This assessment identifies patients who suffer from hearing deficit and may be handicapped by it.

Instructions: Answer Yes, No, or Sometimes for each question. Do not skip any questions even if your patient avoids a situation because of a hearing problem. If your patient uses a hearing aid, please answer according to the way they hear with the aid.

1. Does a hearing problem cause you to feel embarrassed when you meet new people?
2. Does a hearing problem cause you to feel frustrated when talking to members of your family?
3. Do you have difficulty hearing when someone speaks in a whisper?
4. Do you feel handicapped by a hearing problem?
5. Does a hearing problem cause you difficulty when visiting friends, relatives, or neighbors?
6. Does a hearing problem cause you to attend religious services less often than you would like?
7. Does a hearing problem cause you to have arguments with family members?
8. Does a hearing problem cause you difficulty when listening to TV or radio?
9. Do you feel that any difficulty with your hearing limits or hampers your personal or social life?
10. Does a hearing problem cause you difficulty when in a restaurant with relatives or friends?

Scoring: No = 0; Sometimes = 2; Yes = 4.

• 0-8: No handicap
• 9-25: Mild to moderate handicap
• 26-40: Severe handicap

Equivalent Score in Minimum Data Set
(U.S. Centers for Medicare & Medicaid Services)

Score	Interpretation
0-8	HEARS ADEQUATELY — normal talk, TV, phone
9-25	MINIMAL DIFFICULTY when not in quiet setting
26-35	HEARS IN SPECIAL SITUATIONS ONLY — speaker has to adjust tonal quality and speak distinctly
36-40	HIGHLY IMPAIRED — absence of useful hearing

This assessment identifies patients who are at risk for readmission or death within thirty days of discharge. It uses four parameters:

• "L": the length of stay of the admission
• "A": the acuity of the admission (emergency or elective)
• "C": co-morbidities (the Charlson Co-Morbidity Index)
• "E": the number of Emergency Department visits within the last 6 months

LACE scores range from 1 to 19:

• 0-4: Low probability of readmission or death within thirty days of discharge
• 5-9: Moderate probability of readmission or death within thirty days of discharge
• ≥10: High probability of readmission or death within thirty days of discharge

Length of Stay	Days	Score
	1	1
	2	2
	3	3
	4–6	4
	7-13	5
	14+	7
Acuity of admission	If patient was admitted via the ED	3
	If patient was not admitted via the ED	0
Comorbidities	Previous MI	1
	Cerebrovascular disease	1
	Peripheral vascular disease	1
	Diabetes without complications	1
	Congestive heart failure	2
	Diabetes with end organ damage	2
	Chronic pulmonary disease	2
	Mild liver or renal disease	2
	Any tumor (including lymphoma or leukemia)	2
	Dementia	3
	Connective tissue disease	3
	AIDS	4
	Moderate or severe liver or renal disease	4
	Metastatic solid tumor	6
Emergency department visits	How many times the patient has visited an emergency department in the six months prior to admission (not including the emergency department visit immediately preceding the current admission)	Score is this number or 4, whichever is smaller.
Calculation	Total	When button is pressed, total the above scores and display it in a pop-up with one of the following:
	0-4	Low probability of readmission or death within thirty days of discharge
	5-9	Moderate probability of readmission or death within thirty days of discharge
	≥10	High probability of readmission or death within thirty days of discharge

Answer every question.

Has food intake declined over the past 3 months due to loss of appetite, digestive problems, chewing or swallowing difficulties?

0 = severe decrease in food intake
1 = moderate decrease in food intake
2 = no decrease in food intake

Weight loss during the last 3 months

0 = weight loss greater than 3 kg (6.6 lbs)
1 = does not know
2 = weight loss between 1 and 3 kg (2.2 and 6.6 lbs)
3 = no weight loss

Mobility

0 = bed or chair bound
1 = able to get out of bed / chair but does not go out
2 = goes out

Has suffered psychological stress or acute disease in the past 3 months?

0 = yes
2 = no

Neuropsychological problems

0 = severe dementia or depression
1 = mild dementia
2 = no psychological problems

Body Mass Index (BMI) (weight in kg) / (height in m squared)

0 = BMI less than 19
1 = BMI 19 to less than 21
2 = BMI 21 to less than 23
3 = BMI 23 or greater

If BMI is not available, use calf circumference in cm

0 = CC less than 31
3 = CC 31 or greater

Scoring

Score	Interpretation
12-14	NORMAL NUTRITIONAL STATUS
8-11	AT RISK OF MALNUTRITION
0-7	MALNOURISHED

The Morse Fall Scale (MFS) is a rapid and simple method of determining a patient's likelihood of falling. A large majority of nurses (82.9%) rate the scale as "quick and easy to use," and 54% estimated that it took less than 3 minutes to rate a patient. The MFS consists of six variables that are quick and easy to score, and it has been shown to have predictive validity and interrater reliability. The MFS is used widely in acute care, hospital, rehabiliation and nursing homes.

Scoring and Risk Level: The MFS score is tallied and recorded on the patient's chart. Risk level and appropriate interventions are then identified. The six variables are:

• History of falling; immediate or within 3 months
• Secondary diagnosis is present
• Ambulatory aid
• IV/Heparin Lock
• Gait
• Mental status

MFS scores range from 0 to 125:

• 0-24: Low risk
• 25-45: Moderate risk
• 46+: High risk

References

• Evaluating Fall Risk With the Morse Fall Scale
• Preventing Falls: A Guide to Implementing Effective Community-Based Fall Prevention Programs
• Preventing Falls in Hospitals