GG scoring

01

Dependent - Helper does ALL of the effort. Patient does none of the effort to complete the activity. Or, the assistance of 2 or more helpers is required for the patient to complete the activity.

GG0130A Eating: 88, not attempted due to medical restrictions or safety concerns (G-tube)

GG0130A Eating, Mr. R is unable to eat or drink by mouth since he had a stroke 1 week ago. He receives nutrition and hydration through a G-tube, which is administered by a helper.

GG0130A Eating: 04 Supervision or touching assist (food consistency)

GG0130A Eating, Mrs. H does not have any food consistency restrictions, but often needs to swallow two or three times so that the food clears her throat due to difficulty with pharyngeal peristalsis. She requires verbal cues to use the compensatory strategy of extra swallows to clear the food.

GG0130A Eating: 04 Supervision or touching assist (visual deficits)

GG0130A Eating, Mrs. V has difficulty seeing on her left side since her stroke. During meals, a helper must remind her to scan the entire plate to ensure she has seen all the food.

GG0130B Oral Hygiene: 05, set-up or clean-up assist

GG0130B Oral Hygiene, The helper provides steadying assistance to Mr. S as he walks to the bathroom. The helper applies toothpaste onto Mr. S's toothbrush. Mr. S then brushes his teeth at the sink in the bathroom without physical assistance or supervision. Once Mr. S is done brushing his teeth and washing his hands and face, the helper returns and provides steadying assistance as the patient walks back to his bed.

GG0170 12 steps: 88 not attempted due to medical conditions or safety concerns.

GG0170 12 steps, Mrs. D is returning home after a hip replacement. She is restricted from stair climbing until she is seen for her follow-up MD appointment. Just prior to her surgery, she was able to climb her flight of 12 stairs with stand-by assist of her niece.

GG0170O 12 steps: 02, substantial/maximal assist

GG0170 12, steps, At SOC, Ms. Y is recovering from a stroke and has 12 stairs with a railing and she needs to use these stairs to enter and exit her home. The physical therapist uses a gait belt around her trunk and at times is required to support much of the patient's weight as Ms. Y ascends and then descends 12 stairs.

GG0170A Roll L and R: 04 supervision or touching assist

GG0170A Roll L and R, At SOC, the physical therapist helps Mr. R turn onto his right side by instructing him to bend his left leg and roll to his right side. He then instructs him how to position his limbs to return to lying on his back and then to repeat a similar process for rolling onto his left side and then return to lying on his back. Mr. R completes the activity without physical assistance from a helper. Mr. R was moving about in bed without difficulty prior to hospitalization. The therapist expects Mr. R will roll left and right by himself by discharge.

GG0170B Sit to Lying: 01 Dependent

GG0170B Sit to Lying, At SOC, Mrs. H requires assistance from two helpers to transfer from sitting at the edge of the bed to lying flat on the bed due to paralysis on her right side, obesity, and cognitive limitations. One of the helpers explains to Mrs. H each step of the sitting to lying activity. Mrs. H is then fully assisted to get from sitting to a lying position on the bed. Mrs. H makes no attempt to assist when asked to perform the incremental steps of the activity.

GG0170B Sit To Lying: 02 Subsantial or Max Assist

GG0170B Sit to Lying: Mr. A suffered multiple vertebral fractures due to a fall off a ladder. At SOC, he requires assistance from a therapist to get from a sitting position to lying flat on the bed because of significant pain in his lower back. The therapist supports his trunk and lifts both legs to assist Mr. A from sitting at the side of the bed to lying flat on the bed. Mr. A assists himself a small amount by raising one leg onto the bed and then bending both knees while transitioning into a lying position.

GG0170C Lying to Sitting on Side of Bed: 04 supervision or touching assisit

GG0170C, Lying to Sitting on Side of Bed, Ms. H is recovering from a spinal fusion. At SOC, she rolls to her right side and pushes herself up from the bed to get from a lying to a seated position. The therapist provides needed verbal cues to guide Ms. H as she safely uses her hands and arms to support her trunk and avoid twisting as she raises herself from the bed. Ms. H then safely maneuvers to the edge of the bed, finally lowering her feet to the floor to complete the activity without hands-on assistance

GG0170D Sit to Stand: 09 not performed, not applicable

GG0170D, Sit to Stand, Mr. B is being admitted to home health for pressure ulcer care. He has complete tetraplegia from an injury one year ago and has been unable to bear weight in standing since the injury. At SOC, using a patient lift that does not require him to come to standing, he is transferred from his bed into a wheelchair with assistance.

