1 Start 2 Day 1 3 Day 2 4 No Medications 5 Complete Instructions:Complete this survey for each client/resident with Parkinson's disease using an identifier you can easily recognize without revealing personal health information. For example, use the room number or house address to keep track of which medication audits have been conducted. Complete audits in June and December. Name of Site/Agency * - Select -80th Street ResidenceAdult Family Home CareAffirmed Home CareAHA Auxilio-HomeAideAlliance HomecareAlways Best Care Senior Services BurlingtonAlways Best Care Senior Services PeninsulaAlways Best Care Senior Services TempeAngels HomecareAmada Senior CareAngels on Call HomecareArbor TraceArosa AtlantaArosa Los AngelesArosa Metro Kansas CityAssured Home Nursing ServicesAt Home Senior CareBella Vita Assisted LivingBrightStar Care of Naples and Fort MyersBrightStar Care of the Twin CitiesBroadstreet Home CareCare IndeedCare Suites of Edina by VivieChristian Health Care CenterCitrus Health and RehabilitationCOHME (Concerned Home Management for the Elderly, Inc)ComForCare Grand RapidsConnections in Home CareCountry House Assisted Living (ACTS)Country House Skilled Nursing (ACTS)Cypress Care CenterDesert Valley Hospice and Palliative CareEdgewood Assisted LivingEldercare Home CareEnglish RoseGeneva SuitesGolden Harmony Home CareHavenwood of BuffaloHavenwood of BurnsvilleHavenwood of Maple GroveHavenwood of MinnetonkaHavenwood of OnalaskaHeart, Body & Mind Home CareHighview Hills by VivieHome Care PartnersHomeChoice Home Care SolutionsHome Instead Baton RougeHomewatch CareGivers LincolnwoodJohn Knox VillageJoyful CompanionsLady Lake Specialty Care CenterLegacy Homecare LALife Care Center of Nashoba ValleyLife Home HealthLyngblomstenMeadowlarkMitchell ManorNetherbay at Bay ShoreNorBella Prior LakeNYC Health & Hospitals - McKinneyNYC Health & Hospitals - SeaViewOpen Arms SolutionsOrchards of MinnetonkaParkinson's Specialty CareParkview Care CenterReunion Rehabilitation Hospital InvernessRight At Home - ColumbiaRight at Home East BayRight at Home Lee’s SummitRight At Home of SW FloridaRight At Home Twin Cities and South SuburbsRiver Heights by VivieSaint Simeon's Senior CommunitySenior Helpers Triangle AreaSummit PlaceSYNERGY HomeCare of Mid PennSYNERGY HomeCare of NW AtlantaSYNERGY HomeCare of RosevilleSYNERGY HomeCare of Silicon ValleySYNERGY HomeCare of South DadeSYNERGY HomeCare of Golden Valley (West Metro)SYNERGY HomeCare of South Metro (Burnsville)SYNERGY HomeCare of Northeast Metro (Andover & Blaine)SYNERGY HomeCare of East Metro & Western WI (Woodbury)SYNERGY HomeCare of MSP Metro (Roseville)SYNERGY HomeCare of TucsonSYNERGY HomeCare of the West ValleyTalamore Senior Living WoodburyThe Glenn MinnetonkaThe KensingtonThe Levande by VivieThe Lodge at StillwaterThe Plaza by VivieThe Rushseba by VivieThe Terraces of Phoenix - HumanGoodTimber Pines by VivieTouching Hearts at HomeVillage on the Park McKinneyVisiting Angels CTVisiting Angels Helena, MTVisiting Angels Nashua NHVisiting Angels of RaleighVisiting Angels West MetroWalker Place by VivieWestwood Ridge by VivieWilder Healthy Aging and Caregiver Services - Hamline & RavouxWilliston Care CenterYouville House Month of Audit: * June December Year of Audit: * - Select -2025 Name of person conducting audit: * Client/Resident Identifier * (Anonymized) Indicate if your client with PD or related movement disorder is taking any of the medications below: * Reglan (metoclopramide) Compazine (prochlorperazine) Asenden (amozapine) Haldol (haloperidol) Zyprexa (olanzapine) Risperdal (risperidone) Rexulti (brexpiprazole) Depakote (valproate) None of the Above Our agency does not routinely collect medication information. We administered Carbidopa / Levodopa Parkinson's medications to clients/residents during this audit period. * Yes No Leave this field blank