Latest acuity assessment
Level 3 — Moderate assistance
$6,300 / month base rate
annual renewal · target 2026-06-15
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 2025-06-30
Care notes
Mr. Ostrowski was found sitting on the floor of his bathroom at approximately 6:55 PM. He stated he stood from the toilet without using the grab bar and felt his legs 'give out,' a concern consistent with the postural instability associated with his Parkinson's disease. No loss of consciousness reported. Neuro checks completed x4 — all within normal limits. No lacerations or visible bruising. Vital signs stable. MD notified; no orders given at this time. Daughter Karen contacted and updated. PT notified for reassessment. Fall risk interventions reviewed with resident; bed alarm reactivated and non-slip footwear reinforced.
Met with Mr. Ostrowski for a 30-day adjustment check-in. He shared that he is beginning to feel more comfortable but admits evenings feel lonely. His daughter, who lives about an hour away, visits on weekends. He expressed some sadness about the changes his Parkinson's disease has brought to his independence, stating 'I just wish I could do more myself.' Provided supportive listening and discussed coping strategies. Encouraged participation in the afternoon social hour program. Will explore a referral to the facility support group for residents managing progressive neurological conditions. Follow-up scheduled in two weeks.
Met with Mr. Ostrowski and his daughter Karen for a brief adjustment check-in. He shared that he misses his home but feels the staff are kind. Karen expressed some concern about medication timing related to his Parkinson's disease and was reassured that the care team has a standing reminder in place. Discussed the community's activity calendar and encouraged Mr. Ostrowski to try the afternoon music program, which he showed interest in. No significant psychosocial concerns at this time. Follow-up scheduled in 30 days or sooner if needed.
Nutrition assessment completed for Mr. Ostrowski. Weight on admission 168 lbs; current weight 165 lbs, a 3 lb decrease in two weeks, which will be monitored closely. Due to dysphagia risk associated with Parkinson's disease, a swallow screen was recommended and referral placed for SLP. Currently on regular diet with thickened liquids pending SLP evaluation. He expressed preference for Eastern European foods and dislikes fish. Kitchen notified of preferences. Will reassess weight weekly and follow up after SLP evaluation. Appetite reported as improving compared to first few days post-move-in.
Initial PT evaluation completed with Mr. Ostrowski. He presents with reduced stride length and festinating gait pattern related to Parkinson's disease, as well as decreased postural stability. Berg Balance Scale administered; scored 38/56, indicating moderate fall risk. He was engaged and motivated during the session. Short-term goals set: improve gait safety with verbal cueing strategies and introduce LSVT BIG-style exercises. Recommend 3x weekly PT sessions. Family member present via phone call; goals reviewed with them as well. Will coordinate with nursing on fall precaution implementation.
Initial PT evaluation completed with Mr. Ostrowski today. Gait assessment revealed shortened stride length and reduced arm swing bilaterally, characteristic of Parkinson's disease. He demonstrated mild postural instability on the pull test. Functional transfers from chair to standing require contact-guard assistance. Timed Up and Go was 22 seconds. Mr. Ostrowski was motivated and engaged throughout the session. Plan to initiate twice-weekly PT focusing on gait training, balance, and fall prevention strategies. Discussed goals with resident; he expressed desire to walk to the dining room independently.
Medication pass completed without issue. Mr. Ostrowski received his Carbidopa-Levodopa as scheduled. He reminded staff of the importance of on-time dosing, which was noted and flagged for the care team. Observed mild resting tremor in right hand, consistent with his Parkinson's disease diagnosis. No complaints of pain. Vital signs stable: BP 118/72, HR 68, SpO2 97%. He was sitting in recliner watching television and appeared comfortable. Encouraged fluids; he accepted a full glass of water.
Medication administration completed as scheduled, including Carbidopa-Levodopa. Mr. Ostrowski reported his medications are being given at the same times as at home, which he appreciated. Noted mild hand tremor at rest, expected with Parkinson's disease diagnosis. No signs of dyskinesia observed at this time. He verbalized understanding of the importance of on-time med delivery and asked that staff knock before entering. Care preferences documented and shared with oncoming shift. No complaints of pain. Appetite reported as fair at lunch.
Assisted Mr. Ostrowski with morning ADLs including bathing, dressing, and oral care. He required moderate assist for transfers due to rigidity and shuffling gait consistent with his Parkinson's disease. Skin intact, no redness noted on bony prominences. He was pleasant and cooperative throughout. Reminded him about the call light and encouraged him to use it before attempting to stand. Breakfast tray delivered to room per his request while still settling in. Vital signs stable.
Mr. Ostrowski is settling into his room and getting familiar with the layout. Assisted with morning ADLs including dressing and grooming. He moves slowly due to Parkinson's disease and needed moderate assistance with button fastening and shoe tying. No skin breakdown noted on back or heels. Reminded him to use his call light before standing. He was pleasant and cooperative throughout. Appetite at breakfast was good — finished about 75% of his meal. Family called to check in; transferred to social services.