1-10 NURSING FACILITY SERVICES LOCATION: Nursing Home
PATIENT: Thomas Weiss
PHYSICIAN: Frank Gaul, M. D.
HISTORY: Mr. Weiss is seen for a routine visit for Alzheimer's. There is no code in place. The chart is
reviewed along with the nursing notes. Advanced directives are in place. The graphic chart is also
reviewed. The patient is experiencing no fevers, chills, chest pain or shortness of breath. Nurse states
patient continues to be frequently delusional.
EXAMINATION: This well-developed, well-nourished gentleman is sitting without distress.
HEENT-normocephalic and atraumatic. Neck is supple. Lungs are clear to auscultation. Extremities
show little to no edema.
IMPRESSION:
1. Alzheimer dementia
2. Atypical psychosis with delusions
PLAN:
1. As the patient is otherwise clinically stable; the rest of the treatment is without change.