GG0170E Chair/Bed-to-Chair transfer: 05 set-up or clean-up assist

GG0170E,Chair/Bed-to-ChairTransfer Mr. L had a stroke and uses a wheelchair for mobility. When Mr. L gets out of bed at SOC, the therapist moves the wheelchair into the correct position and locks the brakes so that Mr. L can transfer into the wheelchair safely. Mr. L transfers into the wheelchair by himself without the need for supervision or assistance during the transfer. The family reports that Mr. L does transfer safely without the need for supervision, once the wheelchair is placed and locked. The nurse does not expect Mr. L's mobility status to change by discharge.

GG0170F Toilet Transfer: 04 Supervision or Touching Assist

GG0170F, Toilet Transfer, The assessing clinician notes that the home health aide visit note (documented on the afternoon visit on the SOC date) stated that the aide needed to steady Mrs. Z with a light contact when the patient lowers her underwear and then transfers onto the toilet. After voiding, Mrs. Z cleanses herself. She then stands up supporting her own weight as the aide steadies her. Mrs. Z pulls up her underwear as the aide steadies her to ensure Mrs. Z does not lose her balance

GG0170G Car Transfer: 02, Substantial/maximal assistance.

GG0170G Car Transfer, Mrs. W uses a wheelchair and ambulates for only short distances. At SOC, Mrs. W requires the physical therapist to lift most of her weight to get from a seated position in the wheelchair to a standing position. The therapist provides trunk support when Mrs. W takes several steps during the transfer turn. Mrs. W lowers herself into the car seat with steadying assistance from the therapist. Mrs. W moves her legs into the car as the therapist lifts the weight of her legs from the ground

GG0170G Car Transfer: 04 Supervision or touching assist

GG0170G Car Transfer, The day after being admitted to home health, Mrs. N works with an occupational therapist on transfers in and out of the passenger side of a car. When reviewing the therapist's evaluation, the assessing clinician reads that when performing car transfers, Mrs. N required verbal reminders for safety and contact guarding assistance from the OT for guidance and direction. The therapist instructed the patient on strategic hand placement while Mrs. N transitioned to sitting into the car seat. Documentation showed that the therapist opened and closed the car door.

GG0170I Walk 10 Feet: 09 not assessed. Not applicable

GG0170I Walk 10 feet, Mr. L had bilateral amputations 3 years ago, and prior to this HH admission he used a wheelchair and did not walk. At SOC, Mr. L does not use prosthetic devices and only uses a wheelchair for mobility. Mr. L's care plan includes assisting with fitting and use of bilateral lower extremity prostheses.

GG0170J Walk 50 ft with two Turns: 88 not attempted due to medical condition or safety concern

GG0170J Walk 50 ft with two Turns, At SOC, Mr. B is recovering from a recent stroke and now has difficulty walking. Even with assistance, he is able to walk only 30 feet. Mr. B's care plan includes muscle strengthening and gait training.

GG0170K Walk 150 ft: 88 not attempted due to medical or safety concerns

GG0170K Walk 150 ft, Mr. R has recent endurance limitations due to an exacerbation of heart failure and is only walking about 30 feet before he tires, loses strength and must sit and rest. He reports he was walking 150 feet or more with his cane prior to this exacerbation of his heart failure.

GG0170L walking 10 ft on uneven surfaces: 03 partial moderate assist

GG0170L Walking 10 ft on Uneven surfaces, Mrs. N has severe joint degenerative disease and is recovering from sepsis. When walking on the uneven driveway was attempted yesterday when Mrs. N came home from the hospital, she reports that her neighbor had to hold her belt and help lift her a little during a few steps. The neighbor also provided help to advance the walker across the gravel driveway as the patient walked.

