<div id="StartOfCare19" style="display:none">
	
	<form name="formstep19" id="formstep19">
		<div class="form-body">
			<input type="hidden" name="hdnM2010Count" id="hdnM2010Count" />
			<input type="hidden" name="hdnM2002Count" id="hdnM2002Count" />
			<input type="hidden" name="hdnM2020Count" id="hdnM2020Count" />
			<input type="hidden" name="hdnM2030Count" id="hdnM2030Count" />
			
<!---<cfif Session.EmployeeId eq 3124 >--->

<ul class="pagination nav_pagination" style="margin-left:0px;">
					<cfloop index=ind from="1" to="21">
						<cfoutput>
							<li class="nav_StartOfCare#ind# <cfif ind eq 1>active</cfif>" onClick="$('##StartOfCare19').hide(); $('##StartOfCare#ind#').show(); $('.pagination li').removeClass('active'); $('.nav_StartOfCare#ind#').addClass('active');">
								<a href="javascript:;">#ind#</a>
							</li>
						</cfoutput>
					</cfloop>
					
						<a href="#form_modal2" data-toggle="modal"> <img alt="" src="/img/smartdx.png" style=" width:17%"></a><span id="live_score_19" style="color:red; font-weight:bold; font-size:18px;">100%</span>
					<div class="label-stable">
					<label style="background-color:#B5FBB6;">What does green mean? <img src="../../images/icon_help.png" alt="top" style="cursor:pointer" onclick="green_help();" /></label><br />
					<label style="background-color:#FBB2FB;">What does pink mean? <img src="../../images/icon_help.png" alt="top" style="cursor:pointer" onclick="pink_help();" /></label>
				   </div>
				</ul>
			<div class="dashboard-stat2 progress_div" style="margin-left:0px; padding-top: 0px; max-width:450px; width:80%">
					<div class="progress-info">
						<div class="progress" style="height: 9px">
							<span class="progress-bar progress-bar-success green-sharp">
								<span class="sr-only ">0% progress</span>
							</span>
						</div>
						<div class="status">
							<div class="status-title"> progress </div>
							<div class="status-number"> <span class="progressBar">0%</span> </div>
						</div>
					</div>
				</div>

<!---<cfelse>
			<div class="margin-top-10 text-center">
				<ul class="pagination nav_pagination" style="margin:0;">
					<cfloop index=ind from="1" to="21">
						<cfoutput>
							<li class="nav_StartOfCare#ind# <cfif ind eq 1>active</cfif>" onClick="$('##StartOfCare19').hide(); $('##StartOfCare#ind#').show(); $('.pagination li').removeClass('active'); $('.nav_StartOfCare#ind#').addClass('active');">
								<a href="javascript:;">#ind#</a>
							</li>
						</cfoutput>
					</cfloop>
				</ul>

