines for properly completing certificates, including death certificates, and ensuring the accuracy and legitimacy of any medical documents issued.
This document is an application for the ATRIPLA Patient Assistance Program. It requests personal information about the patient such as name, address, income sources, insurance status, and medical information including diagnosis codes. If approved, the program will provide ATRIPLA medication at no cost. The applicant and prescriber must sign to authorize the disclosure and use of the patient's information for determining eligibility and program support.
this is a discussion not a paper I need a paragraph under each quest.docxabhi353063
this is a discussion not a paper I need a paragraph under each question. each paragraph need to be at least 250 words with up to date references.
HAS 515 Week 8 Lecture:
Patient Rights and Responsibilities and Acquired Immunodeficiency Syndrome
Slide #
Scene/Interaction
Narration
Slide 1
Intro Slide
Slide 2
Scene 1
Professor Charles enters classroom and introduces the topics for today’s lesson and begins the lecture.
Prof Charles
: Hello everyone….welcome back to class. Today, we are going to discuss patient rights and responsibilities and acquired immunodeficiency syndrome.
The Patient Self-Determination Act of 1990 (PSDA) made a significant advance in the protection of the rights of patients to make decisions regarding their own health care. Healthcare organizations may no longer passively permit patients to exercise their rights but must protect and promote such rights. The PSDA provides that each individual has a right under state law to make decisions concerning his or her medical care, including the right to accept or refuse medical or surgical treatment and the right to formulate advance directives.
Let’s first discuss the rights of the patient. How are patient rights classified?
Casey:
Patient rights may be classified as either legal (those emanating from law) or human statements of desirable ethical principles (such as the right to healthcare or the right to be treated with human dignity). Both staff and patients should be aware and understand not only their own rights and responsibilities, but also the rights and responsibilities of each other.
Donald
: Patients also have a right to receive a clear explanation of tests, diagnoses, treatment options, prescribed medications, and prognosis; participate in healthcare decisions; understand treatment options; and discontinue or refuse treatment options. It is recognized that the relationship between the physician and the patient is essential for the provision of proper care.
Casey
: In addition to what has already been noted, I would say that legal precedent has established that not only does the institution have responsibility to the patient, but also the patient has responsibility to the institution.
Prof. Charles
: Absolutely… What does the federal and state law and the Constitution have to say about discriminatory practices?
Casey
: Most federal, state and local programs specifically require, as a condition for receiving funds under such programs, an affirmative statement on the part of the organization that it will not discriminate. For example, Medicare and Medicaid programs specifically require affirmative assurances by healthcare organizations that no discrimination will be practiced. Healthcare organizations who do not comply may lose Medicare and Medicaid certification and reimbursement.
Prof. Charles
: Excellent. What is an example of discrimination by a hospital?
Donald:
There was a case,
Stoick v. Caro Community Hospital
, where the patient brought a medical ...
This document provides an overview of the health assessment process, including the purpose, components, and guidelines for taking a patient's health history. The main points are:
- The purpose of a health assessment is to collect physical, mental, and social data about a client to identify problems, make clinical decisions, and evaluate outcomes of care.
- Taking a health history is a key part of the assessment process and involves systematically gathering both subjective data from the client and objective data observed by the nurse.
- There are several components that should be covered during a health history, including biographical data, chief complaints, history of present illness, past medical history, and family, social, and occupational information.
-
The document summarizes preliminary results from a survey on New Zealanders' views about sharing their electronic patient health records. Some key findings from the survey include:
- Respondents expressed the highest levels of comfort and agreement with sharing their health records for purposes of clinical care from hospital doctors and nurses.
- Sharing health records for non-clinical purposes like research saw higher rates of agreement if the records did not contain the respondent's name and address.
- Having a chronic disease or sensitive health condition had a minimal effect on comfort levels with sharing.
- Older age groups, especially those aged 35-64, were more willing to overcome discomfort to agree to share records compared to younger respondents.
The document outlines the rights and responsibilities of patients receiving care at Agnesian HealthCare, including the right to privacy, informed consent, and participation in treatment decisions, as well as the responsibility to provide accurate medical information and fulfill financial obligations. It also provides information on patient safety, communicating with healthcare providers, and how to voice any concerns about the quality of care received.
A medical certificate, sometimes called a doctor's certificate, is a statement from a healthcare provider that describes the results of a medical examination of a patient. It can serve as a sick note or evidence of a health condition. Medical certificates are used for various purposes, such as indicating eligibility for activities or benefits, making insurance claims, describing a medical condition, obtaining jobs or services, certifying freedom from contagious diseases, and issuing death certificates. They provide legally valid documentation of a person's health status or cause of death.
This document provides an overview of the Agnesian Cancer Center staff. It lists the physicians, nurses, therapists, and other associates who provide cancer care services at the center, including medical oncology, radiation oncology, chemotherapy, pharmacy, and navigation support. Contact information is provided for the center's multiple locations. The goal of the cancer care team is to provide high quality, compassionate care to all patients.
This document outlines the rights and responsibilities of patients receiving care at Agnesian HealthCare. It details individuals' rights to receive care based on their needs, to be informed of their treatment plan, and to have their privacy and confidentiality protected. It also lists individuals' responsibilities, which include providing accurate medical information and fulfilling financial obligations. The document emphasizes that patient safety is a top priority, and encourages patients to be active members of their care team by asking questions and speaking up about any concerns.
Deanna J. Viliamu is a medical assistant and customer service representative with over 5 years of experience in various medical settings including clinics, pediatric offices, and hospitals. She has strong skills in patient care, administrative duties, and electronic medical record systems. Her objective is to obtain a position that allows her to utilize her organizational abilities, people skills, and expand her knowledge and experience in the medical field.
Patients have several important legal rights regarding their healthcare. These rights stem from human rights, constitutional rights, consumer protection laws, and medical ethics codes. Some key rights include the right to confidentiality, informed consent, and consideration and respect during treatment. Patients should take steps to protect their rights such as understanding consent forms, requesting medical records, and addressing any complaints at the hospital level before pursuing legal action. Special protections also exist for patients related to HIV/AIDS status, clinical trials participation, and examinations by doctors of a different gender.
1) The document describes a research study that aims to improve quality of life for spinal cord injury patients with recurring pressure sores.
