PDPM Case Histories Journal - Final

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  • 8/9/2019 PDPM Case Histories Journal - Final

    1/69

    R@RM Gaxrjdc ai Rhriarmdjkh

    ?242 EJA ^arc`~l`h fpp7!!pkk-`m*ocan{ap*kam! 4

    K|rx{ K@R

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    2/69

    R@RM Gaxrjdc ai Rhriarmdjkh

    ?242 EJA ^arc`~l`h fpp7!!pkk-`m*ocan{ap*kam! ?

    K|rx{ K@R

    Pdoch ai Kajphjp{

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    R@RM Gaxrjdc ai Rhriarmdjkh

    ?242 EJA ^arc`~l`h fpp7!!pkk-`m*ocan{ap*kam! ;

    K|rx{ K@R

    Ljpra`xkljn pfh R@RM raghkp lj K|rx{

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    \hp# ih~ raghkp mdjdnhr{ fdyh

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    R@RM Gaxrjdc ai Rhriarmdjkh

    ?242 EJA ^arc`~l`h fpp7!!pkk-`m*ocan{ap*kam! 0

    K|rx{ K@R

    Pfh Kddklp| @hyhcamhjp Rranrdm

    Pfh Kddklp| @hyhcamhjp RranrdmPfh Kddklp| @hyhcamhjp RranrdmPfh Kddklp| @hyhcamhjp RranrdmPfh Kddklp| @hyhcamhjp Rranrdm&K@R, l{ `h{lnjh` pa ia{phr kaj`lplaj{ iard `xrdoch {hppchmhjp o| rayl`ljn

    hkajamlk `hyhcamhjp dj` apfhr {xarppa pfh Pxrel{f K|rlap Kammxjlp| &PKK,*Pfh raghkp kamchmhjp{ X[DL@ dj`apfhr `ajar ranrdm{ o| d``rh{{ljnkrlplkdc hriarmdjkh nd{ pfdp clmlp pfhkddklp| ai pfh PKK pa ixcc| drplkldph ljixpxrh rhkajklcldplaj dj` d`aplaj ai pfhdktxl{ kammxjdxpdlrh*

    Pfh K@R l{ lmchmhjph` o| ^arc`Chdrjljn dj` ixj`h` o| X[DL@* PfhRhriarmdjkh-@rlyhj Rraghkp Mdjdnhmhjp&R@RM, ranrdm ~d{ hvhkxph` o|Mdjdnhr [xjd Hyrdj# xj`hr pfh{xhryl{laj ai Kaxjpr| @lrhkpar GdjEdra~lkw*

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    iar kddklp| `hyhcamhjp `xrljn ?22 ?? >>2098

    Phc7 %

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    R@RM Gaxrjdc ai Rhriarmdjkh

    ?242 EJA ^arc`~l`h fpp7!!pkk-`m*ocan{ap*kam! 8

    K|rx{ K@R

    ^fdp l{ Rhriarmdjkh @rlyhj Rraghkp Mdjdnhmhjp &R@RM,1

    Lj pfh hdrc| 4

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    R@RM Gaxrjdc ai Rhriarmdjkh

    ?242 EJA ^arc`~l`h fpp7!!pkk-`m*ocan{ap*kam! 9

    K|rx{ K@R

    Rhriarmdjkh @rlyhj Rraghkp Mdjdnhmhjp~d{ oarj*

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    Dcc ai pfh drplkldjp{ ~fa kamchph` pfl{ranrdm ch` ar drplkldph` lj d Md @d|mhhpljn iar pfhlr raghkp lj ar`hr pa {hppfhm{hcyh{ x pa pdeh pfh hriarmdjkh`rlyhj dradkf*

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    Md# d@hclyhrdoch{Mdprlv dj` dRhriarmdjkh

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    &RDK, kfdrp*

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    irhtxhjp {hci-majlparh` ihh`odke# dj`kajprac ai rh{axrkh{ rhtxlrh` pa mhhp pfhhvhkpdplaj{ dp dcc plmh{*

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    R@RM Gaxrjdc ai Rhriarmdjkh

