Five Star - Immobility

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Home Home

Immobility

Problem: Maintaining or improving residents’ range of motion— and therefore their daily living activities—is critical. Immobility is one of ten quality measures (QMs) used to evaluate your facility’s overall performance, and is assessed on these four CMS regulations:

F317 1. A resident who enters the facility without a limited range of motion does not experience reduction in range of motion unless the resident’s clinical condition demonstrates that a reduction in range of motion is unavoidable; and See Interpretive Guidelines at F318.

F318 2. A resident with a limited range of motion receives appropriate treatment and services to increase range of motion and/or to prevent further decrease in range of motion.
Intent §483.25(e): The intent of this regulation is to ensure that the resident reaches and maintains his or her highest level of range of motion and to prevent avoidable decline of range of motion.

F310 A resident’s abilities in activities of daily living do not diminish unless circumstances of the individual’s clinical condition demonstrate that diminution was unavoidable. This includes the resident’s ability to: (i) Bathe, dress, and groom; (ii) Transfer and ambulate; (iii) Toilet; (iv) Eat; and (v)Use speech, language, or other functional communication systems.
Intent §483.25(a): The intent of this regulation is that the facility must ensure that a resident’s abilities in ADLs do not deteriorate unless the deterioration was unavoidable.

F309 Each resident must receive and the facility must provide the necessary care and services to attain or maintain the highest practicable physical, mental, and psychosocial well-being, in accordance with the comprehensive assessment and plan of care.
Intent §483.25: The facility must ensure that the resident obtains optimal improvement or does not deteriorate within the limits of a resident’s right to refuse treatment, and within the limits of recognized pathology and the normal aging process.

Solution: To help you improve your nursing home’s immobility quality outcomes—and its CMS Five-Star quality rating—Briggs has assembled the precise documentation, charting. education and training, and medical supplies you’ll need. Remember, every Briggs form integrates industry best practices, and has been recognized by customers as best-of-class.

Download the Quality Improvement Measure Guide for Immobility [PDF].

