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Admissions > 06 Pre-Admission (61 docs) > 01 Assessments ( 39 docs)

01 Assessments ( 39 docs)

Free Forms, caregiving, nursing forms, policies, Licensing, Training, Case Management, Home Care, Assisted Living, DD, MI, HCBS

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Documents in 01 Assessments ( 39 docs) (42)

Upon admission to a care facility an Activity Assessment and Care Plan should be completed for the resident.  It is very important to establish and document activity plans for new residents.

An Activity Assessment may be required by the licensing agency.  The Resident Activity Interest Form was designed to give an overall idea of many areas that might be of interest to the resident. Activity Assessment & Care Plan
This NEW wonderful from help the caregiver review problem areas, challenges, best approaches and more! This form not only provides an initial assessment to help you determine if the resident is suitable for your care services and admission,  it also provides a vehicle for assessing ongoing needs and tracking abilities, challenges, problem areas and symptoms.  ( 8 page Assessment used for pre-admission, admission, retention and history) More questions, easy to use, address falls, assaultive behavior and more. Alzheimer's & Dementia Assessment Pre-Admission, Admission/Retention/History
Article on Measuring Cognition Article on Measuring Cognition
This article addresses the importance of assessing residents' basic mental traits prior to admission in a Care Facility.  
A small mental health section is included on the Pre-Admission Appraisal Assessment Form.  If the answers received indicate the prospective resident has some confusion or other mental problems, the Mental Assessment Questionnaire and Mini-Mental Worksheet should be completed.  These forms should give the person doing the assessment a basic history of the mental health of the potential resident as well as an idea of what kind of observation services the resident will need.  If the provider takes residents who are confused or who have some degree of mental illness this type of information is essential. 
Residents who have a history of being sexually inappropriate or assaultive are often difficult to place.  For this reason Assessing Basic Mental Traits
The more information known about the resident's physical and mental condition, the better his/her needs can be determined when an incident or accident occurs.  Excellent tool for training community based care staff.

The more information known about the resident's physical and mental condition, the better his/her needs can be determined. In cases of litigation the Pre-Admission Appraisal Assessment Form, Mental Assessment Questionnaire, Skin and Body Assessment (Form), Nutritional Assessment Form, Resident Activity Interest Form, Levels of Care Assessment Form and the Physician's Report (Form) can be the facility's protection.

When properly completed, the Pre-Admission Appraisal Form demonstrates that the facility... Assessing From Head to Toe - staff training for residential care homes
Free Assessing Time for Services - HTG Ref Guide - this document gives examples of how much time a care giving task may take. Assessing Time for Services - HTG Ref Guide
Cover page for section 6-01 of the Admissions Manual. Assessments Cover
This form used by a Residential Care or Assisted Living facility to assist in assessing a resident's behavior.  Tool for Case Management Assessment for Behaviors  It should be used with the Mini-mental exam and other assessments forms to determine the resident's behavior care needs. Behavioral Assessment, Case Management Assessment for Behaviors
Free Berg Balance Scale Fall Assessment Test - a test to help determine fall risk level. Berg Balance Scale Fall Assessment Test
DADS Texas Individual Profile nformation Form - Free DADS Texas Individual Profile Information Form - Free
A form used by a Care Facility to assess a resident's ability to self store medications and that is to be signed by the resident's physician.  The form requires the physician to answer certain questions about the resident's ability to self-store their medications. Doctor's Assessment - Resident Ability for Self Stored Medications
A resident in any type of care facility can get confused and wander away at anytime, or run away, elope. This Potential Wanderer Risk Elopement Assessment Form is used to help evaluate the potential for a resident to wanderer away from a community-based type care facility. Elopement Wanderer Risk Assessment Form
This free document contains links to various fall risk assessments that are commonly used to help determine a person's fall risk level. Resident Fall Assessments include:
Dynamic Gait Index  - 
Tinetti Performance Oriented Mobility Assessment (POMA) 
VA's Get Up and Go Test  
Berg Balance Scale (BBS) 
Activities-specific Balance Confidence (ABC) Scale 

