NY Fidelis Care Care for Older Adults Assessment Form 2014 free printable template
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FUNCTIONAL STATUS ASSESSMENT Circle those that apply CARE OF OLDER ADULTS ASSESSMENT FORM Patient DOB Member ID Physician Name Cognitive Status Intact Impaired Depressed Not Oriented X Person Place Time circle Ambulation Status Normal/Good Fair Poor Needs assistive device Y / N Sensory Ability Independent Y / N Non Ambulatory Y / N Cane Walker Wheel Chair Scooter Hearing Good Impaired Deaf Use of Hearing Aids/ Device Vision Impaired Uses Glasses/contacts Cataracts Glaucoma Macular...
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How to fill out NY Fidelis Care Care for Older Adults
How to fill out NY Fidelis Care Care for Older Adults Assessment
01
Gather necessary personal information such as name, address, date of birth, and insurance details.
02
Review the assessment form to understand the sections and questions it contains.
03
Begin with the demographic information section and fill in your details accurately.
04
Proceed to the health assessment section, providing information about medical history, current medications, and any ongoing treatments.
05
Complete the functional abilities section, indicating any assistance needed with daily living activities such as bathing, dressing, or meal preparation.
06
Fill in the social and emotional well-being section, mentioning support systems and any mental health concerns.
07
Review the completed assessment for accuracy and ensure all sections are filled out.
08
Submit the assessment to the appropriate office or through the specified online portal.
Who needs NY Fidelis Care Care for Older Adults Assessment?
01
Individuals aged 65 and older who are enrolled in NY Fidelis Care.
02
Caregivers or family members of older adults seeking support services.
03
Older adults requiring assessments for long-term care or additional services.
04
individuals assessing their healthcare options and eligibility for additional assistance.
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What is NY Fidelis Care Care for Older Adults Assessment?
The NY Fidelis Care Care for Older Adults Assessment is a comprehensive evaluation designed to assess the health and wellness needs of older adults enrolled in Fidelis Care.
Who is required to file NY Fidelis Care Care for Older Adults Assessment?
Healthcare providers and professionals who are involved in the care of older adults enrolled in Fidelis Care are required to file the assessment.
How to fill out NY Fidelis Care Care for Older Adults Assessment?
To fill out the NY Fidelis Care Care for Older Adults Assessment, providers need to complete the assessment form using detailed information about the patient's health status, functional abilities, and support needs.
What is the purpose of NY Fidelis Care Care for Older Adults Assessment?
The purpose of the NY Fidelis Care Care for Older Adults Assessment is to identify the specific health and care needs of older adults, allowing for tailored care plans and support services.
What information must be reported on NY Fidelis Care Care for Older Adults Assessment?
The assessment must report information such as the patient's medical history, current health conditions, functional status, social support systems, and any required interventions or services.
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