2) The study involves performing nerve transfer surgery from intercostal nerves in the lower back to nerves in the area of the pressure sore to restore protective sensation.
3) Risks of the surgery include bleeding, infection, scarring, nerve injury, lack of improvement or recurrence, pain, and muscle weakness. The goal is to close wounds and improve quality of life by reducing recurrences.
This document discusses medical records, including their components, importance, confidentiality, and proper documentation. It notes that a medical record contains a patient's key clinical data and consists of identification information, medical history, examination findings, test results, treatment, and progress. Medical records are important for monitoring treatment, referrals, and satisfying legal and insurance requirements. Clinical information in records is confidential, but identification data can generally be released with a legitimate request. Records must be properly maintained, with accurate documentation of any changes, and retained for appropriate time periods depending on the type of case.
- Physicians are obligated to fully communicate with patients and surrogates about diagnoses, prognoses, treatment options and risks in a timely manner to allow for informed medical decision making. However, studies show physicians often fail to discuss end of life care preferences with patients.
- Determinations of medical futility can be difficult due to uncertainties in prognosis and a lack of understanding of patient values. Physicians are encouraged to have open discussions with patients and surrogates about medical futility and end of life options.
- If a surrogate cannot understand the patient's medical situation or make decisions that reflect the patient's wishes, the physician may need to seek a new surrogate or consider the patient's best interests in
The emergency room is staffed 24 hours a day by emergency physicians and nurses to provide urgent medical care outside regular clinic hours. The pre-admission screening process includes a full history, physical exam, nursing assessment, and diagnostic testing. Patients in the emergency room have rights to treatment, informed consent, privacy, confidentiality, involvement in care decisions, and access to protective services.
The document discusses various laws and issues related to end-of-life medical decisions and patient autonomy. It outlines the Patient Self-Determination Act, which aims to ensure patients' advance medical directives are followed. It also describes the Virginia Health Care Decisions Act and key concepts like terminal conditions and persistent vegetative states. It notes issues courts have addressed around patient and surrogate refusal of treatments, as well as state interests that can limit patient autonomy.
1 P a g e Permission to reuse granted by Alfred State Col.docxhoney725342
1 | P a g e
Permission to reuse granted by Alfred State College and Michelle A. Green.
Global Care Medical Center
100 Main St, Alfred NY 14802
(607) 555-1234
Hospital No. 999
: Bed rest Light Usual Unlimited Other:
Regular Low Cholesterol Low Salt ADA _____ Calorie
Follow-Up: Call for appointment Office appointment on Other:
:
2 | P a g e
Permission to reuse granted by Alfred State College and Michelle A. Green.
I, hereby consent to admission to the Global Care Medical Center (ASMC) , and I further consent to
such
routine hospital care, diagnostic procedures, and medical treatment that the medical and professional staff of ASMC may
deem necessary or advisable. I authorize the use of medical information obtained about me as specified above and the
disclosure of such information to my referring physician(s). This form has been fully explained to me, and I understand its
contents. I further understand that no guarantees have been made to me as to the results of treatments or examinations
done at the ASMC.
Signature of Patient
Signature of Parent/Legal Guardian for Minor
Relationship to Minor
WITNESS: Global Care Medical Center Staff Member
CONSENT TO RELEASE INFORMATION FOR REIMBURSEMENT PURPOSES
In order to permit reimbursement, upon request, the Global Care Medical Center (ASMC) may disclose such treatment
information pertaining to my hospitalization to any corporation, organization, or agent thereof, which is, or may be liable
under contract to the ASMC or to me, or to any of my family members or other person, for payment of all or part of the
any release of information is to facilitate reimbursement for services rendered. In addition, in the event that my health
insurance program includes utilization review of services provided during this admission, I authorize ASMC to release
information as is necessary to permit the review. This authorization will expire once the reimbursement for services
rendered is complete.
Signature of Patient
Signature of Parent/Legal Guardian for Minor
Relationship to Minor
WITNESS: Global Care Medical Center Staff Member
3 | P a g e
Permission to reuse granted by Alfred State College and Michelle A. Green.
GLOBAL CARE MEDICAL CENTER 100 MAIN ST, ALFRED NY 14802 (607) 555-1234
Your answers to the following questions will assist your Physician and the Hospital to respect your wishes regarding your
medical care. This information will become a part of your medical record.
YES NO PATIENT S INITIALS
1. Have you been provided with a copy of the information called
2. Have you
Hospital with a copy for your medical record.
3. Have you prepared a Durable Power of Attorney for Health
Care? If yes, please provide the Hospital with a copy for your
medical record.
4. Have you provided this facility with an Advance Directive on
a prior admission and is it still in effect? If yes, Admitti ...
Healthcare Power of Attorney Living WillRob Robertson
This document appoints an agent to make health care decisions if the individual becomes unable. It allows the agent broad authority but prohibits consent for mental health services, experimental treatments, or abortion. The individual can revoke the document orally or by appointing a new agent. Witnesses to the signing cannot be involved in the individual's care or inherit from their estate.
Similar to Patients NameBirth Date AgeStreet AddressPhone Nu.docx (20)
Write a 5-7 page paper describing the historical development of info.docxherbertwilson5999
Healthcare informatics has evolved over time with different types of systems emerging to manage health information. Properly handling personal health data requires ethical expertise. Today's integrated delivery systems rely on informatics to coordinate complex care across settings while protecting privacy.
Write a 5 paragraph essay related to the healthcare fieldthree.docxherbertwilson5999
Write a 5 paragraph essay related to the healthcare field/three major points are required
Use a variety of sentences
Use transitional words
Use in-text citations to avoid plagiarism
Remember to hand it in with a cover and a reference page
.
Write at least a six-page paper, in which youIdentify the.docxherbertwilson5999
Write at least a six-page paper, in which you:
Identify the two LDCs (from the provided list), which you will compare and assess. Explain why you chose these two countries. (Congo and Philippines)
Analyze the features that the LDCs have in common using at least five of the following nine factors (clearly label the five factors using headings):
Geography.
Extractive institutions.
Governmental corruption.
Internal or external conflicts.
Shaky financial systems.
Unfair judicial systems.
Ethnic, racial, or tribal disparities.
Lack or misuse of natural resources.
Closed (statist) economies.
