CNA/STNA Functional Abilities Flow Sheet
The CNA/STNA Functional Abilities Flow Sheet is used to record personal care provided as well as the amount of assistance needed to perform those tasks:
• | Eating | • | Oral Hygiene | |
• | Toileting Hygiene | • | Shower/Bathe Self | |
• | Upper Body Dressing | • | Lower Body Dressing | |
• | Putting On/Taking Off Footwear | • | Personal Hygiene | |
• | Tub/Shower Transfer | |||
This Flow Sheet corresponds to the use of Section GG with the MDS capturing the resident's functional abilities for personal care on a daily basis.
The resident's medical record must reflect the facility provided the necessary care and services to ensure that a resident's abilities in activities of daily living do not diminish unless circumstances of the individual's clinical condition demonstrate that such diminution was unavoidable. This includes the facility ensuring that a resident is given the appropriate treatment and services to maintain or improve his or her ability to carry out the activities of daily living. (F676)
Size: 11" x 8 ½"
Print: Black ink, 2-sides
Hole Punching: 5 Holes top and side
Packaging: 100 per pad