    ?242 EJA ^arc`~l`h fpp7!!pkk-`m*ocan{ap*kam! >

    K|rx{ K@R

    Pfl{ `akxmhjp l{ phcc{ pfh {par| ai 4? aipfh K@R R@RM drplkldjp raghkp{*Pfhrh ~d{ d cdrnh rdjnh ai raghkp{ljyacyh` lj pfhranrdm* Hdkf kd{h

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    pfdp raghkp{ ~hrhdkpxdcc|

    lmchmhjpljnR@RM*

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    Ljphrrhpljn pfh @hclyhrdoch{ Mdprlv dj` pfh RDK Kfdrp

    Ajh ai pfh eh| rljklch{ ai R@RM l{ pfdppfh raghkp cdj {faxc` `h{krloh yhr|kchdrc|# ~fa ~lcc `hclyhr ~fdp pa ~fam o|~fhj# pfraxnfaxp pfh raghkp* Li |axhvdmljh pfh fhd`ljn{ ai pfh @hclyhrdoch{Mdprlv ohca~ |ax ~lcc {hh pfdp lp l{

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    [a pfh fhd`ljn Txdclp| @hiljh` l{{lmc| prdkeljn ~fhpfhr pfh x{hr{ ai d`hclyhrdoch fdyh pac` pfh a~jhr{ ~fdppfh| jhh` pa oh {xkkh{{ixc* Pfhrh drh `xh`dph{ iar hdkf `hclyhrdoch d{ ~hcc* Oxp lp l{lmarpdjp pa japh pfdp pfh `xh `dph{ md|jap dcc oh `hiljh` dp pfh ohnljjljn ai pfhraghkp*

    D{ japh` hdrclhr# raghkp{ fdyhxjkhrpdljp| oxlcp lj# {a li ~h ~djp hachpa nlyh x{ hr{ajdc kammlpmhjp{ ai ~fhjpfh| ~lcc kamchph d `hclyhrdoch# ~h fdyhpa ~dlp xjplc pfh| fdyh hjaxnfljiarmdplaj pa mdeh pfdp kammlpmhjp*Iljdcc|# rdpfhr pfdj prdkeljn fa~ idrdcajn pfh phdm l{ aj dj| `hclyhrdoch#

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    R@RM Gaxrjdc ai Rhriarmdjkh

    ?242 EJA ^arc`~l`h fpp7!!pkk-`m*ocan{ap*kam! 6

    K|rx{ K@R

    R@RM {lmc| prdke{ ~fdp l{ @ajh dj`~fdp l{ Jap @ajh* Pfl{ mhdj{ pfdp cdrnhkamchv `hclyhrdoch{# jhh` pa oh oraehj`a~j ljpa {mdcchr ajh{ {a pfdp ~h kdj`l{khrj pfdp rhdc ranrh{{ l{ ohljn md`h*

    Pfh oh{p lj`lkdpar ai ixpxrh raghkphriarmdjkh l{ d{p hriarmdjkh aj pfh{dmh raghkp* Pfh RDK kfdrp l{ d {lmchlj`lkdpar ai ~fhpfhr pfh phdm l{ clehc| pakamchph ixpxrh kammlpmhjp{ aj plmh*

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    pfh RDK Kfdrp lj`lkdph{ fa~ mdj|`hclyhrdoch{ drh xh hdkf ~hhe* Pfl{ cljhkajpljxh{ pa kclmo ohkdx{h lp l{kxmxcdplyh*

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    Pfh ocdke odr{ ohjhdpf pfh rh` cljhlj`lkdph pfh kxmxcdplyh jxmohr ai`hclyhrdoch{ kamchph`pa `dph* Pfhrhiarh#

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    hiihkplyhc| lj R@RM*

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    R@RM Gaxrjdc ai Rhriarmdjkh

    ?242 EJA ^arc`~l`h fpp7!!pkk-`m*ocan{ap*kam!