				<div class="dashboard-stat2 progress_div" style="margin: 0px auto; padding-top: 0px; max-width: 560px;">
					<div class="progress-info">
						<div class="progress" style="height: 9px">
							<span class="progress-bar progress-bar-success green-sharp">
								<span class="sr-only ">0% progress</span>
							</span>
						</div>
						<div class="status">
							<div class="status-title"> progress </div>
							<div class="status-number"> <span class="progressBar">0%</span> </div>
						</div>
					</div>
				</div>
			</div>
</cfif>--->
             <div class="well">
			<input type="text" style="width:0px;height:0px;border:0" name="txtfocus19" id="txtfocus19" value=""/>
			<div class="form-group">
				<div class="label-stable">
					<label> <cfif AssForm.Assessment_Completed_M0090 gte '2017-01-01'>M2001<cfelse>M2000</cfif> Drug Regimen Review Does a complete drug regimen review indicate potential clinically significant medication issues?</label>
					<div id="rdnM2000d" class="radio-list">
					<cfif AssForm.Assessment_Completed_M0090 gte '2017-01-01'>
                            <label>
                            <input type="radio" id="rdnM2000"  name="rdnM2000" value="0 - No - No issues found during review" onclick="hideM2000(0);" <cfif AssForm.M2000_Adverse EQ "0 - No - No issues found during review">checked</cfif>>0 - No - No issues found during review</label>
						   <label>
                            <input type="radio" id="rdnM2000"  name="rdnM2000" value="1 - Yes - Issues found during review"  onclick="hideM2000(1);" <cfif AssForm.M2000_Adverse EQ "1 - Yes - Issues found during review">checked</cfif>> 1 - Yes - Issues found during review </label>
                            <label>
                            <input type="radio" id="rdnM2000"  name="rdnM2000" value="9 - NA - Patient is not taking any medications"  onclick="hideM2000(1);" <cfif AssForm.M2000_Adverse EQ "9 - NA - Patient is not taking any medications">checked</cfif>> 9 - NA - Patient is not taking any medications</label>
                      <cfelse>
						<label>
						<input type="radio"  name="rdnM2000" value="0 - Not assessed/reviewed" onclick="hideM2000(0);" <cfif AssForm.M2000_Adverse EQ "0 - Not assessed/reviewed">checked</cfif>> 0 - Not assessed/reviewed</label>
						<label>
						<input type="radio"  name="rdnM2000" value="1 - No problems found during review"  onclick="hideM2000(0);" <cfif AssForm.M2000_Adverse EQ "1 - No problems found during review">checked</cfif>> 1 - No problems found during review</label>
						<label>
						<input type="radio"  name="rdnM2000" value="2 - Problems found during review"  onclick="hideM2000(1);" <cfif AssForm.M2000_Adverse EQ "2 - Problems found during review">checked</cfif>> 2 - Problems found during review</label>
						<label>
						<input type="radio"  name="rdnM2000" value="NA - Patient is not taking any medications" onclick="hideM2000(1);" <cfif AssForm.M2000_Adverse EQ "NA - Patient is not taking any medications">checked</cfif>> NA - Patient is not taking any medications</label>
					</cfif>
					</div>
				</div>
				<!---<cfif AssForm.M2000_Adverse contains "0" OR AssForm.M2000_Adverse contains "1">
					<p id="spnM2000" style="color:red;font-weight:bold;">Skip M2002 and answer M2010</p>
				<cfelse>
					<p id="spnM2000" style="display:none;color:red;font-weight:bold;">Skip M2002 and answer M2010</p>
				</cfif>--->
			</div>
			<p class="btn blue margin-bottom-20" id="PrReviewMeds" onclick="ColdFusion.Window.show('ReviewMedsWindow');" style="cursor:pointer;">review meds - signup for automated drug-drug drug-allergy checks</p>
			<div class="form-group" id="hide_drpM2010" <cfif AssForm.M2000_Adverse contains "0">style="display:none;"</cfif>>
				<div class="label-stable">
					<label><cfif AssForm.Assessment_Completed_M0090 gte '2017-01-01'>M2003 Did the agency contact a physician(or physician -designee) by midnight of the next calender day and complete prescribed/recommended actions in response to the identfied potential clinically significant medication issuses?<cfelse>M2002 Medication Follow-up: Was physician (or other primary practitioner) contacted within one calender day to resolve medication issues?</cfif></label>
					<div id="rdnM2002d" class="radio-list">
						<label>
						<input type="radio" name="rdnM2002" value="0 - No" <cfif AssForm.M2002_Med_FU contains "0">checked</cfif>> 0 - No</label>
						<label>
						<input type="radio"  name="rdnM2002" value="1 - Yes" <cfif AssForm.M2002_Med_FU contains "1">checked</cfif>> 1 - Yes</label>
					</div>
				</div>
			</div>
			
			<div class="form-group">
			<div id="span_drpM2010" style="background-color:#B5FBB6">
				<div class="label-stable">
					<label><strong>M2010 Patient/Caregiver High Risk Drug Education: Has pt/caregiver received instruction for all high-risk medications</strong> </label>
					<div id="drpM2010d" class="radio-list">
						<label>
						<input type="radio" name="drpM2010" onclick="count_change();" value="0 - No" <cfif AssForm.M2010_Med_Edu contains "0 -">checked</cfif>> 0 - No</label>
						<label>
						<input type="radio" name="drpM2010" onclick="count_change();"  value="1 - Yes" <cfif AssForm.M2010_Med_Edu contains "1 -">checked</cfif>> 1 - Yes</label>
						<label>
						<input type="radio" name="drpM2010" onclick="count_change();" value="NA - Patient not taking any high risk drugs OR patient/caregiver fully knowledgeable about special precautions associated with all high-risk medications" <cfif AssForm.M2010_Med_Edu contains "NA -">checked</cfif>> NA - Patient not taking any high risk drugs OR patient/caregiver fully knowledgeable about special precautions associated with all high-risk medications</label>
					</div>
				</div>
			</div>
			</div>
			
