Version 2.77

Status Information

Status
DEPRECATED
Comment
Discouraged as items are from a legacy demonstration tool that is no longer maintained. No replacement term defined.

Panel Hierarchy

Details for each LOINC in Panel LHC-Forms

LOINC Name R/O/C Cardinality Example UCUM Units
69412-5 Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Long term care hospital (LTCH) - version 1.0
Indent69416-6 Continuity assessment record and evaluation (CARE) tool - Long term care hospital (LTCH) - Admission - version 1.0
IndentIndent70117-7 Administrative information
IndentIndentIndent58198-3 Type of record during assessment period [CMS Assessment]
IndentIndentIndent58200-7 Correction number during assessment period [CMS Assessment] {#}
IndentIndent54581-4 Facility provider numbers
IndentIndentIndent76468-8 National Provider Identifier (NPI)
IndentIndentIndent69417-4 CMS Certification Number (CCN)
IndentIndentIndent45398-5 State provider number for Facility
IndentIndent52714-3 Provider type [CARE]
IndentIndent54593-9 Assessment reference date - observation end date during assessment period [CMS Assessment] {mm/dd/yyyy}
IndentIndent52455-3 Admission date {mm/dd/yyyy}
IndentIndent69418-2 Reason for assessment
IndentIndent54503-8 Legal name of patient
IndentIndentIndent45392-8 Patient First (Given) name
IndentIndentIndent45393-6 Middle initial
IndentIndentIndent45394-4 Patient Last (Family) name
IndentIndentIndent45395-1 Suffix
IndentIndent45966-9 Social Security and Medicare numbers
IndentIndentIndent45396-9 Social Security number [Identifier]
IndentIndentIndent45397-7 Medicare or comparable number
IndentIndent45400-9 Medicaid number
IndentIndent46098-0 Gender
IndentIndent21112-8 Birth date O {mm/dd/yyyy}
IndentIndent59362-4 Race/Ethnicity 1..6
IndentIndent69372-1 What is the highest level of school this patient has completed?
IndentIndent54505-3 Language
IndentIndentIndent54588-9 Does the resident need or want an interpreter to communicate with a doctor or health care staff?
IndentIndentIndent54899-0 Preferred Language
IndentIndent45404-1 Marital status
IndentIndent11340-7 Lifetime occupation(s)
IndentIndent52556-8 Current Payment Source (s) 1..13
IndentIndent52721-8 Other (specify)
IndentIndent52722-6 Admitted From. Immediately preceding this admission, where was the patient?
IndentIndent52723-4 Other (specify)
IndentIndent69411-7 Medical services received in past 2Mos 1..13
IndentIndent52724-2 If admitted from a medical setting, what was the primary diagnosis being treated in the previous setting? 0..4
IndentIndent86255-7 Primary diagnosis ICD code
IndentIndent70118-5 Hearing, speech, vision
IndentIndentIndent45482-7 Persistent vegetative state/no discernible consciousness at time of assessment
IndentIndent70114-4 Functional status - usual performance
IndentIndentIndent52663-2 Roll left and right
IndentIndentIndent52664-0 Sit to lying
IndentIndentIndent52648-3 Lying to Sitting on Side of Bed
IndentIndent70116-9 Bowel and bladder
IndentIndentIndent69667-4 Bowel continence [CARE]
IndentIndent69867-0 Active Diagnoses 1..3
IndentIndent70115-1 Swallowing - nutritional status
IndentIndentIndent46039-4 Height and weight Set
IndentIndentIndentIndent3137-7 Body height Measured [in_us];cm;m
IndentIndentIndentIndent3141-9 Body weight Measured 0..1 [lb_av];kg
IndentIndent70112-8 Skin conditions
IndentIndentIndent58214-8 Unhealed Pressure Ulcer(s). Does this patient have one or more unhealed pressure ulcer(s) at Stage 1 or higher?
