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Questions and Answers
What is the primary phone number of the patient?
Who is the patient's primary care physician?
Where is the patient's next appointment with Dr. Sanjay Patari?
What is the patient's address?
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Does the patient have a Foley?
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Who is the patient's contact person?
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What is the patient's current living situation?
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Is the patient able to get to their primary doctor's office for follow-up?
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What is the patient's inpatient discharge date?
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Who is the DC planner?
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Study Notes
Patient Information
- Patient's name: Jeanette Short
- Address: 388 Jervey Ln, Bartlett
- Primary Phone: 217-259-3320
- Email: Not provided
- Referral Source: The Oaks of Bartlett
- PCP: Dr. Shahab Mohiuddin
Medical History
- COVID status: No signs or symptoms, negative test result
- Last MD Appt: Visited during hospitalization
- Next MD Appt: Pending
- Inpatient DC Date/Facility: 6/20/24
Referral and Orders
- DC Planner: Dajeet
- Orders: Yes
- MD Confirmed: Yes
Consent and Family
- Patient can sign consent
- Family to contact: Allen (spouse)
- Contact Info Confirmed: Yes
- Family needs to be called: Yes
Living Situation
- Lives at home with spouse Allen
- Pharmacy used: Not specified
- Able to get to primary doctor’s office for follow-up: Not specified
- MD @ HOME NEEDED: Not specified
- Equipment needed: Not specified
- DME Company: Not specified
- DME ordered: Not specified
- DME @ Home: Not specified
Medical Care
- PT/INR: Not specified
- Next Lab: Not specified
- Following MD: Not specified
- Wounds: Not specified
- Foley: Not specified
- Managing MD: Not specified
- Last Change Date: Not specified
Additional Information
- Next appointment with Dr. Sanjay Patari on July 3rd
- RN/PT/OT: Not specified
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Description
A checklist for home health care, including patient information and COVID-19 screening.
