CTO/NOTES

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HS OBJECT DISPLAY            Jun 16, 2014@09:25:09          Page:    1 of    1 Detailed Display for HOSP COURSE SUMM 40-53 OBJ

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ORQQCN DETAIL Params -- literal	97 Results - Current Pat. Status:  Inpatient Ward:                 ZZTESTWARD Primary Eligibility:  EHR PATIENT (NOT VERIFIED) Patient Type:         NON-VETERAN (OTHER) OEF/OIF:              NO

Order Information To Service:           PHYSICAL THERAPY From Service:         ZZTESTWARD Requesting Provider:  KING,MATTHEW M Service is to be rendered on an INPATIENT basis Place:                Consultant's choice Urgency:              Routine Earliest Appr. Date:  Apr 29, 2014 Orderable Item:       PHYSICAL THERAPY Consult:              Consult Request Reason For Request: This is a routine request to evaluate this patient for fall risk and physical therapy to reduce the risk of falling. Inter-facility Information This is not an inter-facility consult request.

Status:               COMPLETE Last Action:          COMPLETE/UPDATE

Facility Activity               Date/Time/Zone      Responsible Person  Entered By --- CPRS RELEASED ORDER    04/29/14 14:25      KING,MATTHEW M      KING,MATTHEW M RECEIVED                04/29/14 14:32      KING,MATTHEW M      KING,MATTHEW M SCHEDULED               04/29/14 14:34      KING,MATTHEW M      KING,MATTHEW M CNKXNKX NCKCX

COMPLETE/UPDATE        04/29/14 14:39      KING,MATTHEW M      KING,MATTHEW M

Note: TIME ZONE is local if not indicated

LOCAL TITLE: PHYSICAL THERAPY CONSULT RESULT STANDARD TITLE: PHYSICAL THERAPY CONSULT DATE OF NOTE: APR 29, 2014@14:35    ENTRY DATE: APR 29, 2014@14:36:12 AUTHOR: KING,MATTHEW M      EXP COSIGNER: URGENCY:                           STATUS: COMPLETED

PHYSICAL THERAPY EVALUATION

PAST MEDICAL HISTORY:

PATIENT GOALS:

PREVIOUS LEVEL OF FUNCION/SOCIAL ENVIRONMENT (LIVING ARRANGEMENTS, EQUIPMENT, ECT.):

PHYSICAL ASSESSMENT

SPEECH:     VISION:     HEARING: ROM:

STRENGTH:

TRANSFERS:

BED MOBILITY:

BALANCE: SITTING STATIC      DYNAMIC STANDING STATIC     DYNAMIC

GAIT:

SENSATION:

SKIN:

ENDURANCE:

PAIN LEVEL:

BARRIERS TO LEARNING:

ASSESSMENT:

GOALS: independently in 4 weeks

independently in 4 weeks

Patient will ambulate 250 feet independently in 4 weeks

0 pain in 4 weeks

ADDITIONAL GOALS:

TREATMENT PLAN:

FREQUENCY/DURATION:


 * PLEASE ADD THE CONSULTING PROVIDER AS AN ADDITIONAL SIGNER TO THIS NOTE**

/es/ MATTHEW M KING, MD Medical Physician Signed: 04/29/2014 14:39

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