Documentation
		Pack	List Price
Rehabilitation & Therapy
CFS10-1HH	Rehabilitation Screen	100/pad	12.28
CFS10-1HF	Rehabilitation Screen	100/pad	12.28
3789HH	Rehabilitation Evaluation	100/pk	28.72
3790HH	Rehabilitation Treatment Plan	100/pad	12.28
3628	Resident Functional Assessment	100/pad	9.54
CFS6-12HH	Range of Motion Assessment	100/pad	12.28
CFS6-12HF	Range of Motion Assessment	100/pad	12.28
3626	Rehabilitation Nursing Program Evaluation	100/pad	9.54
CFS10-6HH	Therapy Treatment Progress Notes	100/pad	12.28
CFS10-6HF	Therapy Treatment Progress Notes	100/pad	12.28
CFS10-5/4P	Therapy Progress Notes	100/pk	43.45
1045	Therapy Notes	100/pad	11.67
3794P	Occupational Therapy Daily Service and Treatment Grid	100/pk	46.65
CFS10-3HH	Occupational Therapy Evaluation and Treatment Plan	100/pad	12.28
3793P	Occupational Therapy Progress Status	100/pad	10.2
1009B	Physical Therapy Progress Record	100/pad	11.67
1008	14-Month Physical Therapy Record	100/pad	11.67
1433/2	Physical Therapy	100/pk	31.95
3791P	Physical Therapy Progress Status	100/pad	10.20
3792P	Physical Therapy Daily Service and Treatment Grid	100/pk	46.95
CFS10-2HH	Physical Therapy Evaluation and Treatment Plan	100/pad	12.28
3424P	Tinette Assessment tool:Balance and Gait	100/pad	10.20
Restorative Nursing
3715HH	Restorative Nursing Program Needs Identification	100/pad	12.28
3721HH	Functional Restorative Progress Comparison	100/pad	12.28
3722HH	Functional Restorative Progress Comparison Addendum	100/pad	12.28
3726	Restorative Program Tracking Form	100/pk	28.95
3720HH	Restorative Nursing Care Plan and Progress Notes	100/pad	12.28
3727	CNA Care Plan Reference Sheet	100/pad	12.28
3632HH	Restorative Care Flow Record SC	100/pad	12.28
3732	Restorative Meeting Summary	100/pad	10.20
3241	Restorative Aide Notes	100/pad	11.67
3717HH	Restorative Nursing Transfer Form	100/pad	12.28
3718HH	Restorative Nurse's Progress Notes	100/pad	12.28
3740P	Restorative Nurse's Progress Notes	100/pad	10.20
CFS6-33HH	Rehabiltiaion/Restorative Service Delivery Record	100/pad	12.28
CFS6-33HF	Rehabiltiaion/Restorative Service Delivery Record	100/pad	12.28
3731HH	5-Week Restorative care Flow Record	100/pad	12.28
3731HF	5-Week Restorative care Flow Record	100/pad	12.28
3719HH	1-month Restorative Care Flow Record	100/pad	12.28
3719HF	1-month Restorative Care Flow Record	100/pad	12.28
CFS6-13HH	Restorative Care Flow Record	100/pad	12.28
CFS6-13HF	Restorative Care Flow Record	100/pad	12.28
Education and Training
8315	F315 Simplified	1 each	79.95
Charting
508	Chart Divider - Nurse Assistant - Paper - Orange - Side	25/pk	11.50
507	Chart Divider - Nurse Assistant - Paper - Orange - Bottom	25/pk	11.50
483	Chart Divider - Assessments - Paper - Lt. Blue - Side	25/pk	11.50
414	Chart Divider - Assessments - Paper - Lt. Blue - Bottom	25/pk	11.50
448	Chart Divider - Assessments - Tyvek- Lt. Blue - Side	25/pk	28.75
440	Chart Divider - Assessments - Tyvek - Lt. Blue - Bottom	25/pk	28.75
5492	Chart Divider - Assessments - Poly- Lt. Blue - Side	each	1.35
5491	Chart Divider - Assessments - Poly - Lt. Blue - Bottom	each	1.35
642	Chart Divider - Occupational Therapy - Paper - Pink - Side	25/pk	11.50
641	Chart Divider - Occupational Therapy - Paper - Pink - Bottom	25/pk	11.50
646	Chart Divider - Occupational Therapy - Tyvek - Pink - Side	25/pk	28.75
645	Chart Divider - Occupational Therapy - Tyvek - Pink - Bottom	25/pk	28.75
5684	Chart Divider - Occupational Therapy - Poly - Pink - Side	each	1.35
5683	Chart Divider - Occupational Therapy - Poly - Pink - Bottom	each	1.35
662	Chart Divider - Physical Therapy - Paper - Dk. Blue - Side	25/pk	11.50
661	Chart Divider - Physical Therapy - Paper - Dk. Blue - Bottom	25/pk	11.50
664	Chart Divider - Physical Therapy - Tyvek - Dk. Blue - Side	25/pk	28.75
663	Chart Divider - Physical Therapy - Tyvek - Dk. Blue - Bottom	25/pk	28.75
5656	Chart Divider - Physical Therapy - Poly - Dk. Blue - Side	each	1.35
5655	Chart Divider - Physical Therapy - Poly - Dk. Blue - Bottom	each	1.35
674	Chart Divider - Restorative - Paper - Orange - Side	25/pk	11.50
675	Chart Divider - Restorative - Paper - Orange - Bottom	25/pk	11.50
675	Chart Divider - Restorative - Tyvek - Orange - Side	25/pk	28.75
677	Chart Divider - Restorative - Tyvek - Orange - Bottom	25/pk	28.75