IndentIndentIndent70113-6 Current number of unhealed (non-epithelialized) pressure ulcers at each stage - Long term care hospital [CARE]
IndentIndentIndentIndent54884-2 Number of pressure injuries - stage 1 during assessment period [CMS Assessment] {#}
IndentIndentIndentIndent54886-7 Number of these Stage 2 pressure ulcers that were present upon admission/reentry {#}
IndentIndentIndentIndent58123-1 Date of Pressure injury.oldest non-epithelialized stage 2 [CMS Assessment] {mm/dd/yyyy}
IndentIndentIndentIndent52576-6 Number of pressure ulcers at assessment - stage 3 [CARE]
IndentIndentIndentIndent54887-5 Number of these Stage 3 pressure ulcers that were present upon admission/reentry {#}
IndentIndentIndentIndent52577-4 Number of pressure ulcers at assessment - stage 4 [CARE]
IndentIndentIndentIndent54890-9 Number of these Stage 4 pressure ulcers that were present upon admission/reentry {#}
IndentIndentIndentIndent54893-3 Number of unstageable pressure ulcers due to non-removable dressing/device {#}
IndentIndentIndentIndent54894-1 Number of these unstageable pressure ulcers that were present upon admission/reentry {#}
IndentIndentIndentIndent54946-9 Number of unstageable pressure ulcers due to coverage of wound bed by slough and/or eschar {#}
IndentIndentIndentIndent54947-7 Number of these unstageable pressure ulcers that were present upon admission/reentry {#}
IndentIndentIndentIndent54950-1 Number of unstageable pressure ulcers with suspected deep tissue injury in evolution {#}
IndentIndentIndentIndent54951-9 Number of these unstageable ulcers that were present upon admission/reentry {#}
IndentIndentIndentIndent52477-7 Dimensions of unhealed stage 3 or 4 pressure ulcers or eschar - LTCH
IndentIndentIndentIndentIndent52728-3 Pressure Ulcer Length cm
IndentIndentIndentIndentIndent52729-1 Pressure Ulcer Width: cm
IndentIndentIndentIndentIndent57228-9 Pressure Ulcer Depth cm
IndentIndentIndentIndent55073-1 Most Severe Tissue Type for Any Pressure Ulcer
IndentIndent70120-1 Assessment administration
IndentIndentIndent68995-0 Person completing form name Provider
IndentIndentIndent46500-5 Discipline of Person Completing Assessment
IndentIndentIndent70157-3 Form sections completed Provider
IndentIndentIndent70158-1 Date sections completed Provider
IndentIndentIndent70127-6 Signature of assessment coordinator verifying assessment completion
IndentIndentIndent30947-6 Date form completed {mm/dd/yyyy}
Indent69413-3 Continuity Assessment Record and Evaluation (CARE) tool - Long term care hospital (LTCH) - Planned discharge - version 1.0
IndentIndent70117-7 Administrative information
IndentIndentIndent58198-3 Type of record during assessment period [CMS Assessment]
IndentIndentIndent58200-7 Correction number during assessment period [CMS Assessment] {#}
IndentIndent54581-4 Facility provider numbers
IndentIndentIndent76468-8 National Provider Identifier (NPI)
IndentIndentIndent69417-4 CMS Certification Number (CCN)
IndentIndentIndent45398-5 State provider number for Facility
IndentIndent52714-3 Provider type [CARE]
IndentIndent54593-9 Assessment reference date - observation end date during assessment period [CMS Assessment] {mm/dd/yyyy}
IndentIndent52455-3 Admission date {mm/dd/yyyy}
IndentIndent69418-2 Reason for assessment
IndentIndent52525-3 Discharge date {mm/dd/yyyy}
IndentIndent54503-8 Legal name of patient
IndentIndentIndent45392-8 Patient First (Given) name
IndentIndentIndent45393-6 Middle initial
IndentIndentIndent45394-4 Patient Last (Family) name
IndentIndentIndent45395-1 Suffix
IndentIndent45966-9 Social Security and Medicare numbers
IndentIndentIndent45396-9 Social Security number [Identifier]
IndentIndentIndent45397-7 Medicare or comparable number
IndentIndent45400-9 Medicaid number
IndentIndent46098-0 Gender
IndentIndent21112-8 Birth date O {mm/dd/yyyy}
IndentIndent59362-4 Race/Ethnicity 1..6
IndentIndent69372-1 What is the highest level of school this patient has completed?
