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OASIS

1.60 Correction 1

Submission body record

Behavior Demonstrated: Memory Deficit

(M0610) Behaviors Demonstrated AT LEAST ONCE A WEEK (Reported or Observed): (Mark all that apply.)

1 - Memory deficit: failure to recognize familiar persons/places, inability to recall events of past 24 hours, significant memory loss so that supervision is required
2 - Impaired decision-making: failure to perform usual ADLs or IADLs, inability to appropriately stop activities, jeopardizes safety through actions
3 - Verbal disruption: yelling, threatening, excessive profanity, sexual references, etc.
4 - Physical aggression: aggressive or combative to self and others (e.g., hits self, throws objects, punches, dangerous maneuvers w/ wheelchair or other objects)
5 - Disruptive, infantile, or socially inappropriate behavior (EXCLUDES verbal actions)
6 - Delusional, hallucinatory, or paranoid behavior
7 - None of the above behaviors demonstrated

1

600

600

01,03,09

04,05,06,07,08

X

CODE

0, 1

0=No/Unchecked, 1=Yes/Checked

*1. If M0100_ASSMT_REASON matches one of the active RFA"s, then at least one item from M0610_BD_MEM_DEFICIT thru M0610_BD_NONE must be equal to 1.

*2. If M0610_BD_NONE=1 then M0610_BD_MEM_DEFICIT thru M0610_BD_DELUSIONS must be 0 (zero).

-Revised list of RFAs to make field inactive on RFA 04 and 05.

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