PFEDeviceRequestLocation: Skilled nursing facility

PFEDeviceRequestUser

• user: Betsy Smith-Johnson Female, DoB Unknown ( http://example.org/identifiers/patient#10A3D58WH1600)
• relationship: Used By

PFEDeviceRequestUser

• user: PractitionerRole Physiotherapist
• relationship: Managed By

PFEDeviceRequestClinicalJustification

• note: Betsy requires a rolling walker to support safe ambulation, transfers, and participation in rehabilitation activities while recovering from stroke-related right-sided weakness and physical deconditioning. In her current state, Betsy is unable to ambulate safely and has been assessed as a fall risk. The use of the walker during physical therapy will support the patient's ability to decrease her fall risk.
• assessment: Observation Mobility - admission performance during 3 day assessment period [CMS Assessment]
• assessment: Observation Self-care - admission performance [CMS Assessment]
• use-of-device: DeviceUseStatement: status = active; recordedOn = 2020-07-11 16:32:00-0500
• goal: Goal: lifecycleStatus = active; achievementStatus = In Progress; description = Able to walk in room (finding); start[x] = 2024-01-18; note = Betsy will be able to complete safe functional mobility independently including navigating around furniture and maintaining balance to decrease risk of falls

basedOn: ServiceRequest Physical therapy assessment (procedure)

priorRequest: DeviceRequest: extension = ; status = completed; intent = order; code[x] = ->Device: distinctIdentifier = WHLCHR-E1130-FLA-FDR; manufactureDate = 2024-01-15; expirationDate = 2030-01-15; lotNumber = LOT20240115; serialNumber = SN-WC-E1130-001; type = Standard wheelchair, fixed full length arms, fixed or swing away detachable footrests

status: Active

intent: Order

priority: Routine

code: Walker, folding, wheeled, adjustable or fixed height

Parameters

subject: Betsy Smith-Johnson Female, DoB Unknown ( http://example.org/identifiers/patient#10A3D58WH1600)

encounter: Encounter: status = in-progress; class = inpatient encounter (ActCode#IMP); type = Skilled nursing facility; period = 2024-07-17 09:30:00-0500 --> (ongoing); reasonCode = Physical therapy assessment (procedure)

occurrence: 2024-07-18

authoredOn: 2024-07-17

requester: PractitionerRole Physiotherapist

reasonCode: Physical deconditioning (finding)

reasonReference: Condition Right hemiparesis (disorder)

insurance: Coverage: identifier = Member Number: PAS-987654321; status = active; subscriberId = SUB-123456789; relationship = Self

supportingInfo:

• RiskAssessment
• Observation Walk 10 feet - functional ability during 3 day assessment period [CMS Assessment]
• Observation Walk 50 feet with two turns - functional ability during 3 day assessment period [CMS Assessment]
• Encounter: status = in-progress; class = inpatient encounter (ActCode#IMP); type = Skilled nursing facility; period = 2024-07-17 09:30:00-0500 --> (ongoing); reasonCode = Physical therapy assessment (procedure)

note:

Order for a rolling walker to support mobility rehabilitation and to reduce fall risk.