Other Helpful ProvidersWeb Documents: Resident Fall Prevention Care Plan,  Post Fall Management Plan Fall Risk Assessments - For Community Based Care
Free resident assessment and resident intervention log.  For assisted living, home and community based services.  Procedure for caring for developmentally disabled residents.  Procedures for caring for mentally ill residents.  CMS RAP Free Assessment and Intervention Log
Free Asthma Assessment by www.getasthmahelp.org Free Asthma Assessment
free form - Unified Parkinsons Disease Rating Scale free form - Unified Parkinsons Disease Rating Scale
The Tinetti assessment tool is an easily administered task-oriented test that measures an older adult's gait and balance abilities. Free Tinetti Performance Oriented Mobility Assessment
GAF basic assessment for psychological, social, and occupational functioning on a hypothetical continuum of mental health-illness. It does not include impairment in functioning due to physical (or environmental) limitations. Global Assessment of Functioning (GAF) Scale
Free Information on how to do a functional assessment for Behavior Issues. How to Conduct a Functional Assessment for Behavior Issues
Risk Prevention Plan for community care homes and HCBS programs. This Risk Prevention Plan is used help minimize or eliminate the Identified Risk.  This document needs to be readily available to staff working directly with the individual.  It is used as a guide for caregivers.  If the unsafe risk cannot be safely managed, then transferring to a higher level care home is usually warranted if third party providers cannot be utilized to meet the individual?s needs.  Homes for elderly, developmentally disabled and mental ill.  Case Management Form Individual Risk Prevention Plan
Links to the Kingston Assessments for residents with dementia. Kingston Assessment Links
This Levels of Care Assessment Form was designed to assist the caregiver or admission coordinator to help determine the level of care a resident may need.  This form is simple to use - any assisted living staff could complete it.  Upon admission, the resident will be assessed for the Level of Care Service that needs to be provided.  After admission, if there are increases or decreases in the Level of Care this form can be updated and the corresponding Level of Care Rate can be applied. Levels of Care Assessment Form for Residential Care, Assisted Living & all types of Case Managers
This great free lifestyle assessment form is used to document the resident's business and personal information for the responsible party.  It is helpful for family members and can be given out free as part of the pre-admission packet. Lifestyle Assessment Form
A good form used to help staff assess a resident's mental capacity and potential behavior problems prior to admission to a residential care or assisted living facility. Mental Assessment Questionnaire
This form is used by community-based care facilities to help assess a resident's mental status.  It is a layman's tool only and it is not to be used to make a medical diagnosis. Used by Assisted living homes and residential care facilities. Mini-Mental Worksheet for Non-Medical Facilties
free information on Minimum Data Set MDS 3 Look Back Periods Minimum Data Set MDS 3 Look Back Periods
Before a resident is allowed to operate a mobility scooter in your facility you should complete the Operation Check List making sure that the person is able to operate the mobility scooter safely. Mobility Scooter Operation Check List for Assisted Living and Community Based Care Homes
A form used by a community-based care facility to assess a resident's nutritional intake.  List of areas to monitor, medical problems related to eating and nutrition, and common signs of malnutrition. RCFE, ALF, RCF, ARF Case Manager, Care Coordinator, Wellness Coordinator Nutritional Assessment Form for Community Based Care, Case Management
Free: OASIS Outcome and Assessment Information Set, free handbook. OASIS Outcome and Assessment Information Set - free handbook
A free form used to assess a resident's pain through non-verbal communication.  Great form for residential care homes for dementia. PAINAD Assessment
A great form that is completed by the resident's physician prior to admission to a Residential Care Facility.  This form is more detailed than the usual state's form, and most likely will help the care provider better assess the resident's potential for admission. Physician's Report (Form)
One of the most important forms to complete prior to accepting a resident for care.  This form works well for all types of care facilities.  This form has been developed over a 20 year period of time, with great updates added.  This form is a great tool for assisted living staff assessment and residential care facilities to help evaluate and assess a resident's health and care service needs prior to admittance to the facility.  

We cannot stress enough how important it is to assess a potential resident correctly, prior to accepting them for admission.  Facilities need to make sure they can handle all the resident's care needs.

This multi-page detailed form is an excellent tool for caregiving staff to assist in the pre-admission process. See Levels of Care Form.  Skilled Nursing Facilities typical follow Medi-Care criteria. Pre-Admission Appraisal Assessment Form
Pre-screening for Serious Mental Illness article includes federal definations Pre-screening for Serious Mental Illness
The document contains a linked list of over 40 resident assessments. Accepting the wrong resident can destroy a business.  One resident who is inappropriate for your facility could for example: harm another resident; need more care than the facility can handle which could lead to a negligent liability lawsuit; wander away from the facility; start a fire; go into a diabetic coma, etc.. Resident Care Assessments for Care Businesses over 40 assessments Case Management
Form used to determine if resident can handle their own laundry needs in a community based care home or assisted living facility. Resident Laundry Assessment Form
This good Resident's Health Status Form used to access resident's physical abilities for performing activities.  It can be used in tandem with the Pre-Admission Appraisal Form and/or the Levels of Care Form. Resident's Health Status - Assessment of Abilities
Risk & Unsafe Behavior Assessment for Community Carew Providers and Case Managers.  This assessment form is an excellent tool to evaluated high risk behaviors. Risk & Unsafe Behavior Assessment
A form used by the care home staff to assess a resident's ability to Self Medication Assessment Form
A good form used by care facilities to conduct and document a Skin and Body Assessment of the resident upon admission, and upon re-admission (even from the hospital). It is essential to document any bedsores, wounds, scars, bruises, rashes or other visble skin conditions, to safeguard the resident's health and to make sure the facility is not blamed for a pre-exsisting condition. Skin and Body Assessment (Form) for Community Care Case Managers & Staff
This is a questionnaire of religious and spiritual beliefs designed to help the provider understand how to better assist with spiritual health. Spiritual Assessment
This helpful form is designed to assist in recording the level of assistance needed when providing transfer-assist care.  Residents who need assistance with transferring on an ongoing basis are usually cared for in nurshing homes, or by utilizing Home Health to assist in monitoring the care in a community-based setting. Transfer Assist Assessment - Case Management Form
Good article on VIOLENCE RISK SCREENING IN COMMUNITY CORRECTIONS, much of the information can be applied to community residential settings. VIOLENCE RISK SCREENING IN Community Corrections
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