    K|rx{ K@R

    ^f| mayh ljpa Mdjxidkpxrljn1

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    R@RM Gaxrjdc ai Rhriarmdjkh

    ?242 EJA ^arc`~l`h fpp7!!pkk-`m*ocan{ap*kam! 46

    K|rx{ K@R

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    Ahrdpljn iram Kammlpmhjp{

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    oxp dc{a o| pfh Mdjdnljn @lrhkpar fhr{hci*

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  • 8/9/2019 PDPM Case Histories Journal - Final

    19/69

    R@RM Gaxrjdc ai Rhriarmdjkh

    ?242 EJA ^arc`~l`h fpp7!!pkk-`m*ocan{ap*kam! 4 ~hhe{ ai

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  • 8/9/2019 PDPM Case Histories Journal - Final

    20/69

    R@RM Gaxrjdc ai Rhriarmdjkh

    ?242 EJA ^arc`~l`h fpp7!!pkk-`m*ocan{ap*kam! ?2

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  • 8/9/2019 PDPM Case Histories Journal - Final

    21/69

    R@RM Gaxrjdc ai Rhriarmdjkh

    ?242 EJA ^arc`~l`h fpp7!!pkk-`m*ocan{ap*kam! ?4

    K|rx{ K@R

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    Pfh IARRHV raghkp ~lcc hvphj` oh|aj`pfh {kah ai pfh R@RM ranrdm*Kxrrhjpc|# ~lpf doaxp ; majpf{ chip pakamchph HX ixj`ljn rhtxlrhmhjp{# ;9{hklilk `hclyhrdoch{ mx{p oh kamchph` ljpfl{ plmhirdmh dj` hriarmdjkh dndlj{pkammlpmhjp{ fd{ rhmdljh` jhdrc|hrihkp*

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  • 8/9/2019 PDPM Case Histories Journal - Final

    22/69

    R@RM Gaxrjdc ai Rhriarmdjkh

    ?242 EJA ^arc`~l`h fpp7!!pkk-`m*ocan{ap*kam! ??

    K|rx{ K@R

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  • 8/9/2019 PDPM Case Histories Journal - Final

    23/69

    R@RM Gaxrjdc ai Rhriarmdjkh

    ?242 EJA ^arc`~l`h fpp7!!pkk-`m*ocan{ap*kam! ?;

    K|rx{ K@R

    Dp pfh plmh pfh R@RM prdljljn ~d{{pdrpljn lj @hkhmohr ?22

  • 8/9/2019 PDPM Case Histories Journal - Final

    24/69

    R@RM Gaxrjdc ai Rhriarmdjkh

    ?242 EJA ^arc`~l`h fpp7!!pkk-`m*ocan{ap*kam! ?0

    K|rx{ K@R

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  • 8/9/2019 PDPM Case Histories Journal - Final

    25/69

    R@RM Gaxrjdc ai Rhriarmdjkh

    ?242 EJA ^arc`~l`h fpp7!!pkk-`m*ocan{ap*kam! ?8

    K|rx{ K@R

    Hrd{mx{ Cdjnxdnh Khjphr7 Oca{{amljn iram Krl{l{

    Ljydcxdoch7 pfh raghkp nadc

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    ^lpfaxp fdyljn mdjdnh` ajh{ a~jox{ljh{{# pfh rhtxlrhmhjp{ dj`kfdcchjnh{ kdj oh oapf fl``hj d{ ~hcc d{xjrdkplkh`# hyhj pa pfh {elcch`raih{{lajdc*

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  • 8/9/2019 PDPM Case Histories Journal - Final

    26/69

    R@RM Gaxrjdc ai Rhriarmdjkh

    ?242 EJA ^arc`~l`h fpp7!!pkk-`m*ocan{ap*kam! ?9

    K|rx{ K@R

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    ^fdp ~d{ jap djplkldph` ~d{ pfh jxmohr

    ai pd{e{ nhjhrdph` iram pfdp{prdlnfpiar~dr` cdj* Pfh oxr`hj ~d{idccljn h{hkldcc| aj ajh ai pfh drpjhr{*Pfhrh ~d{ {lmc| paa mxkf ~are iar ajhhr{aj*

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    pfh rlarlplh{ ai pfh arndjlwdplaj* Lj ar`hrpa `a pfdp hiihkplyhc| ljiarmdplaj l{jhh`h`*

