Latest acuity assessment
Level 3 — Moderate assistance
$6,300 / month base rate
annual renewal · target 2026-07-15
ADL score
12
0–28; higher = more independent
Falls / 90d
2
Cognition
mild
Behavioral risk
low
Medications
11
Mobility aid
walker
Diet
mechanical_soft
Wandering risk
No
Diagnoses
G20Parkinson's disease
Moved in 2025-09-10
Care notes
Mr. Reyes reported a near-fall at approximately 1630 in his room while reaching for his water glass on the nightstand. He caught himself on the bed rail and did not go to the floor. He denied hitting his head or any pain. Assessment completed — no visible injuries, vital signs stable, neurological check unremarkable. He acknowledged his balance can be unpredictable due to Parkinson's disease, especially later in the day when medication effects may wear off. Water glass and personal items repositioned within easier reach. Bed height lowered. Daughter notified by phone and asked that a therapy consult be considered. Will place PT referral request per supervisor guidance.
At approximately 1640 Mr. Reyes was found seated on the floor of his room near the bathroom doorway. He states he lost his balance turning around and slid down the wall — denies hitting his head. No visible injuries noted; resident alert and oriented x3. Charge nurse notified immediately and assessed Mr. Reyes; no apparent injury. Resident's Parkinson's disease-related postural instability identified as contributing factor. Incident report completed per policy. Daughter Elena notified by charge nurse at 1705. PT notified for re-evaluation. Resident reminded to use call light before transferring. Grip bar placement in bathroom to be reviewed with maintenance.
Met with Mr. Reyes and his daughter Elena for a 30-minute adjustment meeting. Mr. Reyes shared he is feeling more comfortable in the community but misses his home routine. Elena expressed concern about her father's Parkinson's disease progression and asked about what additional support services are available as needs change. Reviewed care plan with family, discussed PT involvement and medication management. Mr. Reyes identified enjoying dominoes and Spanish-language television — will coordinate with activities staff. Overall mood appears mildly anxious but hopeful. Will follow up in two weeks and revisit care conference scheduling.
Met with Mr. Reyes for a 30-minute adjustment check-in. He has been a resident for about 12 days and reports feeling 'okay but still getting used to it.' He expressed some sadness about losing independence, particularly around driving and cooking, which he connects to the progression of his Parkinson's disease. He remains socially engaged and has a strong support system — his daughter visits twice a week. Discussed coping strategies and encouraged him to express any concerns to staff. Will follow up in two weeks and coordinate with activities to identify hobbies that accommodate his motor limitations. No safety concerns at this time.
Mr. Reyes attended his first group activity today — afternoon music and reminiscing session in the common room. He was initially hesitant but warmed up quickly. He shared that he used to play guitar before his Parkinson's diagnosis made it too difficult, which sparked a great group conversation. He smiled frequently and stayed the full 45 minutes. Encouraged him to join chair exercises tomorrow morning, which he said he would consider. It was a great first group engagement since his move-in on 9/10. Staff will continue to invite him to low-impact programming.
Administered scheduled Carbidopa-Levodopa 25-100mg per physician orders at 0800. Mr. Reyes reports medication timing is very important to him — he asked that staff not delay doses as late administration worsens his Parkinson's symptoms. Note placed in MAR to flag on-time administration as a priority. Resident's swallowing appeared intact; medications taken with full glass of water without difficulty. Morning vitals: BP 118/72, HR 68, temp 98.1°F, SpO2 97% on room air. No complaints of dizziness or orthostatic symptoms reported at this time.
Initial PT evaluation completed with Mr. Reyes today. Resident presents with Parkinson's disease with notable bradykinesia, shuffling gait pattern, and mild postural instability. Berg Balance Score 38/56, indicating moderate fall risk. Timed Up and Go 18 seconds. Resident motivated and engaged during session, expressed concern about falling in new environment. Plan to see 3x/week focusing on gait training, balance exercises, and fall prevention strategies. Short-term goal: improve TUG to under 14 seconds within 4 weeks. Family notified of plan of care.
Administered Mr. Reyes's scheduled Carbidopa-Levodopa 25-100mg at 0800 as ordered. He reminded staff that timing of his Parkinson's medication is very important to him, and he was right — educated him that we will keep it on a consistent schedule. He took all medications without difficulty and drank a full glass of water. He reported some stiffness in his left hand this morning but said it usually improves after meds kick in. No signs of nausea or dizziness noted post-administration. Will continue to monitor.
Assisted Mr. Reyes with morning ADLs including dressing, grooming, and oral hygiene. He required moderate assistance with buttoning shirt due to hand tremors related to his Parkinson's disease. Ambulated to dining room with standby assist using his quad cane — gait was slow but steady this morning. Skin check completed; no redness or breakdown noted. Appetite at breakfast was good, finished approximately 75% of meal. Resident was pleasant and cooperative throughout. Reminded him of call light use and he verbalized understanding.
Assisted Mr. Reyes with morning ADLs including bathing, dressing, and grooming. He required moderate assist with buttoning his shirt due to hand tremors related to his Parkinson's disease. He was cooperative and in good spirits, joking with staff. Gait appeared slow but steady with walker. Reminded him to take small, deliberate steps. No complaints of pain. Appetite good at breakfast — finished most of his eggs and toast. Family called to check in; he spoke with his daughter for about 10 minutes and seemed happy afterward.