ROHO Cushion Inflation Monitoring Form

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ROHO Cushion Inflation Monitoring Form

Nursing Policy & Procedure Manual

ROHO Cushion Inflation Monitoring Form 

 

Per Policy, Document Weekly Hand Checks. Month/Year:  __________________________ 

 

Resident Name 

Date Cushion Check Done/Initials 

Action Taken?       Yes or No 

Date Cushion Check Done/Initials 

Action Taken?       Yes or No 

Date Cushion Check Done/Initials 

Action Taken?       Yes or No 

Date Cushion Check Done/Initials 

Action Taken?       Yes or No 

Date Cushion Check Done/Initials 

Action Taken?       Yes or No 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

References: 

  • Centers for Medicare & Medicaid Services (CMS), Requirements of Participation for Long-Term Care Facilities. 

  • State Operations Manual (SOM), CMS. 

Tags
ROHO Cushion Inflation Monitoring Form
ROHO cushion
inflation monitoring
Resident Care
Pressure Ulcer Prevention
cushion maintenance
CMS Guidelines
State Operations Manual
Long-Term Care
Nursing policy & procedure manual.
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