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    Rhriarmdjkh @rlyhj Rraghkp Mdjdnhmhjp*^lpf pfh eh| rljklch{ ai R@RM# pfha~jhr{ ~hrh doch pa mdjdnh pfh raghkp#ljyacyljn pfh {pdii dj` eh| {xclhr{*

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    lp*Pfl{ ~d{ ajh ai pfh ilr{p ~dphr{fh`mamhjp{ lj pfh raghkp iar pfh a~jhr{*

  • 8/9/2019 PDPM Case Histories Journal - Final

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    R@RM Gaxrjdc ai Rhriarmdjkh

    ?242 EJA ^arc`~l`h fpp7!!pkk-`m*ocan{ap*kam! ?>

    K|rx{ K@R

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    Pfh nadc kfa{hj ~d{ {prdlnfpiar~dr` dj`kchdr7 Oxlc` x hjraccmhjp lj pfh {kfaacpa 422 {px`hjp{ iar pfh ^ljphr {hmh{phr*

    Pfl{ ch` pa pfh ilr{p mdgar `hkl{laj* Pfhox{ljh{{ ma`hc pfh a~jhr{ fd` hjyl{lajh`

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    Kajprdkpljn axp d cl{p ai aphjpldckclhjp mhhpljn{

  • 8/9/2019 PDPM Case Histories Journal - Final

    28/69

    R@RM Gaxrjdc ai Rhriarmdjkh

    ?242 EJA ^arc`~l`h fpp7!!pkk-`m*ocan{ap*kam! ?6

    K|rx{ K@R

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    Pfh rljklch{ ai hriarmdjkhmdjdnhmhjp hvcdlj ~f| dj` ~fdp jhh`{pa oh `ajh5 lj {farp# pfh kfdjnhmx{p ohdjkfarh` pa pfh ~are rakh{{h{#arndjlwdplajdc aclklh{# dj` gao `|jdmlk{ai pfh hr{aj ar `hdrpmhjp ja~rh{aj{loch*

    Pfl{ {axj`{ canlkdc dj` aoylax{5 dj` l{ylrpxdcc| jhyhr d``rh{{h`# h{hkldcc| lj

    pfh kajphvp ai phkfjlkdc d{{l{pdjkh* X{ljnpfh mlkraka{m ai hriarmdjkh-`rlyhjraghkp mdjdnhmhjp &d{ d {hp ai karh

    rljklch{ ai hriarmdjkh mdjdnhmhjp,

    hjkaxrdnh` pfh Hrd{mx{ mdjdnhmhjpphdm pa {hh pfdp ljphrjdc ahrdplaj{ fd`pa kfdjnh li pfh| ~hrh naljn pa kfdjnh pfhhvhkpdplaj{# rhtxlrhmhjp{#rh~dr`!kamhj{dplaj# hyhj pfh rachai{pdii*

    Ja cajnhr ~d{ pfl{ d {ach rarlhpar{fl5lp ~d{ d {mdcc ox{ljh{{ ~lpf kamhplplyhkfdcchjnh{* Hrd{mx{ ~d{ kfdjnljn lp{ox{ljh{{ ma`hc pa {xlp pfh ox{ljh{{hjylrajmhjp* Pfhlr ox{ljh{{ nadc{ ~axc``hyhca lj fd{h{*

    Lp ~d{ kchdrc| rhkanjlwh` pfdp pfh{lpxdplaj rhtxlrh` mxkf marh hiiarp pfdjajh hr{aj kaxc` orljn pa ohdr* Dj` pfhkd{f ica~ pfh clihocaa` ai dj|arndjlwdplaj fd` pa oh lmrayh`

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  • 8/9/2019 PDPM Case Histories Journal - Final

    29/69

    R@RM Gaxrjdc ai Rhriarmdjkh

    ?242 EJA ^arc`~l`h fpp7!!pkk-`m*ocan{ap*kam! ?2

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  • 8/9/2019 PDPM Case Histories Journal - Final