Use at least seven credible sources. Wikipedia, encyclopedias, dictionaries, and blogs do not qualify as reputable academic source work at the college level. Do not use sources that are older than seven years.
.
Write a 2 page paper analyzing the fact pattern scenario below. Plea.docxherbertwilson5999
Write a 2 page paper analyzing the fact pattern scenario below. Please use your own state law. Your analysis should include application of the topics covered during the past 7 weeks. For example, search and seizure, search warrant, execution of warrant, exclusionary rule, Miranda rights, and the right against self incrimination.
Make sure all citations are in APA or Blue book format.
Please see the attached grading rubric below. This grading rubric will be used to grade this assignment.
Leila is a police officer. She is out of uniform and knocked on Dan's front door of his house and asked if she could enter to enforce a warrant she had. The warrant was a search warrant issued by a magistrate at the Lawrence District Court. His name is Mark McCale, a retired police officer for the state police department in Lawrence. The warrant indicated that "the first floor of Dan's house will be searched for a gun used in connection with a robbery and some jewelry, which was stolen." While looking in Dan's house, Officer Leila smelled what she thought to be gun powder emanating from the second floor. Officer Leila immediately walked upstairs and found a gun at the tops of the stairs. She went to confiscate the gun and while doing so noticed a note attached to the gun with an address on it. Later that afternoon police officers went to the address of the house listed on the note of the gun. Jewelry was found at this address and collected by the police officers. The address was a known address for stolen jewelry to be pawned. While at Dan's house, Dan told Officer Leila that, "I do not know what you are here for, because I did not rob Terri Grubb's jewelry store." Officer Leila asked Dan to go to the police station and Dan agreed. As they walked into the police station, Magistrate McCale yelled, "is that the person who robbed Terri Grubb's jewelry store?!" Dan replied, "I told Officer Leila already, I did not rob Terri Grubb's jewelry store."
Supporting Materials
Week 8 Assignment Grading Rubric.docx
(14 KB)
.
Write a 2 page paper analyzing the fact pattern scenario below. .docxherbertwilson5999
Write a 2 page paper analyzing the fact pattern scenario below. Please use your own state law. Your analysis should include application of the topics covered during the past 7 weeks. For example, search and seizure, search warrant, execution of warrant, exclusionary rule, Miranda rights, and the right against self incrimination.
Make sure all citations are in APA or Blue book format.
Please see the attached grading rubric below. This grading rubric will be used to grade this assignment.
Leila is a police officer. She is out of uniform and knocked on Dan's front door of his house and asked is should could enter to enforce a warrant she had. The warrant was a search warrant issued by a magistrate at the Lawrence District Court. His name is Mark McCale, a retired police officer for the state police department in Lawrence. The warrant indicated that "the first floor of Dan's house will be searched for a gun used in connection with a robbery and some jewelry, which was stolen." While looking in Dan's house, Officer Leila smelled what she thought to be gun powder emanating from the second floor. Officer Leila immediately walked upstairs and found a gun at the tops of the stairs. She went to confiscate the gun and while doing so noticed a note attached to the gun with an address on it. Later that afternoon police officers went to the address of the house listed on the note of the gun. A bunch of jewelry was found at this address and collected by the police officers. The address was a known address for stolen jewelry to be pawned. While at Dan's house, Dan told Officer Leila that, "I do not know what you are here for, because I did not rob the Terri Grubb's jewelry store." Officer Leila asked Dan to go to the police station and Dan agreed. As they walked into the police station, Magistrate McCale yelled, "is that the person who robbed Terri Grubb's jewelry store?!" Dan replied, "I told Officer Leila already, I did not rob the Terri Grubb's jewelry store."
.
Write a 100-word response in Spanish that addresses both of .docxherbertwilson5999
Write a
100
-word response in
Spanish
that addresses both of the following questions:
1.
What are some of the distinctive characteristics that make Costa Rica a haven for naturalists and environmentalists?
2.
What are some of the steps that the government, private sector and individuals are doing to maintain the balance between man and nature?
.
Write a Request for Proposal (approx. 3 - 4 pages in a word doc.docxherbertwilson5999
The document provides guidance on creating a Request for Proposal (RFP) that is approximately 3-4 pages. It lists 9 key elements that should be included in an effective RFP: 1) a clear statement of work with deliverables, 2) a timeline for proposal submission, 3) how questions will be handled, 4) information for vendors to develop a cost proposal, 5) a project timeline and milestones, 6) the type of contract, 7) evaluation criteria, 8) an outline and format for proposals, and 9) a scheduled award date. Submitters are asked to write an RFP that incorporates these elements and submit the PMP template for Section 8.
Write a 5 paragraph essay related to Physical Therapy Assistant th.docxherbertwilson5999
Write a 5 paragraph essay related to Physical Therapy Assistant /three major points are required
Use a variety of sentences
Use transitional words
Use in-text citations to avoid plagiarism
Include a cover and a reference page
Minimal of three sources
.
Write a 5 page paper with at-least three images that represent.docxherbertwilson5999
Write a 5 page paper with at-least three images that represent the African American Visual Arts Movement (discuss artists, art, historical information . Give background information, characteristics and style. Analyze each work of art. Do not forget to list at-least three sources used to assist in writing paper, APA format guidelines. Place appropriate captions under each image.
Fragments of African American Art
Contemporary Art
Surrealism
Realism
OR
After reviewing the videos below and researching , write a two page paper on the
challenges of
African American VISUAL Artists
and other professional minority visual artists through out history and up to the present day
. Use a minimum of 5 references that will assist you in writing your paper.
https://www.youtube.com/watch?v=u8kg8xzJNt8
.
Write a 5 paragraph essay related to the healthcare fieldthree maj.docxherbertwilson5999
Write a 5 paragraph essay related to the healthcare field/three major points are required
Use a variety of sentences
Use transitional words
Use in-text citations to avoid plagiarism
Remember to hand it in with a cover and a reference page
.
Write at least Ten sentences on your discussion. Compare and con.docxherbertwilson5999
Write at least Ten sentences on your discussion.
Compare and contrast the California economy of the Great Depression and the California economy of World War II. Which industries were prevalent during the war and why was California's location/geography so important?
.
