{"sno": "new", "year": "2024", "answer": [{"options": {"value": "MICHAUD M RACHEL", "optionId": "u4v"}, "questionId": "K-lowx"}, {"options": {"value": "10000081853", "optionId": "vvv"}, "questionId": "B-lowx"}, {"options": {"value": "1954-06-26", "optionId": "tdb"}, "questionId": "M-iz6p"}, {"options": {"value": "2024-12-20T18:37"}, "questionId": "W-iz6p"}, {"options": {"value": "2077834150", "optionId": "uphno"}, "questionId": "U-Phno"}, {"options": {"value": "c.hembrick@focuscares.com", "optionId": "b4v"}, "questionId": "Q-lowx"}, {"options": {"value": "Focus Care", "optionId": "p4v"}, "questionId": "X-lowx"}, {"options": {"value": "Candace Hembrick ", "optionId": "q4v"}, "questionId": "N-lowx"}, {"options": {"value": "Diabetes, HTN, Other", "optionId": ["ul5", "uz0", "epq"]}, "questionId": "U-w165"}, {"options": {"value": "804-874-5660", "optionId": "i4v"}, "questionId": "S-lowx"}, {"options": {"value": "Yes", "optionId": "su8"}, "questionId": "Q-jtcz"}, {"options": {"value": "No", "optionId": "l6B"}, "questionId": "A-que"}, {"options": {"value": "No", "optionId": "l6D"}, "questionId": "B-que"}, {"options": {"value": "Member has not left her home in two years  She stated that this started with COVID and then it has gotten to the point where she is afraid to leave her home  Member appeared tearful when speaking about the possibility of potentially leaving her home  Her husband explained that she also has not taken an actual shower in over a year  She fell last year on Christmas Eve and no matter how many shower chairs or assistive grab bars that she has she refuses to get into the shower  Member reported that she had a fear of falling  Also she reported that this time of year has gotten hard for her over the years due to her daughters death  She stated that her daughter passed away about four years ago and that she does not want to take any medications because she is afraid of the side effect from them since her daughter was on medications and feels this is what attributed to her death  The member is willing to have virtual visits with a counselor or therapist  Discussed that since member is afraid of falling as well as leaving the house that her mental health has definitely attributed significantly to her decreased physical health  She wants help but states that she is too scared of falling and leaving her home so she would like home health options explored first  Member has not had medications to treat her HTN in over a year  She currently has an appointment scheduled for January twenty third of next year for endocrinology but if she does not show up for a face to face visit they will not refill her Insulin or Levothyroxine and she will be dropped from their patient list  As of this time it has been well over two years since she has had any of her basic labs drawn  The members increased fear anxiety and depression of leaving the home and falling has taken over to the point where she has not been able to take care of her physical health  Member stated that they were at one point working with a social worker to try and obtain home health providers and services to see the member but they have not heard anything in about a year  Member definitely needs labs drawn behavioral health therapy physical therapy and home health provider  Current medical diagnosis have significantly been exacerbated due to her lack of her access to care from her not leaving her home for over two years", "optionId": "l6l"}, "questionId": "P-gbms"}, {"options": {"value": "PT/OT, counselor or therapist, member has not left home in 2 years due to fear or leaving her home, PCP, labs have not been done in 2 years, increased anxiety, depression, fall risk, has not showered in over a year, home health aid and assistance needed, sleep apnea monitoring, increased co-morbidities, break/gap in physical & mental health care", "optionId": "C-MV65"}, "questionId": "C-MV65"}], "clientId": "client_014", "memberId": "10000081853", "referralId": "vu8", "submittedBy": "chembrick", "sentToQADate": "2024-12-20T23:45:13.165Z", "submittedUserType": "nurse", "referralFormStatus": "0", "sentToHelpLineDate": ""}