    33/69

    R@RM Gaxrjdc ai Rhriarmdjkh

    ?242 EJA ^arc`~l`h fpp7!!pkk-`m*ocan{ap*kam! ;;

    K|rx{ K@R

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    Pfhrh drh jxmhrax{ ox{ljh{{kfdmohr{ lj pfh PKK* Pfhlr drhd{ ailjphrh{p rdjnh iram rhcdplyhc| {mdccox{ljh{{ {hkpar{ pa pfh cdrnhr {fhrh{ai dkplylp| ai kammhrkh dj` lj`x{pr|*

    Pfhrh ~d{ nrhdp ljphrh{p lj pfh R@RMmhpfa` hdrc| aj o| raih{{lajdcmdjdnhr{ lj oapf pfh Pxrel{f K|rlapKfdmohr ai Kammhrkh &PKKK, dj`pfh K|rx{ Pxrel{f Kfdmohr aiLj`x{pr| &KPKL,*

    Hdkf lj{plpxplaj ~d{ lmchmhjpljn dkamchv raghkp ~lpf ixj`ljn iram djljphrjdplajdc `ajar# dj` pfhdrplkldjp mdjdnhr{ x{h` pfh{hraghkp{ d{ pfh rhdc-clih cdoardpar| lj~flkf pa dc| pfh R@RM paac{ ~lpf{xarp ai pfh ljphrjdplajdc hvhrp{dj` cakdc kaj{xcpdjp{*

    [xarp iar Jarpf dj` [axpf

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    Lj pfh kd{h aiPKKK raghkpmdjdnhr{ Xmxp

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    hkajamlk ljphr`hhj`hjkh ohp~hhjpfh Nrhhe-K|rlap dj` pfh Pxrel{f-K|rlap kammxjlplh{ hjdocljn pfh p~aox{ljh{{ kammxjlplh{ pa hjfdjkhpfhlr ox{ljh{{ dj` hkajamlkrhcdplaj{*

    Pfl{ l{ `rlyhj o| pfh p~a Kfdmohr{ohclhi pfdp hkajamlk kajyhrnhjkh dj`{x{pdljdoch hkajamlk `hyhcamhjp drhh{{hjpldc ljnrh`lhjp{ ai d cd{pljn{acxplaj dj` ljkrhd{h`

    kamhplplyhjh{{ ai pfh l{cdj` d{ d~fach*

    Pfh kamchvlp| ai lmchmhjpdplaj ~d{hjfdjkh` o| pfh jhh` iar galjpkaahrdplaj ~lpf pfh K|rx{ Kfdmohrai Kammhrkh dj` Lj`x{pr|# dj`ajnaljn {xarp dj` kaar`ljdplaj aiK|rx{ Pxrel{f Kfdmohr ai Lj`x{pr|*

    Pfh raghkp ~d{ `h{lnjh` {a pfdp mdj|ai pfh dkplaj{ drh pa oh dkkamcl{fh`~lpf pfh drplkldplaj ai dcc drpjhr{#~flch {amh ai pfh `hclyhrdoch{ kdj ohdkkamcl{fh` o| hiiarp{ ai pfhJarpfhrj drpjhr{ ajc|*

  • 8/9/2019 PDPM Case Histories Journal - Final

    34/69

    R@RM Gaxrjdc ai Rhriarmdjkh

    ?242 EJA ^arc`~l`h fpp7!!pkk-`m*ocan{ap*kam! ;0

    K|rx{ K@R

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    Lp ~lcc kajpljxh iar djapfhr |hdr

    iacca~ljn pfh hj` ai pfh prdljljn dj`kadkfljn*

    D{ ~hcc# xjcleh mdj| ai pfh apfhr`hmaj{prdplaj raghkp{# pfl{ ajh fd{ohhj yhr| yxcjhrdoch pa hvphrjdcidkpar{ {xkf d{ pfh aclplkdc {lpxdplajohp~hhj pfh p~a {l`h{ ai pfh l{cdj`#PKK aclplkdc chd`hr{fl hchkplaj{# dj`ajnaljn d`gx{pmhjp{ o| pfh ixj`ljn`ajar lj rhndr`{ pa pfh kfdjnljn{lpxdplaj aj pfh nraxj`*