Write at least a three-page analysis using the case study on pages.docxherbertwilson5999
This document provides instructions and examples for students to write posts discussing similarities and differences between the current COVID-19 pandemic and past pandemics like the 1918 influenza pandemic and 2009 H1N1 pandemic. Students are asked to write three original posts making comparisons and commenting on five other student posts. The examples provided compare transmission methods and case numbers between COVID-19 and H1N1. References must be included. The document also provides questions for students to respond to in writing assignments on global leadership and managing corporations internationally while considering cultural differences.
Write at least a six-page paper, in which you Identify th.docxherbertwilson5999
Write at least a six-page paper, in which you:
Identify the two LDCs (from the list above), which you will compare and assess. Explain why you chose these two countries.
Analyze the features that the LDCs have in common using
at least five of the following nine factors
(clearly label the five factors using headings):
geography
extractive institutions
governmental corruption
internal or external conflicts
shaky financial systems
unfair judicial systems
ethnic, racial or tribal disparities
lack or misuse of natural resources
closed (statist) economies
Use
at least seven credible sources
. Wikipedia, encyclopedias, dictionaries, blogs and other material that does not qualify as reputable academic source work at the college level. Do not use sources that are older than seven years.
.
Write at least a paragraph for each.1) What is your understand.docxherbertwilson5999
Write at least a paragraph for each.
1) What is your understanding of how a 401(k) plan works? What are the advantages/disadvantages for an employer/employee?
2) What three major types of benefits do contributions to Social Security pay for?
3) What are the employee benefits required by law?
*Use APA format please! and cite accordingly!
.
Write at least 500 words analyzing a subject you find in this .docxherbertwilson5999
Write at least 500 words analyzing a subject you find in this
article
related to a threat to confidentiality, integrity, or availability of data. Use an example from the news.
Include at least one quote from 3 articles, place them in quotation marks and cite in-line (as all work copied from another should be handled).
Cite your sources in a reference list at the end. Do not copy without providing proper attribution (quotation marks and in-line citations). Write in essay format not in bulleted, numbered or other list format
.
Write at least 750 words paper on Why is vulnerability assessme.docxherbertwilson5999
Write at least 750 words paper on “Why is vulnerability assessment critical for data security?” And also prepare twelve minutes or more presentations on this topic by adding notes under each slide. with a separate reference list of at least 3 academically appropriate sources. Provide appropriate attribution. It is important that you use your own words, that you cite your sources, that you comply with the instructions regarding the length of your post. Do not use spinbot or other word replacement software. It usually results in nonsense and is not a good way to learn anything.
.
Write As if You Are Writing in Your Journal (1st Person)Your T.docxherbertwilson5999
**Write As if You Are Writing in Your Journal (1st Person)
Your Thoughts And Intentions.
What challenges do you face (i.e., bad habits, weaknesses, etc.) that you need to address to move forward as a leader? How can you begin to address them? (Be sure to make personal application and make it practical).
.
Write an original, Scholarly Paper, addressing a topic relevant to t.docxherbertwilson5999
Write an original, Scholarly Paper, addressing a topic relevant to the course. A scholarly paper should demonstrate a standard of critical thinking at levels of analysis, evaluation, and synthesis. Be sure to use and cite references that meet the standard for scholarship.
.
Write an observation essay that explains the unique significance.docxherbertwilson5999
Write an
observation essay
that explains the unique significance of a particular person or place within a larger community. Describe the person or place through vivid description, narration, dialogue and sensory details. Help others outside of your community understand why the person or place is important to the community.
Assignment
Observation
, as the CEL describes it, requires writers to "study their subjects and learn something by seeing them in a particular way" (93). Observation essays do more than just report facts: they also "find the hidden meaning, the significant issues, and the important aspects of a particular subject" (93).
Your purpose in this Observation Essay is to
convey the significance of a particular person or place in your community through details that show how the subject "fits" within the community's priorities and values
. Your descriptions and details should make it easy for someone unfamiliar with your community to understand why the person or place you chose is relevant and significant to the community.
*Note: although this essay is intended to be based in recent, firsthand observations, you may write from recent memories instead if you are restricted in travel and mobility during the COVID pandemic. If you are writing from memories, try to recreate scenes and descriptions as though you are seeing them again for the first time.
In order to achieve this purpose, you need to:
Observe and Take field notes. Begin with observing the person or place and writing down notes about what you see, hear, and sense. Plan to observe this person or place 2-3 times. In your notes, record specific actions that you notice, dialogue you overhear, interactions you have with other people, and any important details about the scene that might help you SHOW its significance through vivid detail and narration.
Describe the person or place through actions, details, and dialogue that offer
insight
into why this person or place has unique
significance
as an important part of the community.
Explain context and background that shows how the person or place matters within the larger community. Context might include history, factual information, anecdotes, geographical information, or other details that help an audience understand the person or place as part of something bigger than themselves/itself.
Follow a carefully planned organizational structure that gives priority to specific details, themes, and values. Your final draft should be organized to show the significance of the person or place and should not simply list details in the order you observed them.
Offer a strong introduction that hooks readers with vivid details or action and focuses attention on the significance of the subject. Provide a strong conclusion that
As you look back over your observations and notes, remember that your essay should do more than simply relate details without any larger significance. Your observation of the person or place should .
Write an introduction in APA format in about 2 pages to describe.docxherbertwilson5999
Write an introduction in APA format in about 2 pages to describe any bank organization – its background etc. Then explain how data science and big data is useful for the back.
Also explain the IT team dynamics in the organization I.e. all the positions that are in the IT team of the bank developers, project managers etc.
Also explain how the company uses the agile model in the workflow for the data science projects.
Explain what is structured and unstructured data. What the sources of structured and unstructured data in a bank and what are the sources of these data.
Please provide at least 3-4 in text citation and references.
.
How to Make a Field Mandatory in Odoo 17Celine George
In Odoo, making a field required can be done through both Python code and XML views. When you set the required attribute to True in Python code, it makes the field required across all views where it's used. Conversely, when you set the required attribute in XML views, it makes the field required only in the context of that particular view.
Exploiting Artificial Intelligence for Empowering Researchers and Faculty, In...Dr. Vinod Kumar Kanvaria
Exploiting Artificial Intelligence for Empowering Researchers and Faculty,
International FDP on Fundamentals of Research in Social Sciences
at Integral University, Lucknow, 06.06.2024
By Dr. Vinod Kumar Kanvaria
A workshop hosted by the South African Journal of Science aimed at postgraduate students and early career researchers with little or no experience in writing and publishing journal articles.
