On November 06, 2020 a
Exhibit,Appendix
was filed
involving a dispute between
Kevin Lynch
As Administrator Of The Estate Of Rose Bouknight,
and
Glen Island Center For Nursing And Rehabilitation And,
Jopal Bronx Llc
D B A Workmen'S Circle Multicare Center,
Montefiore Medical Center,
for Torts - Medical, Dental, or Podiatrist Malpractice
in the District Court of Westchester County.
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FILED: WESTCHESTER COUNTY CLERK 10/30/2022 08:25 PM INDEX NO. 64205/2020
NYSCEF DOC. NO. 122 RECEIVED NYSCEF: 10/30/2022
EXHIBIT U
FILED: WESTCHESTER COUNTY CLERK 10/30/2022 08:25 PM INDEX NO. 64205/2020
NYSCEF DOC. NO. 122 NSG Admission Record - V 3 RECEIVED NYSCEF: 10/30/2022
Resident: BOUKNIGHT, ROSE Effective Date: 02/07/2018 22:58
(17789)
b. Ability to express ideas and wants, consider both verbal and non-verbal expression
0. Understood
1. Usually understood
2. Sometimes understood
3. Rarely/never understood
-. Not assessed
c. Understanding verbal content, however able (with hearing aid or device if used)
0. Understands
1. Usually understands
2. Sometimes understands
3. Rarely/never understands
-. Not assessed
d. Lip Read
e. Signs and gestures
f. Electronic Communication Device
g. Comments:
13. Sleep/Rest
a. No complaints Usual:
f. Wake Up Time
b. Sleeps 6-8 hours g. Naps
c. Difficulty Falling Asleep h. Usual Bedtime
d. Easily Aroused i. Sleeps in Chair/Upright
e. Awake at Night Secondary To: j. Additional Info./Comments:
Signed By Signed Date
Korto Ballayan, Licensed Practical Nurse [e-SIGNED] 02/07/2018
5. Skin
1. Body Chart
Identify marks by # and describe below, include measurements and pictures (if taken) as appropriate. Initiate skin integrity tracking
sheet in treatment book as per policy.
a. Body Chart
Page 1171 of 2253 Run on: 10/15/2020
FILED: WESTCHESTER COUNTY CLERK 10/30/2022 08:25 PM INDEX NO. 64205/2020
NYSCEF DOC. NO. 122 NSG Admission Record - V 3 RECEIVED NYSCEF: 10/30/2022
Resident: BOUKNIGHT, ROSE Effective Date: 02/07/2018 22:58
(17789)
Site Description
24) Groin moist
29) Right hand (back) Multiple discoloration on hands
30) Left hand (back) Multiple discoloration on hands
31) Right buttock healed excoriation 1x1cm
4) Face Multiple discoloration on face
49) Right heel dryness on heel
50) Left heel dryness on heel
51) Right toe(s) Mycotic toe nails
52) Left toe(s) Mycotic toe nails
53) Sacrum pressure ulcer 5x3cm
b. Additional Information/Comment:
Multiple scab wound on L back, moisture on groin
Signed By Signed Date
Daisy Caringal, RN Supervisor [e-SIGNED] 02/08/2018
6. Wandering/Elopement
1. Elopement/Unsafe Wandering Screen
Page 1172 of 2253 Run on: 10/15/2020
Document Filed Date
October 30, 2022
Case Filing Date
November 06, 2020
Category
Torts - Medical, Dental, or Podiatrist Malpractice
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FILED: WESTCHESTER COUNTY CLERK 10/30/2022 08:25 PM INDEX NO. 64205/2020 NYSCEF DOC. NO. 122 RECEIVED NYSCEF: 10/30/2022 EXHIBIT U FILED: WESTCHESTER COUNTY CLERK 10/30/2022 08:25 PM INDEX NO. 64205/2020 NYSCEF DOC. NO. 122 NSG Admission Record - V 3 RECEIVED NYSCEF: 10/30/2022 Resident: BOUKNIGHT, ROSE Effective Date: 02/07/2018 22:58 (17789) b. Ability to express ideas and wants, consider both verbal and non-verbal expression 0. Understood 1. Usually understood 2. Sometimes understood 3. Rarely/never understood -. Not assessed c. Understanding verbal content, however able (with hearing aid or device if used) 0. Understands 1. Usually understands 2. Sometimes understands 3. Rarely/never understands -. Not assessed d. Lip Read e. Signs and gestures f. Electronic Communication Device g. Comments: 13. Sleep/Rest a. No complaints Usual: f. Wake Up Time b. Sleeps 6-8 hours g. Naps c. Difficulty Falling Asleep h. Usual Bedtime d. Easily Aroused i. Sleeps in Chair/Upright e. Awake at Night Secondary To: j. Additional Info./Comments: Signed By Signed Date Korto Ballayan, Licensed Practical Nurse [e-SIGNED] 02/07/2018 5. Skin 1. Body Chart Identify marks by # and describe below, include measurements and pictures (if taken) as appropriate. Initiate skin integrity tracking sheet in treatment book as per policy. a. Body Chart Page 1171 of 2253 Run on: 10/15/2020 FILED: WESTCHESTER COUNTY CLERK 10/30/2022 08:25 PM INDEX NO. 64205/2020 NYSCEF DOC. NO. 122 NSG Admission Record - V 3 RECEIVED NYSCEF: 10/30/2022 Resident: BOUKNIGHT, ROSE Effective Date: 02/07/2018 22:58 (17789) Site Description 24) Groin moist 29) Right hand (back) Multiple discoloration on hands 30) Left hand (back) Multiple discoloration on hands 31) Right buttock healed excoriation 1x1cm 4) Face Multiple discoloration on face 49) Right heel dryness on heel 50) Left heel dryness on heel 51) Right toe(s) Mycotic toe nails 52) Left toe(s) Mycotic toe nails 53) Sacrum pressure ulcer 5x3cm b. Additional Information/Comment: Multiple scab wound on L back, moisture on groin Signed By Signed Date Daisy Caringal, RN Supervisor [e-SIGNED] 02/08/2018 6. Wandering/Elopement 1. Elopement/Unsafe Wandering Screen Page 1172 of 2253 Run on: 10/15/2020