New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 60 - HOME CARE SERVICES
Appendix B
Universal Citation: NJ Admin Code B
Current through Register Vol. 56, No. 6, March 18, 2024
RANCHO SCALE
| Level | Response | Patient Function |
| I | No response | Patient is completely unresponsive to any |
| stimulus. | ||
| II | Generalized response | Patient reacts to the environment, but not as a |
| specific response to the stimulus--responses | ||
| are often the same despite change of stimuli. | ||
| The earliest response is often gross movement | ||
| to deep pain. | ||
| III | Localized response | Patient reacts in a specific manner to the |
| stimulus, but may inconsistently turn head to | ||
| sound, withdraw an extremity to pain, squeeze | ||
| fingers placed in the hand, or respond to | ||
| family members more than others. | ||
| IV | Confused, agitated | Patient is in a heightened state of activity, |
| but is still severely detached from the | ||
| surroundings. Internal confusion and very | ||
| limited ability to learn is combined with short | ||
| attention span and easy fatigue. The patient | ||
| is unable to cooperate and may be aggressive, | ||
| combative, or incoherent. | ||
| V | Confused, inappropriate/ | Patient appears alert and is able to respond to |
| nonagitated | simple commands. Responses are best with | |
| familiar routines, people, and structured | ||
| situations. Distractibility and short | ||
| attention span lead to difficulty learning new | ||
| tasks and agitation in response to | ||
| frustrations. If physically mobile, there may | ||
| be wandering. Much external structure is | ||
| needed. Initiation and memory are limited. | ||
| VI | Confused, appropriate | Patient shows goal-directed behavior, but still |
| is dependent on external structure and | ||
| direction. Simple directions are followed | ||
| consistently and there is carry-over of | ||
| relearned skills (like dressing), yet new | ||
| learning progresses very slowly with little | ||
| carry-over. Orientation is better and there is | ||
| no longer inappropriate wandering. | ||
| VII | Automatic, appropriate | Patient appears appropriate and oriented with |
| familiar settings such as home and hospital, | ||
| but is confused and often helpless in | ||
| unfamiliar surroundings. The daily routine can | ||
| be managed with minimal confusion as long as | ||
| there are no changes. There is little recall | ||
| of what has just been done. There is only a | ||
| superficial understanding of the disability, | ||
| with lack of insight into the significance of | ||
| the remaining deficits. Judgment is impaired | ||
| with inability to plan ahead. New learning is | ||
| slow and minimal supervision is needed. | ||
| Driving is unsafe; supervision is needed for | ||
| safety in the community or in school and | ||
| workshop settings. | ||
| VIII | Purposeful, appropriate | Patient may not function as well as before the |
| injury, but is able to function independently | ||
| in home and community skills, including | ||
| driving. Alert, oriented, and able to | ||
| integrate past and present events. Vocational | ||
| rehabilitation is indicated. Difficulties | ||
| dealing with stressful or unexpected situations | ||
| can arise, as there may be a decrease in | ||
| abstract reasoning, judgment, intellectual | ||
| ability, and tolerance of stress relative to | ||
| premorbid capabilities. |
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