TCM Nurse Note_Contact Made

Transitional Care Management Initial Contact Note
Date of admission: [date name="date_of_admission"]
Date of discharge: [date name="date_of_discharge"]
Hospital: [text name="hospital" default="Name of hospital"]
Attending Physician: [text name="attending" default="Attending provider name, if known"]
Reason for Hospitalization: [textarea name="reason" default=""]
Discharge Diagnoses: [textarea name="discharge_diagnoses" default=""][select name="Records" value="Records available and uploaded into GehriMed.|Records request sent today."]
Date of Initial Contact:[date name="contact_date" default="08/27/2021"]
Contact made by: [select name="Person_contacting_patient" value="Lisa Lemin, LPN|Lynn Capelli, LPN|Jamie Roosa, LPN|Lisa Taylor, BSW|Cory Cornett, LPN|Kayla Tugwell "]
Spoke with:[comment memo="Check all that apply"][checkbox name="Contact_Person" value="Patient|Patient's power of attorney|Patient's primary caregiver|Facility nurse responsible for patient"]
Medication reconciliation was performed today.
The patient has the following NEW medications:[textarea name="New_meds" default="No new medications."]
The following medications were stopped:[textarea name="Stopped_meds" default="No medications were stopped."][select name="Med_Issues" value="The patient has no problems or concerns with current medications.|The patient has problems or concerns with medications, message sent to provider."][text name="Med_Problems" memo="Description of medication problems, leave blank if none"][select name="Med_Refills" value="The patient denies needing prescriptions or refills at this time.|The patient needs a prescription for medication, message sent to provider."][text name="Med_Needs" memo="Medications needed, leave blank if none"]
Pending Labs and Imaging Studies: [textarea name="pending_findings" default="No studies or lab results were pending at the time of discharge."]
Recommended Outpatient Evaluations/Appointments: [textarea name="outpatient_evaluations" default="No outpatient appointments were recommended."]Home health services: [select name="HH_Services" value="The patient was referred to home health and services have started.|The patient was referred to home health, awaiting initial assessment.|The patient was not referred to home health."][text name="Agency_Name" memo="Name of home health agency, leave blank if none"]
We reviewed the hospital discharge instructions together. The patient and/or caregiver was given the opportunity to ask questions.
Summary of transition: [textarea name="Transition_summary" memo="How is the patient handling their transition home? Do they feel their condition is stable enough to be safe at home?"][select name="New_Symptoms" value="The patient has new or unresolved symptoms that require urgent attention, message sent to provider.|The patient denies any new or unresolved symptoms that require urgent attention."][select name="DME_Needs" value="The patient has a need for DME equipment, message sent to provider.|The patient does not have any needs for DME equipment at this time."][select name="Scheduling_Appts" value="The patient needs assistance with scheduling follow-up appointments, assistance provided.|The patient does not need assistance with scheduling follow-up appointments."][select name="Questions" value="The patient has questions about their discharge instructions that could not be addressed today, message sent to provider.|The patient has no additional questions about their discharge instructions."]
Scheduled TCM Provider Visit: [date name="date_of_visit"]