IndentIndent54505-3 Language
IndentIndentIndent54588-9 Does the resident need or want an interpreter to communicate with a doctor or health care staff?
IndentIndentIndent54899-0 Preferred Language
IndentIndent45404-1 Marital status
IndentIndent11340-7 Lifetime occupation(s)
IndentIndent52556-8 Current Payment Source (s) 1..13
IndentIndent52721-8 Other (specify)
IndentIndent52716-8 Was the patient's discharge delayed for at least 24 hours?
IndentIndent52717-6 Reason for discharge delay
IndentIndent52718-4 Other (specify)
IndentIndent52688-9 Discharge Location. Where will the patient be discharged to?
IndentIndent70118-5 Hearing, speech, vision
IndentIndentIndent45482-7 Persistent vegetative state/no discernible consciousness at time of assessment
IndentIndent70114-4 Functional status - usual performance
IndentIndentIndent52663-2 Roll left and right
IndentIndentIndent52664-0 Sit to lying
IndentIndentIndent52648-3 Lying to Sitting on Side of Bed
IndentIndent70116-9 Bowel and bladder
IndentIndentIndent69667-4 Bowel continence [CARE]
IndentIndent69867-0 Active diagnoses 1..3
IndentIndent70115-1 Swallowing - nutritional status
IndentIndentIndent46039-4 Height and weight Set
IndentIndentIndentIndent3137-7 Body height Measured [in_us];cm;m
IndentIndentIndentIndent3141-9 Body weight Measured 0..1 [lb_av];kg
IndentIndent70112-8 Skin conditions
IndentIndentIndent58214-8 Unhealed Pressure Ulcer(s). Does this patient have one or more unhealed pressure ulcer(s) at Stage 1 or higher?
IndentIndentIndent70113-6 Current number of unhealed (non-epithelialized) pressure ulcers at each stage - Long term care hospital [CARE]
IndentIndentIndentIndent54884-2 Number of pressure injuries - stage 1 during assessment period [CMS Assessment] {#}
IndentIndentIndentIndent54886-7 Number of these Stage 2 pressure ulcers that were present upon admission/reentry {#}
IndentIndentIndentIndent58123-1 Date of Pressure injury.oldest non-epithelialized stage 2 [CMS Assessment] {mm/dd/yyyy}
IndentIndentIndentIndent52576-6 Number of pressure ulcers at assessment - stage 3 [CARE]
IndentIndentIndentIndent54887-5 Number of these Stage 3 pressure ulcers that were present upon admission/reentry {#}
IndentIndentIndentIndent52577-4 Number of pressure ulcers at assessment - stage 4 [CARE]
IndentIndentIndentIndent54890-9 Number of these Stage 4 pressure ulcers that were present upon admission/reentry {#}
IndentIndentIndentIndent54893-3 Number of unstageable pressure ulcers due to non-removable dressing/device {#}
IndentIndentIndentIndent54894-1 Number of these unstageable pressure ulcers that were present upon admission/reentry {#}
IndentIndentIndentIndent54946-9 Number of unstageable pressure ulcers due to coverage of wound bed by slough and/or eschar {#}
IndentIndentIndentIndent54947-7 Number of these unstageable pressure ulcers that were present upon admission/reentry {#}
IndentIndentIndentIndent54950-1 Number of unstageable pressure ulcers with suspected deep tissue injury in evolution {#}
IndentIndentIndentIndent54951-9 Number of these unstageable ulcers that were present upon admission/reentry {#}
IndentIndentIndentIndent52477-7 Dimensions of unhealed stage 3 or 4 pressure ulcers or eschar - LTCH
IndentIndentIndentIndentIndent52728-3 Pressure Ulcer Length cm
IndentIndentIndentIndentIndent52729-1 Pressure Ulcer Width: cm
IndentIndentIndentIndentIndent57228-9 Pressure Ulcer Depth cm
IndentIndentIndentIndent55073-1 Most Severe Tissue Type for Any Pressure Ulcer
IndentIndent70119-3 Healed pressure ulcers - Long term care hospital [CARE]
IndentIndentIndent54957-6 Were pressure ulcers present on the prior assessment (OBRA or PPS)?
