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Visit NoteSN
10/12 · Skilled nursing visit
Vitals
BP128/82
HR76
SPO₂95%
Narrative
Wound assessment
OASIS-ERecert
Assessment · Integumentary
Items
M1021
M1033
OASIS review
M1311
M1830
M1850
GG0170
GG0130
Plan of CareHHA-485
Pt. #A-1042 · Recertification · 60-day episode
Goals
Ambulate 50 ft with walker
Medication self-management
Wound care goal
Gap
Diagnoses
Heart failure, chronicI50.32
Type 2 diabetesE11.9
Interventions
ClinixAI Insights
Analyzing3 to review
- Documentation gap detectedPlan of Care · wound care goal not documented
- Suggested review actionConfirm OASIS M1033 response with clinician
- Check supporting clinical documentationVisit note · 10/12 · narrative
Clinician review required
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