বাংলাদেশের অর্থনৈতিক সমীক্ষা ২০২৪ [Bangladesh Economic Review 2024 Bangla.pdf] কম্পিউটার , ট্যাব ও স্মার্ট ফোন ভার্সন সহ সম্পূর্ণ বাংলা ই-বুক বা pdf বই " সুচিপত্র ...বুকমার্ক মেনু 🔖 ও হাইপার লিংক মেনু 📝👆 যুক্ত ..
আমাদের সবার জন্য খুব খুব গুরুত্বপূর্ণ একটি বই ..বিসিএস, ব্যাংক, ইউনিভার্সিটি ভর্তি ও যে কোন প্রতিযোগিতা মূলক পরীক্ষার জন্য এর খুব ইম্পরট্যান্ট একটি বিষয় ...তাছাড়া বাংলাদেশের সাম্প্রতিক যে কোন ডাটা বা তথ্য এই বইতে পাবেন ...
তাই একজন নাগরিক হিসাবে এই তথ্য গুলো আপনার জানা প্রয়োজন ...।
বিসিএস ও ব্যাংক এর লিখিত পরীক্ষা ...+এছাড়া মাধ্যমিক ও উচ্চমাধ্যমিকের স্টুডেন্টদের জন্য অনেক কাজে আসবে ...
This presentation was provided by Steph Pollock of The American Psychological Association’s Journals Program, and Damita Snow, of The American Society of Civil Engineers (ASCE), for the initial session of NISO's 2024 Training Series "DEIA in the Scholarly Landscape." Session One: 'Setting Expectations: a DEIA Primer,' was held June 6, 2024.
How to Manage Your Lost Opportunities in Odoo 17 CRMCeline George
Odoo 17 CRM allows us to track why we lose sales opportunities with "Lost Reasons." This helps analyze our sales process and identify areas for improvement. Here's how to configure lost reasons in Odoo 17 CRM
This slide is special for master students (MIBS & MIFB) in UUM. Also useful for readers who are interested in the topic of contemporary Islamic banking.
LAND USE LAND COVER AND NDVI OF MIRZAPUR DISTRICT, UPRAHUL
This Dissertation explores the particular circumstances of Mirzapur, a region located in the
core of India. Mirzapur, with its varied terrains and abundant biodiversity, offers an optimal
environment for investigating the changes in vegetation cover dynamics. Our study utilizes
advanced technologies such as GIS (Geographic Information Systems) and Remote sensing to
analyze the transformations that have taken place over the course of a decade.
The complex relationship between human activities and the environment has been the focus
of extensive research and worry. As the global community grapples with swift urbanization,
population expansion, and economic progress, the effects on natural ecosystems are becoming
more evident. A crucial element of this impact is the alteration of vegetation cover, which plays a
significant role in maintaining the ecological equilibrium of our planet.Land serves as the foundation for all human activities and provides the necessary materials for
these activities. As the most crucial natural resource, its utilization by humans results in different
'Land uses,' which are determined by both human activities and the physical characteristics of the
land.
The utilization of land is impacted by human needs and environmental factors. In countries
like India, rapid population growth and the emphasis on extensive resource exploitation can lead
to significant land degradation, adversely affecting the region's land cover.
Therefore, human intervention has significantly influenced land use patterns over many
centuries, evolving its structure over time and space. In the present era, these changes have
accelerated due to factors such as agriculture and urbanization. Information regarding land use and
cover is essential for various planning and management tasks related to the Earth's surface,
providing crucial environmental data for scientific, resource management, policy purposes, and
diverse human activities.
Accurate understanding of land use and cover is imperative for the development planning
of any area. Consequently, a wide range of professionals, including earth system scientists, land
and water managers, and urban planners, are interested in obtaining data on land use and cover
changes, conversion trends, and other related patterns. The spatial dimensions of land use and
cover support policymakers and scientists in making well-informed decisions, as alterations in
these patterns indicate shifts in economic and social conditions. Monitoring such changes with the
help of Advanced technologies like Remote Sensing and Geographic Information Systems is
crucial for coordinated efforts across different administrative levels. Advanced technologies like
Remote Sensing and Geographic Information Systems
9
Changes in vegetation cover refer to variations in the distribution, composition, and overall
structure of plant communities across different temporal and spatial scales. These changes can
occur natural.
How to Build a Module in Odoo 17 Using the Scaffold MethodCeline George
Odoo provides an option for creating a module by using a single line command. By using this command the user can make a whole structure of a module. It is very easy for a beginner to make a module. There is no need to make each file manually. This slide will show how to create a module using the scaffold method.
Liberal Approach to the Study of Indian Politics.pdf
Patients NameBirth Date AgeStreet AddressPhone Nu.docx
1. Patient's Name
Birth Date Age
Street Address
Phone Number
Hospital Number
Sex Marital Status State Zip County
City
Patient's Occupation
Soc. Sec. #
Name
Address
Relationship
Phone No.
Responsible for Account
Religion
Date Admitted Time AM
PM
2. Date Discharged Time AM
PM
Date of Last Admission Name & Address of Any Institution
From Which Discharged in Last 60 Days
Admitting Physician
Aitemding Physician
Consultant
Sundance HealthCare SystemsSundance HealthCare
SystemsSundance HealthCare SystemsSundance HealthCare
SystemsSundance HealthCare Systems
Painted Valley, USAPainted Valley, USAPainted Valley,
USAPainted Valley, USAPainted Valley, USA
Notify In
Emergency
Room
Race
Ethnicity
Admitting Diagnosis (Within 24 Hours) ICD-9-CM CODESICD-
9-CM CODESICD-9-CM CODESICD-9-CM CODESICD-9-CM
CODES
Principal Diagnosis
Secondary Diagnoses
4. Jade Dare Daughter Self
2102 Fillmore Los Angeles 538 322-7734
101-87-3546 Taoism Asian
Retired Non-Hispanic
Dare, Jane V. 8032 Hao Jung Street # 822999
10/31/xx 73 San Francisco 823 762-3673
F Married California 85321-9626 Calaveras 773
Congestive heart failure, left pleural effusion, pneumonia.
