Rancho Los Amigos Scale

When it activates

Scribeable activates a calculator from the encounter. The Rancho Los Amigos Scale can activate when the transcript or pasted chart context documents any of these:

• TBI recovery assessment
• Brain injury rehabilitation monitoring
• Cognitive recovery tracking

Note-type scope: it activates on notes whose subject resolves to rehab, neurology. A note that resolves to another subject does not carry it even when the clinician's specialty matches; a note with no resolvable subject (a generic consultation) falls back to the specialty match.

Inputs the note needs

1 input. Each is resolved from the transcript, the pasted chart context and charted labs; at this calculator’s tier a missing input is never requested, and a missing required input keeps the score out of the draft.

Scoring

Levels I-X: I=No response, II=Generalized response, III=Localized response, IV=Confused/agitated, V=Confused/inappropriate/non-agitated, VI=Confused/appropriate, VII=Automatic/appropriate, VIII=Purposeful/appropriate with standby, IX=Purposeful/appropriate with standby on request, X=Purposeful/appropriate modified independent.

Interpretation

I-III: Low-level responses — sensory stimulation program. IV: Agitated — safety measures, structured environment. V-VI: Confused — structured tasks, reduce stimulation. VII-VIII: Appropriate with supervision — increasing independence. IX-X: Independent — community reintegration.

Evidence

Sources carried in Scribeable's citation registry for this calculator; guideline version: Hagen 1972.

• Hagen C et al. Levels of Cognitive Functioning (Rancho Los Amigos Scale)Hagen et al. (Rancho) 1972 · 1972 · Rancho Los Amigos · link last verified 2026-03-28

How Scribeable handles it in the note

When an encounter activates the Rancho Los Amigos Scale (its highest tier is recommended), Scribeable does not ask you for missing inputs. The score is computed in code from whatever inputs resolve from the transcript, the pasted chart context or charted labs; a computed value is written into the draft only when every required input already resolves.

The score is computed in code from the resolved inputs, not recalled by the language model. A stated Rancho Los Amigos Scale value is compared against the computed one when the draft's structured summary carries it; a disagreement found there is flagged to the second drafting pass, which is instructed to correct the score and its interpretation, unless Scribeable has supplied the computed value to that pass, in which case the value the draft writes is checked against the supplied one and a detected difference is shown beside the note for you to adjudicate rather than silently rewritten.

Classified as a risk score: activated strictly, by a documented trigger, never by a permissive reading of the encounter.

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Can activate in: Neurology, Neurosurgery, Physical Medicine & Rehabilitation.