			<div class="form-group">
			<div id="drpM2020d" style="background-color:#FBB2FB">
				<div class="label-stable">
					<label><strong>M2020 Management of Oral Medications: Current ability to prepare and take all prescribed oral medications reliably and safely</strong></label>
					<div class="radio-list">
						<label>
						<input type="radio" name="drpM2020" onclick="color_change();" value="0 - Able to independently take the correct oral medication(s) and proper dosage(s) at the correct times." <cfif AssForm.Oral_Meds_M0780 contains "0 -">checked</cfif>> 0 - Able to independently take the correct oral medication(s) and proper dosage(s) at the correct times.</label>
						<label>
						<input type="radio" name="drpM2020" onclick="color_change();" value="1 - Able to take medication(s) at the correct times if: (a) individual dosages are prepared in advance by another person; OR (b) another person develops a drug diary or chart." <cfif AssForm.Oral_Meds_M0780 contains "1 -">checked</cfif>> 1 - Able to take medication(s) at the correct times if: (a) individual dosages are prepared in advance by another person; OR (b) another person develops a drug diary or chart.</label>
						<label>
						<input type="radio" name="drpM2020" onclick="color_change();" value="2 - Able to take medication(s) at the correct times if given reminders by another person at the appropriate times" <cfif AssForm.Oral_Meds_M0780 contains "2 -">checked</cfif>> 2 - Able to take medication(s) at the correct times if given reminders by another person at the appropriate times</label>
						<label>
						<input type="radio" name="drpM2020" onclick="color_change();" value="3 - Unable to take medication unless administered by another person." <cfif AssForm.Oral_Meds_M0780  contains "3 -">checked</cfif>> 3 - Unable to take medication unless administered by another person.</label>
						<label>
						<input type="radio" name="drpM2020" onclick="color_change();" value="NA - No oral medications prescribed." <cfif AssForm.Oral_Meds_M0780 contains "NA -">checked</cfif>> NA - No oral medications prescribed.</label>
					</div>
				</div>
				</div>
			</div>
			<div class="form-group">
				<div class="label-stable">
					<label>M2030 Management of Injectable Medications: Current ability to prepare and take prescribed injectable medications reliably/safely</label>
					<div id="drpM2030d" class="radio-list">
						<label>
						<input type="radio" name="drpM2030" value="0 - Able to independently take the correct medication(s) and proper dosage(s) at the correct times." <cfif AssForm.Inject_Meds_M0800 contains "0 -">checked</cfif>> 0 - Able to independently take the correct medication(s) and proper dosage(s) at the correct times.</label>
						<label>
						<input type="radio" name="drpM2030" value="1 - Able to take injectable medication(s) at the correct times if: (a) individual syringes are prepared in advance by another person; OR (b) another person develops a drug diary or chart." <cfif AssForm.Inject_Meds_M0800 contains "1 -">checked</cfif>> 1 - Able to take injectable medication(s) at the correct times if: (a) individual syringes are prepared in advance by another person; OR (b) another person develops a drug diary or chart.</label>
						<label>
						<input type="radio" name="drpM2030" value="2 - Able to take medication(s) at the correct times if given reminders by another person based on the frequency of the injection" <cfif AssForm.Inject_Meds_M0800 contains "2 -">checked</cfif>> 2 - Able to take medication(s) at the correct times if given reminders by another person based on the frequency of the injection</label>
						<label>
						<input type="radio" name="drpM2030" value="3 - Unable to take injectable medication unless administered by another person." <cfif AssForm.Inject_Meds_M0800 contains "3 -">checked</cfif>> 3 - Unable to take injectable medication unless administered by another person.</label>
						<label>
						<input type="radio" name="drpM2030" value="NA - No injectable medications prescribed." <cfif AssForm.Inject_Meds_M0800 contains "NA -">checked</cfif>> NA - No injectable medications prescribed.</label>
					</div>
				</div>
			</div>
			<h4>M2040 Prior Medication Management Indicate ability with managing oral and injectable medications prior to this current illness, exacerbation, or injury.</h4>
			<div class="form-group">
				<div class="label-stable">
					<label>Oral Medications</label>
					<div id="rdnOrald" class="radio-list">
						<label>
						<input type="radio" name="rdnOral" value="0 - Independent" <cfif AssForm.Oral_Meds_M0780p EQ "0 - Independent">checked</cfif>> 0 - Independent</label>
						<label>
						<input type="radio" name="rdnOral" value="1 - Needed Some Help" <cfif AssForm.Oral_Meds_M0780p EQ "1 - Needed Some Help">checked</cfif>> 1 - Needed Some Help</label>
						<label>
						<input type="radio" name="rdnOral" value="2 - Dependent" <cfif AssForm.Oral_Meds_M0780p EQ "2 - Dependent">checked</cfif>> 2 - Dependent</label>
						<label>
						<input type="radio" name="rdnOral" value="NA - Not Applicable" <cfif AssForm.Oral_Meds_M0780p EQ "NA - Not Applicable">checked</cfif>> NA - Not Applicable</label>
					</div>
				</div>
			</div>
			<div class="form-group">
				<div class="label-stable">
					<label>Injectable Medications</label>
					<div id="rdnInjectd" class="radio-list">
						<label>
						<input type="radio" name="rdnInject" value="0 - Independent" <cfif AssForm.Inject_Meds_m0800p EQ "0 - Independent">checked</cfif>> 0 - Independent</label>
						<label>
						<input type="radio" name="rdnInject" value="1 - Needed Some Help" <cfif AssForm.Inject_Meds_m0800p EQ "1 - Needed Some Help">checked</cfif>> 1 - Needed Some Help</label>
						<label>
						<input type="radio" name="rdnInject" value="2 - Dependent" <cfif AssForm.Inject_Meds_m0800p EQ "2 - Dependent">checked</cfif>> 2 - Dependent</label>
						<label>
						<input type="radio" name="rdnInject" value="NA - Not Applicable" <cfif AssForm.Inject_Meds_m0800p EQ "NA - Not Applicable">checked</cfif>> NA - Not Applicable</label>
					</div>
				</div>
			</div>
			<div class="form-group">
				<label>Comments</label>
				<textarea class="form-control" name="txtComment" id="txtComment" onblur="CommentChangeBlur('formstep19')" rows="3"><cfoutput>#AssForm.Assessment_note#</cfoutput></textarea>
			</div>
			<h4>Patient's Own Words:</h4>
			  <div class="row">
			   <div class="col-md-4">
			     <div class="form-group">
				<label>Strengths</label>
				<textarea class="form-control" name="Strengths" id="Strengths" onblur="StrengthsChangeBlur('formstep19')" rows="3"><cfoutput>#AssForm.Strengths#</cfoutput></textarea>
				</div>
			</div>
			<div class="col-md-4">
			     <div class="form-group">
				<label>Goals</label>
				<textarea class="form-control" name="Goals" id="Goals" onblur="GoalsChangeBlur('formstep19')" rows="3"><cfoutput>#AssForm.Goals#</cfoutput></textarea>
				</div>
			</div>
			<div class="col-md-4">
			     <div class="form-group">
				<label>Care Preference</label>
				<textarea class="form-control" name="Care_Preference" id="Care_Preference" onblur="Care_PreferenceChangeBlur('formstep19')" rows="3"><cfoutput>#AssForm.Care_Preference#</cfoutput></textarea>
				</div>
			</div>
			  
