Neurological Observation Record

Neurological Observation Record 

Effective Date: [Original NPP Date] 

Revised Date: [Current Date] 

Policy: 

To ensure the timely and accurate monitoring of residents requiring neurological observations, staff will use the Neurological Observation Record form. This form facilitates the documentation and assessment of critical neurological parameters over specified time intervals. 

Residents Name:  ____________________________________________________________________ Room #:  ___________________ 

Neuro assessment code:  ü - Indicates Normal for Resident     * - Indicates Abnormal for Resident – See Nurse’s Notes                 

References: 

• Centers for Medicare & Medicaid Services. State Operations Manual, Appendix PP - Guidance to Surveyors for Long-Term Care Facilities. [Link to current CMS SOM] 

• CMS Requirements of Participation for Long-Term Care Facilities. [Link to current guidelines]