Write an Initial PSYCH VISIT, chief complaint, , Psychiatric visit HPI, current Psych meds, exam, social history,, screening tools and results MSE, diagnosis and recommended Plan (medication and dosages), rationale for using the medications for 77 years old female referred to be seen for initial psychiatric visit. She is currently residing at a skilled nursing facility. She is here post hospitalization of encounter of orthopedic care and acquired deformities of the toe. She has Psych diagnosis of MDD and Insomnia. Assessment was done in the patient's room. During this assessment, she was very sleepy but said her sleep is good and her mood is stable. She is very think and fragile and said she will like to sleep some more. Current Medications: Escitalopram 5mg for MDD