			  
			</div>
			
		<div class="row">
		  <div class="col-md-4">
			     <div class="form-group">
				<label>Risk Factor</label>
				<textarea class="form-control" name="Risk_Factor" id="Risk_Factor" onblur="Risk_FactorChangeBlur('formstep19')" rows="3"><cfoutput>#AssForm.Risk_Factor#</cfoutput></textarea>
				</div>
			</div>
			<div class="col-md-4">
			     <div class="form-group">
				<label>Interventions</label>
				<textarea class="form-control" name="Interventions" id="Interventions" onblur="InterventionsChangeBlur('formstep19')" rows="3"><cfoutput>#AssForm.Interventions#</cfoutput></textarea>
				</div>
			</div>
			
			<div class="col-md-4" style="padding:4%;">
			<div class="form-group">
				<label>Add Vital <img name="imgbtnaddvital" id="imgbtnaddvital" src="../../images/icon_add.png" style="cursor:pointer" onclick="ColdFusion.Window.show('Vitaldiv')"/></label>
				<input type="hidden" name="AssTrackID" id="AssTrackID" value="<cfoutput>#AssForm.Assessment_Tracker_ID#</cfoutput>">
			</div>
			</div>
			</div>
			
			<!---<div class="form-group">
				<label>Add Vital <img name="imgbtnaddvital" id="imgbtnaddvital" src="../../images/icon_add.png" style="cursor:pointer" onclick="ColdFusion.Window.show('Vitaldiv')"/></label>
			</div>--->
		</div>
		</div>
		<div class="form-actions">
			<input class="btn blue" type="button" value="Previous" onClick="$('#StartOfCare19').hide(); $('#StartOfCare18').show(); $('.pagination li').removeClass('active'); $('.nav_StartOfCare18').addClass('active'); $('html, body').animate({scrollTop: '0px'}, 300);">
			<input class="btn green" type="button" name="BtnStep3" value="Next" onClick="UpdateSoc('19');" >
				<button type="button" id="imgclose" class="btn default" onclick="StepClose(19);">Cancel</button>
			</div>
	</form>
</div>