CONDITIONS OF ADMISSIONCONDITIONS OF
ADMISSIONCONDITIONS OF ADMISSIONCONDITIONS OF
ADMISSIONCONDITIONS OF ADMISSION
1. CONSENT TO HOSPITAL CARE
I am presenting myself for admission to Sundance HealthCare
Systems. I voluntarily consent to the rendering of
medical care which is determined to be necessary or beneficial
in the professional judgement of my physician. This
includes routine diagnostic procedures and medical treatment by
authorized agents and employees of the Hospital,
and by its medical staff, or their designees.
I acknowledge that no guarantees have been made to me as to
the effect of such examination or treatment on my
condition.
5. 2. AUTHORIZATION TO RELEASE INFORMATION
I authorize Sundance HealthCare Systems to release such
information from my medical record as may be necessary
for the completion of the hospital’s or my physician’s claims
for reimbursement to my insurance company or agency.
I UNDERSTAND THAT DISCLOSURE MAY INCLUDE
DIAGNOSES AND OPERATIONS OR PROCEDURES PER-
FORMED AND THAT, AT THE REQUEST OF MY
INSURANCE COMPANY OR AGENCY, MY COMPLETE
MEDI-
CAL RECORD MAY BE SUBJECT TO REVIEW. IN
ADDITION, I UNDERSTAND THAT COPIES OF MY
RECORD
MAY BE OBTAINED BY MY INSURANCE COMPANY OR
AGENCY.
3. ASSIGNMENT OF BENEFITS
In consideration of the services received or to be received for
this admission to Sundance HealthCare Systems, I
assign all insurance benefits due me. I further warrant that the
hospital shall be entitled to the full amount of its
charges. Any credit balance resulting for any reason will be
applied to other existing accounts. This also assigns
benefits to Anesthesia Consultants, PC.
I hereby agree to pay any and all hospital charges that exceed or
that are not covered by my hospitalization insur-
ance coverage. This assignment shall be irrevocable.
4. VALUABLES DISCLAIMER
I understand that Sundance HealthCare Systems maintains a safe
for the safekeeping of money and valuables. I,
also, understand that I assume full responsibility for any and all
of my valuables, money, clothing, dentures, and other
personal items while a patient in the hospital unless deposited
with the Hospital for safekeeping.
6. Valuables Deposited with the Hospital YES NO
5. REQUEST FOR FACILITY ACCOMMODATIONS
I agree to pay to the Hospital any difference between the semi-
private rate provided by my hospitalization insurance
and the Hospital charges for a private accommodation. I
understand that private accommodations are more expen-
sive than the room rate payable by my hospitalization insurance
and that it is my responsibility to pay the difference.
I request a Private Room YES NO
This document has been fully explained to me, and I certify that
I understand its contents and agree to it freely.
AM
DATE TIME PM Patient or authorized person
Witness Relationship
Guarantor/Insured Certificate Holder
Signature is not that of the patient because: ( ) patient is a
minor
( ) other reason (specify):
6/13/xx 1415 ���������� �
���������
��
�
�
7. Patient's Name
Birth Date Age
Street Address
Phone Number
Hospital Number
Sex Marital Status State Zip County
City
Patient's Occupation
Soc. Sec. #
Name
Address
Relationship
Phone No.
Responsible for Account
Religion
Date Admitted Time AM
PM
8. Date Discharged Time AM
PM
Date of Last Admission Name & Address of Any Institution
From Which Discharged in Last 60 Days
Admitting Physician
Aitemding Physician
Consultant
Sundance HealthCare SystemsSundance HealthCare
SystemsSundance HealthCare SystemsSundance HealthCare
SystemsSundance HealthCare Systems
Painted Valley, USAPainted Valley, USAPainted Valley,
USAPainted Valley, USAPainted Valley, USA
Notify In
Emergency
Room
Race
Ethnicity
Admitting Diagnosis (Within 24 Hours) ICD-9-CM CODESICD-
9-CM CODESICD-9-CM CODESICD-9-CM CODESICD-9-CM
CODES
Principal Diagnosis
Secondary Diagnoses
Complications
10. # 822999
This 73-year-old female presents to ER C/O of SOB x 3-4 days.
Not sleeping well. Increase pedal edema.
Denies cough or fever. Has history of atrial fibrillation severe
regurgitation from tricuspid and mitral valve
dysfunction.
Allergy: Sulfa
Medications:
1. Capoten 25 mg po tid
2. Furosemide 40 mg po qd
3. Digoxin 0.125 mg po qod
4. Nortriptyline HCL 10 mg po qhs
5. Tylenol 325 mg tabs prn for pain
6. KLOR 10 mg qd
7. Milk of Magnesia 30 cc po qd prn
Family History: Noncontributory.
Social History: Has been living with husband. Negative for
alcohol. Ex-smoker for many years.
PHYSICAL EXAMINATION:
Pleasant, sitting upright.
HEENT: Difficult fundoscopic exam.
Neck: Supple with positive venous distension
CNS: Rate 104, irregular with gallop. Crackles in left lower
lobe. Right is dull.
Abdomen: Benign.
Genitalia: Normal except for red sacral area. No obvious
breakdown.
Extremities: 3+ pitting edema to knees.
Neurological: Appropriate. Alert.
