4 3 LEVEL 2 LEVEL 1 Areas of Functioning (4 points) (3 points) (2 points) (1 point) HEALTH STATUS (continued) Client reports severe Client reports chronic Client reports changes in Client has no current or eating problems, acute nausea, vomiting, eating habits in the past 3 past eating problems NUTRITIONAL NEEDS nausea, vomiting, diarrhea and/or other months and requests and does not need any diarrhea, and/or other physical maladies; assistance with improving nutritional intervention; physical maladies; OR nutrition; AND/OR OR Client reports or MCM OR Client reports and CM Client reports or MCM has observed weight loss Client has occasional has observed no weight observes significant in the past 6 months. episodes of nausea, loss or excessive weight weight loss in the last 3 vomiting or diarrhea; gain; And Client reports months; OR no problems with nausea, OR Client reports excessive vomiting or diarrhea. Client has a diagnosis of weight gain in the last 12 wasting syndrome. months.
Areas of Functioning 4 (4 points) 3 (3 points) LEVEL 2 (2 points) LEVEL 1 (1 point) HEALTH STATUS (continued) NUTRITIONAL NEEDS Client reports severe eating problems, acute nausea, vomiting, diarrhea, and/or other physical maladies; OR Client reports or MCM observes significant weight loss in the last 3 months; OR Client has a diagnosis of wasting syndrome. Client reports chronic nausea, vomiting, diarrhea and/or other physical maladies; OR Client reports or MCM has observed weight loss in the past 6 months. Client reports changes in eating habits in the past 3 months and requests assistance with improving nutrition; OR Client has occasional episodes of nausea, vomiting or diarrhea; OR Client reports excessive weight gain in the last 12 months. Client has no current or past eating problems and does not need any nutritional intervention; AND/OR Client reports and CM has observed no weight loss or excessive weight gain; And Client reports no problems with nausea, vomiting or diarrhea.
ELECTRONIC_Standardized_Michigan_HIV_MCM_Acuity_Pilot_Tool_2.2016_517969_7.docx