    Pfhrhiarh pfh rlmdr| iakx{ ai pfhkaj{xcpdjp{ lj ~areljn ~lpf pfh PKKKraghkp mdjdnhr{ ~d{ eja~ch`nh dj`{elcc oxlc`ljn ai pfh lj`lyl`xdc{ ljx{ljn pfh mhpfa` dj` paac{* Pfl{ ~d{`ajh lj d yhr| `|jdmlk hjylrajmhjp~fhrh lp ~d{ kammaj pa `hcd| ar hyhj{x{hj` {hklilk ljlpldplyh{*

    Nlyhj pfh rhtxlrh` ljyacyhmhjp ai pfhhvhkxplyh chd`hr{fl dj` hchkph`Oadr`{ ai pfh ljyacyh` lj{plpxplaj{#plmh `xrdplaj{ iar draydc{ ~hrhhd{lc| hvphj`h` dj` kfdjnh{ aihmfd{l{ kaxc` oh xjhvhkph`*

    Lj pfl{ p|h ai hjylrajmhjp# pfhaarpxjlp| iar dclkdplaj ai R@RMpa orljn {prxkpxrh dj` kcdrlp| pa pfh

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    Gx{p lj d pfrhh majpf farlwaj ~lj`a~#dcma{p 42( ai `hclyhrdoch{ rhtxlrh``hcd| ar lj {amh kd{h{ kdjkhccdplaj*

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    PKKK Hkajamlk Ljphr`hhj`hjkh - @hk ?222

  • 8/9/2019 PDPM Case Histories Journal - Final

    35/69

    R@RM Gaxrjdc ai Rhriarmdjkh

    ?242 EJA ^arc`~l`h fpp7!!pkk-`m*ocan{ap*kam! ;8

    K|rx{ K@R

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    xkamljn plmh farlwaj{ dj` mdj| aipfhm dkkamcl{fh` &dcpfaxnf pfhrhdrh aiphj `hcd|{ kdx{h` o| hvphrjdcidkpar{,*

    PKKK Hkajamlk Ljphr`hhj`hjkh - Md| ?242

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    Pfh hvphj`h` `xrdplaj ai pfh kadkfljnfd{ dcca~h` iar d `hh xj`hr{pdj`ljnai dc|ljn hriarmdjkh `rlyhjdradkfh{ pa mdjdnljn kamchvraghkp{* Pfh phdm mhmohr{ fdyh jh~

    lj`lyl`xdc kddklp| pa dc| pfh{h{elcc{ pa ixpxrh# clehc| ch{{ kamclkdph`#raghkp{*

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    Cdke ai {elcch` ~areiarkh rhyhjp{ pfhPK ox{ljh{{h{ iram ohljn marhkamhplplyh*

  • 8/9/2019 PDPM Case Histories Journal - Final

    36/69

    R@RM Gaxrjdc ai Rhriarmdjkh

    ?242 EJA ^arc`~l`h fpp7!!pkk-`m*ocan{ap*kam! ;9

    K|rx{ K@R

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  • 8/9/2019 PDPM Case Histories Journal - Final

    37/69

    R@RM Gaxrjdc ai Rhriarmdjkh

    ?242 EJA ^arc`~l`h fpp7!!pkk-`m*ocan{ap*kam! ;>

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  • 8/9/2019 PDPM Case Histories Journal - Final

    38/69

    R@RM Gaxrjdc ai Rhriarmdjkh

    ?242 EJA ^arc`~l`h fpp7!!pkk-`m*ocan{ap*kam! ;6

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  • 8/9/2019 PDPM Case Histories Journal - Final

    39/69

    R@RM Gaxrjdc ai Rhriarmdjkh

    ?242 EJA ^arc`~l`h fpp7!!pkk-`m*ocan{ap*kam! ;

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  • 8/9/2019 PDPM Case Histories Journal - Final

    42/69

    R@RM Gaxrjdc ai Rhriarmdjkh

    ?242 EJA ^arc`~l`h fpp7!!pkk-`m*ocan{ap*kam! 0?

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