12. To Be Completed Upon Transfer: Date: _____/_____/_____
Time: ____:____
Transferred From:
________________________________________
Reason for Transfer:
________________________________________
Transferred Via: � Ambulance � Paramedics � Police � Fire
� Relative � O t h e r : _________________________________
Diagnoses on Principal
Transfer Secondary
Form 3734 (4/02) nsg
Sundance HealthCare Systems
Painted Valley, USA
���������� �
���
�����
��� � ���
Transfer Form
Transfer Data: Report Author Date
Face Sheet
Discharge Summary
History and Physical Exam
13. Consultation(s)
Ancillary Department(s)
Immunizations
� Pneumovax � Flu
� Tetanus _____
Self-Cares
Bathes Self � Yes � No
Washes Face/Hands � Yes �No
Oral Care/Self � Yes � No
Combs Hair � Yes � No
Shaves Self � Yes � No
Dresses Self � Yes � No
Transfers Self � Yes � No
Walks Self � Yes � No
Feeds Self � Yes � No
Restraints � Yes � No
Side Rails � Yes � No
Dietary
14. Diet � Unrestricted � Low Salt
� Diabetic _____ # Calories
� Low Residue � Bland
Nursing Summary
Transfer Data: Report Author Date
Imaging
EKG/Cardio
CBC
Urinalysis
Other Lab
Personal Property/Assistive Devices
Patient has: Corrective Lenses: � Glasses Sent with Patient �
Yes � No
� Contacts � Yes � No
� Reading Glasses Only � Yes � No
Dentures � Upper � Full � Partial � Yes � No
� Lower � Full � Partial � Yes � No
Hearing Aids � Right � Left � Yes � No
Assist Devices � Walker � Cane � Reacher � Yes � No
Advanced Directives:
15. Patient has: Living Will: � Yes � No Location:
_____________________
Power of Attorney: � Yes � No Location:
_____________________
Code Level: ____________________ Executor:
_____________________
6 18 xx 10 25
Sundance HealthCare Systems
Need for continued skilled nursing care
�
CHF, left pleural effusion and pneumonia
� Hospital Record
�
None None Named
� �
� � �
� �
�
� �
�
� �
�
�
�
19. Delirium:
Resident triggers delirium because of deterioration of cognitive
skills and deterioration of communica-
tions skills. Causal factor of the RAP appears to be her
cardiac diagnosis. She also appears to be
depressed and very unhappy.
Will be seen by Dr. Archibald M. Graham on nursing home
rounds.
Based on above documentation, will proceed with care planning.
�����������
��
������
RAP Problem Area # 2
Cognitive Loss/ Dementia:
Resident triggers cognitive loss/dementia because of mild, short
term memory loss (forgetful) and some
decision making problems. She is alert and oriented, but
sometimes will forget the time or wonder why
she is here. She has been complaining since admission
regarding her room (too small, too humid, too
hot, etc.) She swears at the staff and other residents. She cries
easily.
Factor of triggered RAP appears to be sadness, unhappiness
over being away from her husband. She
had no diagnosis of dementia at this time.
Will be seen by Dr. Archibald M. Graham on nursing home
22. Resident has self care deficit. She needs physical assist of 1
staff with dressing and bathing. She
receives physical assistance of 1 to transfer at least q. d. She
has been incontinent of BM almost q.d.
Staff assists to bathroom and on and off toilet. She is too weak
and SOB to be completely independent
at this time. Causal factor appears to be end-stage
cardiomyopathy.
Resident will be seen by Dr. Archibald M. Graham on nursing
home rounds.
Based on the above documentation, will proceed to care
planning.
�����������
��
������
RAP # 6
Mood State:
Resident is very unhappy here. Cries often “I want to go
home”. States that she can’t make it another
day without her husband. Many complaints about the staff,
food, other residents, etc.
Causal factor appears to be sadness due to being apart from her
husband.
Resident will be seen by Dr. Archibald M. Graham at nursing
home rounds.
Based on above documentation, will proceed with care planning.
24. �����������
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RAP # 8
Falls:
Resident is at risk for falls based on the fact that she takes
psychotropic medications. She has not fallen
since she has been here. She needs assistance of 1 to transfer
and ambulate. In the wheelchair she must
be pushed to and from all locations as she becomes SOB if
doing it herself. No restraints are being
used. No complaints of vertigo, etc.
Causal factors appear to be triggered by psychotropic drug
usage.
Based on above documentation, will proceed with care planning.
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Sundance Medical Center
Painted Valley, USA
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Physician Orders and Progress NotesForm # _ _ _ _
26. Nortriptyline HCL 10 mg po qd
Digoxin 0.125 mg po qod
Diet: Low sodium, low cholesterol. Lactose
intolerance. No dairy products.
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6/13/xx Two step Mantoux
Standing orders
VO Dr. Archibald M. Graham / ������������ �
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6/13/xx Standing Orders for Area Nursing Facility Residents
To The Physician: Please draw a RED LINE Through
orders you DO NOT WISH resident to receive. All
other orders may be implemented by the nurse at the
time without contacting the physician.
At the time of implementation of a standing order, the
28. 6/13/xx
1. ACHING/FEVER: Acetaminophen 650 mg. po
prn /fever > 100 po or tympanic 101 rectal.
2. BOWEL MANAGEMENT:
a. MOM 30 cc po q.d. prn
b. Fleets Enema ® q.d. prn
3. CATHETERIZATION:
a. Straight catheterize prn for UA
b. Straight catheterize prn inability to void: notify
MD within 24 hours
4. CERUMEN: Ear wax removal per facility protocol.
5. COUGH: Guaifenesin (pharmacy stock) 10 cc po
q.4h. p.r.n.
6. DRY AND/OR IRRITATED EYES: Methyicellulose
(pharmacy stock) eye drop to affected eye(s)
q.4h. prn.
7. DIARRHEAL: Kaopectate Concentrate 2
tablespoons after each loose stool prn not to exceed
29. 7 doses in a 24 our period.
8. DYSPNEA: Oxygen 2 liters/min prn nasal cannula:
contact physician for order if mask is indicated.
9. GI DISTRESS: Antacid (pharmacy stock) 1
teaspoon po q4h prn.
10. IMMUNIZATION: Influenza vaccine 0.5 mg (IM)
X 1 dose annually.
Diphtheria and tetanus (IM) according to facility
policy.
a. If a resident has never received a Diphthia/
Tetanus series, give:
1.0.5 cc D/T initially
2.0.5 cc DT 4-8 weeks later
3.0.5 cc DP 6 months later
b. If a booster is needed, give adult Diphtheria/
Tetanus 0.5 cc
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31. b. tract infection suspect:
c. Dipstrick for leukocytes and nitrates prn
symptoms or UTI. Call MD for orders if results
positive.
d. Or UA if symptomatic
12. REHABILITATION SERVICES (PT. OT.
SPEECH): Screen/evaluate and treat as indicated.
13. SKIN BREAKDOWN:
a. Cleanse open areas with normal saline daily and
leave open to air.
b. Transparent dressing to open areas until healed.
Change prn.
c. Hydroactive dressing to pressure ulcer until
healed. Change prn.
d. Steri-strips prn minor lacerations.
14. THERAPEUTIC LOA: May go on therapeutic leave
of absence with current meds according to facility
policy.
