*Assessment—Taking stock of all observations, information, and knowledge about a resident from all available sources (e.g., medical records, the resident, resident’s family, and/or guardian or other legally authorized representative).
†Decision-making — Determining with the resident (resident’s family and/or guardian or other legally authorized representative), the resident’s physician and the interdisciplinary team, the severity, functional impact, and scope of a resident’s clinical issues and needs.
‡Care Planning—Establishing a course of action with input from the resident (resident’s family and/or guardian or other legally authorized representative), resident’s physician and interdisciplinary team that moves a resident toward resident-specific goals utilizing individual resident strengths and interdisciplinary expertise; crafting the “how” of resident care