N.J. Admin. Code § Tit. 10, ch. 60, app B

Current through Register Vol. 56, No. 24, December 18, 2024

Appendix B

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.

N.J. Admin. Code Tit. 10, ch. 60, app B