FUNCTIONAL PERFORMANCE LEVELS PART 1
FUNCTIONAL PERFORMANCE LEVELS PART 2
GG SELF-CARE ACTIVITIES
GG MOBILITY ACTIVITIES
LEVEL AND TASK
100

One nurse aide (helper) provides verbal cues or touching/steadying/contact guard assistance as the resident completes the activity.

WHAT IS: 

SUPERVISION OR TOUCHING ASSISTANCE? (GG 04)

100

Performance level when two nurse aides (helper) are required for the safe completion of an activity, even if the second helper only provides supervision/stand-by assist and does not end up needing to provide hands-on assistance. 

WHAT IS:

Dependent? (GG 01) 

100

This task includes how the resident brings food to his or her mouth and swallows during meals.

WHAT IS:

Eating? (GG0130A)

100

This task includes assisting the resident from sitting in the wheelchair to standing at the side of the bed.

WHAT IS:

Sit to stand? (GG0170D)

100

The nurse aide (helper) opens all of Mrs. Royal’s cartons and containers on her food tray before leaving the room. There are no safety concerns regarding her ability to eat, and she eats the food herself with the utensils provided.

WHAT IS:

Setup or cleanup assistance for Eating? (GG 05)

200

One nurse aide (helper) lifts, holds or supports the resident's trunk or limbs but provides less than half the effort. 

WHAT IS:

Partial/moderate assistance? (GG 03)

200

Performance level when a resident requires one nurse aide to provide support and a second nurse aide to manage the necessary equipment to allow the activity to be completed.

WHAT IS: 

Dependent? (GG 01)

200

This task includes perineal hygiene after voiding.

WHAT IS:

Toileting hygiene? (GG0130C)

200

This task includes helping the resident off the toilet.

WHAT IS:

Toilet transfer? (GG0170F)

200

Mr. Chiefs has Parkinson’s disease and significant tremors that cause intermittent difficulty for him to perform perineal hygiene after having a bowel movement in the toilet. He is able to lower his pants but asks the nurse aide to help him with perineal hygiene. He then pulls up his pants without assistance.

WHAT IS:

Partial/moderate assistance for Toilet hygiene?

 (GG 03)

300

One nurse aide (helper) assists only before or following the activity, but NOT during the activity. 

WHAT IS: 

Setup or cleanup assistance? (GG 05)

300

Charted when the resident refuses to complete the activity.

WHAT IS:

Refused? (GG 07)

300

This task includes rinsing dentures.

WHAT IS: 

Oral hygiene? (GG0130B)

300

This task typically includes how the resident walks a short distance, such as from the bed to the bathroom.

WHAT IS:

Walk 10 ft? (GG0170I)

300

Mr. Midwest has limited mobility resulting from multiple and complex medical conditions. He prefers to wash his full body while sitting in front of the sink in his bathroom. The nurse aide (helper) assists with washing, rinsing, and drying his arms/hands, upper legs, lower legs, buttocks, and back.

WHAT IS:

Substantial/maximal assistance for Shower/bathe self? (GG 02)

400

One nurse aide (helper) lifts or holds the resident's trunk or limbs and provides MORE than half the effort. 

WHAT IS: 

Substantial/maximal assistance? (GG 02)

400

Charted when the resident did not attempt an activity due to weather constraints (i.e., did not complete car transfer due to blizzard).

WHAT IS:

Not attempted due to environmental limitations? (GG 10)

400

This task includes buttoning a resident’s blouse.

WHAT IS:

Upper body dressing? (GG0130F)

400

This task is typically achieved when a resident walks from his or her room, turns into the hallway, walks to the dining room, turns into the dining room, and walks to his or her table.

WHAT IS:

Walk 50 feet with two turns? (GG0170J)

400

Mr. Husker requires assistance from two nurse aides (helpers) to move from sitting at the edge of the bed to lying flat on the bed due to paralysis on his right side and cognitive limitations.

WHAT IS:

Dependent (for Sit to lying)? (GG 01)

500
The resident completes the activity alone with no assistance from the nurse/nurse aide (helper). 
WHAT IS:

Independent? (GG 06)

500

Performance level when a resident requires two staff to transfer with a mechanical lift due to facility policy.

WHAT IS:

Dependent? (GG 01)

500

This task includes shaving a resident’s face.

WHAT IS:

Personal hygiene? (GG0130I)

500

This task may include the resident propelling self to BINGO in a wheelchair to a location that is at least 200 feet away.

WHAT IS:

Wheel 150 feet? (GG0170S)

500

Mrs. Bluejay is sitting on the side of the bed. The nurse aide (helper) provides contact guard support as Mrs. Jones stands and pivots into the wheelchair.

WHAT IS:

Supervision or touching assistance? (For Chair/bed-to-chair transfer) (GG 04)

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