5689	Chart Divider - Restorative - Poly - Orange - Side	each	1.35
5690	Chart Divider - Restorative - Poly - Orange - Bottom	each	1.35
Medical Products
Mobility	Wheelchairs
503-0658-0200	DMI® 18" Wheelchair with Fixed Armrests	1 each	151.89
503-0664-0200	DMI® 18" Wheelchair with Removable Desk Arms	1 each	165.89
	Transport Chairs
501-1037-0678	DMI® 19" Folding Steel Transport Chair with Hand Brakes, Chrome Frame, Black Seat	1 each	123.09
501-1037-0778	DMI® 19" Folding Steel Transport Chair with Hand Brakes, Burgundy Frame, Black Seat	1 each	123.09
501-1052-2100	DMI® 19" Ultra Lightweight Aluminum Transport Chair, Royal Blue Frame, Black Seat	1 each	133.79
501-1052-4100	DMI® 19" Ultra Lightweight Aluminum Transport Chair, Titanium Frame, Black Seat	1 each	133.79
	Walkers
802-1017-0645	DMI® Single Release Aluminum Folding Walker with 5" Non-Swivel Wheels, Silver	1 each	37.29
802-1079-0600	DMI® Bariatric Two-Button Release Aluminum Folding Walker with Rubber Tips, Silver	1 each	53.39
	Rollators
802-1011-0700	DMI® Aluminum Rollator with Weight-Activated Brakes, Burgundy	1 each	84.29
501-1028-0700	DMI® Lightweight Aluminum Rollator, Burgundy	1 each	105.89
501-1028-2100	DMI® Lightweight Aluminum Rollator, Royal Blue	1 each	105.89
501-1028-4100	DMI® Lightweight Aluminum Rollator, Titanium	1 each	105.89
	Canes
502-1309-0255	DMI® Adjustable Aluminum Cane, Standard Handle, Black	1 each	8.79
802-1333-0200	DMI® Adjustable Quad Cane, Small base, Black	1 each	13.59
Pressure Relief	HeelBoot and Lifter
D 12000	HeelBoot™ Orthotic Boot, Regular	1 each	71.50
D 12001	HeelBoot™ Orthotic Boot, Large	1 each	71.50
D 12055	Heelbo® Lifter™ Foot Elevator, Extended Calf Base	1 each	107.39
D 12054	Heelbo® Lifter™ Foot Elevator, Octagon Shape	1 each	86.69
D 12056	Heelbo® Lifter™ Foot Elevator, Anti-Rotation Base	1 each	92.09
	Heelbo
D 12037	Heelbo® Heel and Elbow Protector, Yellow, Small	12 pair/bx	95.41
D 12038	Heelbo® Heel and Elbow Protector, Blue, Medium	12 pair/bx	95.41
D 12039	Heelbo® Heel and Elbow Protector, White, Large	12 pair/bx	95.41
D 12040	Heelbo® Heel and Elbow Protector, Green, X-Large	12 pair/bx	95.41
D 12041	Heelbo® Heel and Elbow Protector, Beige, XX-Large	12 pair/bx	95.41
D 12059	Heelbo® Premium Heel and Elbow Protector, Yellow, Small	6 pair/bx	163.16
D 12060	Heelbo® Premium Heel and Elbow Protector, Blue, Medium	6 pair/bx	163.16
D 12061	Heelbo® Premium Heel and Elbow Protector, White, Large	6 pair/bx	163.16
D 12062	Heelbo® Premium Heel and Elbow Protector, Green, X-Large	6 pair/bx	163.16
	Tubing Pads
D 12033	Cann-U-Wrap™ Tubing Pads	100 pair/bx	63.39
	Bed Pads
552-8002-0000	DMI® Convoluted Bed Pad, Hospital-size, 33" x 72" x 2"	1 each	12.29
552-8003-0000	DMI® Convoluted Bed Pad, Hospital-size, 33" x 72" x 3"	1 each	16.09
552-7940-0000	DMI® Convoluted Bed Pad, Hospital-size, 33" x 72" x 4"	1 each	23.10
552-7945-0000	DMI® Convoluted Bed Pad, Hospital-size, 33" x 76" x 4"	1 each	24.95
552-7948-0051	DMI® Convoluted Bed Pad, Full-size, 50" x 72" x 2"	1 each	24.29
552-7948-0052	DMI® Convoluted Bed Pad, Queen-size, 56" x 78" x 2"	1 each	25.39
552-1984-0000	DMI® Alternating Pressure Pump and Pad	1 each	74.39
552-1980-0000	DMI® Alternating Pressure Pump Only	1 each	59.89
552-1982-0000	DMI® Alternating Pressure Pad Only	1 each	17.89
	Bed Wedges
555-8028-1900	DMI® Foam Bed Wedge, 12" x 24" x 24", White	1 each	19.79
555-8028-0100	DMI® Foam Bed Wedge, 12" x 24" x 24", Blue	1 each	19.79
	Chair Pads
552-8004-0000	DMI® Convoluted Foam Chair Pad, 16" x 18" x 4"	1 each	6.20
552-8004-9910	DMI® Convoluted Foam Chair Pad with Cover, 16" x 18" x 4"	1 each	9.20
552-8005-0000	DMI® Convoluted Foam Chair Pad with Back, 18" x 32" x 3"	1 each	9.10
	SkinSleeves
D 04-6000S	Posey® Skinsleeves, Arm, Small Adult	1 pair	14.49
D 04-6000	Posey® SkinSleeves, Arm, Adult	1 pair	14.49
D 04-6001	Posey® SkinSleeves, Leg, One Size Fits All	1 pair	14.49
Positioning	Cervical Pillows
554-7905-1900	STRESS-EASE PILLOW 17X22 in	1 each	13.50
554-8011-4300	MEMORY FOAM PILLOW RADIAL-CUT	1 each	19.49
554-8001-1900	CERVICAL COMFORT PILLOW	1 each	18.60
554-8009-6400	CERVICAL REST PILLOW 24 IN	1 each	9.89
	Lumbar Cushions
555-7300-0200	LUMBAR CUSHION STANDARD	1 each	11.40
555-7300-2400	LUMBAR CUSHION STANDARD	1 each	11.40