33. ANY TIME DURING THIS RESIDENT’S STAY
WITHOUT NOTIFYING ME. ANY ORDER NOT
USED FOR 30 DAYS MAY BE DROPPED FROM
CURRENT ORDERS AND RESTARTED AT ANY
TIME WITHOUT NOTIFYING ME.
6/13/xx ��������
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6/14/xx OT for Strengthening, endurance building and
ADL training.
TO Dr. Archibald M. Graham / ������������ �
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6/18/xx Okay for patient to transfer to St. Mary's Care Center
for continued skilled nursing care.
TO Dr. Archibald M. Graham / ������������ �
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35. activities earlier this afternoon. No complaints.
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10:00pm T 99, R 72, P 20, BP 108/56. In wheelchair visiting
with another resident in the library earlier.
Now refusing to sleep in her room. States the room is too small
and she feels like she can’t
breathe when she is in there. Wants to sit in the recliner near
the nurse’s station for now.
Margie Cutler, RN
11:00 p.m Has been dozing in the recliner. Now is awake and
requesting to go to the bathroom.
Assisted to the bedroom in her room. Voided a large amount
and had a moderate small
brown bowel movement. Still refuses to stay in her room.
Margie Cutler, RN
6/14/xx
2:00 a.m T 98.2, R 80, P22, BP 108/62 Has been dozing while
reclined in the recliner by the
nurses station.
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37. Room 773
# 822999
1:00 p.m Patient was evaluated and treated initially by Physical
Therapy.
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3:00 p.m Asked to speak with husband on the phone.
Afterwards the patient stated that she does not
want to stay here because no one is caring for her. Husband
called and spoke to the head
nurse. Husband was assured that Jane’s needs are being
attended to.
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4:30 p.m Social worker here to see patient.
Margie Cutler, RN
7:00 p.m Family came and brought the resident’s husband. He
lives in their home about 30 miles away.
Patient would like to return home with her husband. Family is
stressing the need to stay in this
facility for awhile until she gets stronger and can return to her
home with home health support.
38. Margie Cutler, RN
10:00 p.m Appearing sleepy and wants to go to bed. Resident
still does not want to sleep in her room.
States that it is too small but will try it tonight.
Margie Cutler, RN
6/15/xx
6:00am Appears to have slept all night. No complaints.
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10:00 am Resident was hit on the forehead by another resident.
No break in skin, Resident states
head does not hurt and glasses were not hit. Calm and sitting in
chair. Will continue to
observe for potential injury. BP 96/68, P116, R 24, PERL.
Grasp equal and strong.
Denies any discomfort. States, “I’m not scared”.
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Sundance Medical Center
Painted Valley, USA
40. who close by. Is able to feed self after the food has been cut-up
and containers are opened
for her. Hollers throughout meals, “I don’t like that” and “This
is not fit to eat.” Also has
been having weepy episodes and states, “I want to get out of
here and go home”.
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6/17/xx
10:05am Talked to son and a Care Conference is scheduled for
tomorrow
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2:35 p.m Resident is oriented to person, place and time. Verbal
abuse is increasing to all staff and
other residents. Spends very little time in her room. States, “It
is too small and cold. I
just can’t stay in there”.
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6/18/xx 10:025am Patient prepared for discharge and transfer.
Transfer to St. Mary’s Care Center
42. Dare, Jane
Dr. Archibald M. Graham
Room 773
# 822999
PT notes
6/14/x Initial treatment: Resident transferred well with minimal
assistance. Independent bed mobility.
Strength is equal bilaterally. 4/5 hip musculature, 4/5 quads, 5/5
hamstrings, 4/5 ankle. Sitting
and standing balance is good. Ambulated 60’ with wheeled
walker and minimal assistance of
one. Will see 5 times a week for exercise and gait training with
goal of independence in
mobility.
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Social worker notes
6/14/x Tried talking with patient when she was in her
wheelchair by the nurses station. She was angry
and I was unable to have a conversation with her. A few
minutes later she was in the dining
room and came with me into the library. Her mood had changed
drastically and I was able to
43. review the Bill of Rights. Patient was pleasant but her answers
were short phrases.
Patient would like to return to her home. Explained to patient
that a decision was made with
her, her family and her physician to spend some time in this
facility after her stay in the hospital.
The ultimate plan is for her return to her home to be with her
husband. Son requests a Care
Conference and it is scheduled for 6/18/xx.
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OT notes
6/15/xx Resident is being seen for ADL training. She is alert
and oriented. She states that her goal is
to return to previous living with her husband. Strength and
endurance is poor. Functional skills
have decreased due to deceased strength and endurance.
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PT
6/16/xx Resident is independent in bed mobility. Transfers with
standby assistance. Walks 50’ with
45. Dare, Jane
Dr. Archibald M. Graham
Room 773
# 822999
OT notes
6/17/xx Jane has been pleasant and cooperative. Occasionally
she has SOB and decreased
endurance due to high humidity weather. Overall demonstrates
improving strength,
endurance and standing tolerance through increasing weights,
repeated exercises, and
increasing standing time. Resident would benefit from
continued occupational therapy.
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Care Conference 6/18/xx
Son states that his mother wants to be near his father who lives
in Northwild, about 30 miles
away but his father would not be able to care for her and she is
not yet a candidate for home
health. There is a long term care facility a short distance from
their home with a current opening
at this time. The son believes that his mother would be much
happier if a transfer could be
46. made as soon as possible. Arrangements will be made.
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6/18/xx Physical and Occupational Therapy Discharge Summary
Jane received physical and occupational therapy from the time
she was admitted to our facility
through her discharge. She progressed from assistance of 1
with transfers and ambulation to
minimal assistance only. She is independent in bed mobility.
Strength has improved, as has her
endurance. The resident can ambulate 100 to 150 feet with a
wheeled walker. She can
ambulate without a walker, but gait pattern is poor. Her largest
remaining problem is shortness
of breath, and this limits her activity level. We have been
unable to have her become completely
independent of the wheelchair because of this.
Our recommendations are that Jane continue to ambulate at least
1 to 2 times/day, and
that she be encourage to participate in her cares as much as
possible.
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48. FINDINGS: PA and lateral chest compared with 6-7-xx. There
has been slight improvement in the left
lower lung field infiltrate. Small bilateral pleural fluid
collections persist. Stable cardiac and mediastinal
silhouettes.
CONCLUSION: Slight interval improvement of the appearance
of the chest.
WCR/bca
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