GG0170M 1 Step (curb): 04 Supervision or touching assist

GG0170M 1 Step (curb), Mrs. Z had a stroke and needs to learn how to step up and down one step to enter and exit her home. At SOC, the physical therapist provides needed verbal cueing as Mrs. Z uses her quad cane to aid her balance in stepping up and back down one step. The therapist does not provide any physical assistance.

GG0170N 4 Steps: 03, partial/moderate assist

GG0170N 4 Steps, at SOC, Mr. J has lower body weakness and the physical therapist provides light touching assistance when he ascends 4 steps. While descending 4 steps, the physical therapist faces the patient and descends the stairs providing minimal trunk support, with one hand on the patient's hip and the other holding the gait belt, as Mr. J holds the stair railing

GG0170P Picking up an object: 04 supervision or touching assist

GG0170P Picking up an Object, Mr. P has a neurologic condition that has resulted in coordination and balance problems. At SOC, he reports he and his wife worked with the OT in the SNF on picking things off the floor. He demonstrates how he stoops to pick up a pencil from the floor as his wife provides the right amount of verbal cues for safety and stands by, ready to help in case he loses his balance.

GG0170P Picking up an Object: 05, set-up or clean up assist

GG0170P Picking up an Object, Ms. C has recently undergone a hip replacement. At SOC, she walks with a walker without assistance. When she drops a hair brush from her walker basket, she asks her daughter to locate her long-handled reacher and bring it to her. Using the reacher, Mrs. C is able to bend slightly, and safely pick up the hair brush with the reacher, without need of additional assistance or verbal cues.

GG0170R Wheel 50 Feet with Two Turns: 06, Independent

GG0170R Wheel 50 Feet with Two Turns, At SOC, Mrs. M is unable to bear any weight on her right leg due to a recent fracture. The nurse observes as the certified nursing assistant in the assisted living facility provides steadying assistance when transferring Mrs. M from the bed into her manual wheelchair. Once in her wheelchair, Mrs. M propels herself safely about 60 feet down the hall using her left leg and safely makes two turns without any necessary physical assistance or supervision

GG0170R Wheel 50 Feet with Two Turns: 02, substantial/maximal assistance

GG0170R Wheel 50 Feet with Two Turns, Once seated in the manual wheelchair, Ms. R wheels about 10 feet, including around one corner to the hallway. Due to shoulder pain, she asks her son to push the wheelchair the additional 40 feet around another corner and into her bathroom.

GG0170S Wheel 150 Feet: 04, supervision or touching assist

GG0170S Wheel 150 Feet, Mr. N uses a below-the-knee prosthetic limb. Mr. N has peripheral neuropathy and limited vision due to complications of diabetes. Via observation and patient report, the assessing clinician determines that Mr. N's usual performance is that a helper is needed to provide verbal cues for safety due to vision deficits, and the patient mobilizes his manual wheelchair a distance of 150 within his home.

GG1070F Toilet transfer: coded 88, Not attempted due to medical condition or safety concerns.

GG1070F Toilet transfer , At SOC, Mrs. S is on bedrest due to a new medical complication. She uses a bedpan for bladder and bowel management. The assessing clinician expects the patient will return to independent use of the bathroom toilet once the current condition resolves.

06

Independent - Patient completes the activity by him/herself with no assistance from a helper.

09

Not applicable - Not attempted and the patient did not perform this activity prior to the current illness, exacerbation or injury.

10

Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)

88

Not attempted due to medical conditions or safety concerns

03

Partial/moderate assistance - Helper does LESS THAN HALF the effort. Helper lifts, holds or supports trunk or limbs, but provides less than half the effort.

07

Patient refused

05

Setup or clean-up assistance - Helper sets up or cleans up; patient completes activity. Helper assists only prior to or following the activity.

02

Substantial/maximal assistance - Helper does MORE THAN HALF the effort. Helper lifts or holds trunk or limbs and provides more than half the effort. 01.

04

Supervision or touching assistance - Helper provides verbal cues and/or touching/steadying and/or contact guard assistance as patient completes activity. Assistance may be provided throughout the activity or intermittently.