IndentIndent54952-7 Worsening in pressure ulcer status since last assessment
IndentIndentIndent54953-5 Stage 2 {#}
IndentIndentIndent54954-3 Stage 3 {#}
IndentIndentIndent54955-0 Stage 4 {#}
IndentIndent70120-1 Assessment administration
IndentIndentIndent68995-0 Person completing form name Provider
IndentIndentIndent46500-5 Discipline of Person Completing Assessment
IndentIndentIndent70157-3 Form sections completed Provider
IndentIndentIndent70158-1 Date sections completed Provider
IndentIndentIndent70127-6 Signature of RN Assessment Coordinator Verifying Assessment Completion
IndentIndentIndentIndent70127-6 Signature:
IndentIndentIndentIndent30947-6 Date RN Assessment Coordinator signed assessment as complete: {mm/dd/yyyy}
Indent69414-1 Continuity assessment record and evaluation (CARE) tool - Long term care hospital (LTCH) - Unplanned discharge - version 1.0
IndentIndent70117-7 Administrative information
IndentIndentIndent58198-3 Type of record during assessment period [CMS Assessment]
IndentIndentIndent58200-7 Correction number during assessment period [CMS Assessment] {#}
IndentIndent54581-4 Facility provider numbers
IndentIndentIndent76468-8 National Provider Identifier (NPI)
IndentIndentIndent69417-4 CMS Certification Number (CCN)
IndentIndentIndent45398-5 State provider number for Facility
IndentIndent52714-3 Provider type [CARE]
IndentIndent54593-9 Assessment reference date - observation end date during assessment period [CMS Assessment] {mm/dd/yyyy}
IndentIndent52455-3 Admission date {mm/dd/yyyy}
IndentIndent69418-2 Reason for assessment
IndentIndent52525-3 Discharge date {mm/dd/yyyy}
IndentIndent54503-8 Legal name of patient
IndentIndentIndent45392-8 Patient First (Given) name
IndentIndentIndent45393-6 Middle initial
IndentIndentIndent45394-4 Patient Last (Family) name
IndentIndentIndent45395-1 Suffix
IndentIndent45966-9 Social Security and Medicare numbers
IndentIndentIndent45396-9 Social Security number [Identifier]
IndentIndentIndent45397-7 Medicare or comparable number
IndentIndent45400-9 Medicaid number
IndentIndent46098-0 Gender
IndentIndent21112-8 Birth date O {mm/dd/yyyy}
IndentIndent59362-4 Race/Ethnicity 1..6
IndentIndent52556-8 Payor information 1..13
IndentIndent70128-4 Discharge return status
IndentIndent72202-5 Discharge disposition - long term care hospital [CARE]
IndentIndent70118-5 Hearing, speech, vision
IndentIndentIndent45482-7 Persistent vegetative state/no discernible consciousness at time of assessment
IndentIndent70114-4 Functional status - usual performance
IndentIndentIndent52663-2 Roll left and right
IndentIndentIndent52664-0 Sit to lying
IndentIndentIndent52648-3 Lying to Sitting on Side of Bed
IndentIndent70116-9 Bowel and bladder
IndentIndentIndent69667-4 Bowel continence [CARE]
IndentIndent69867-0 Active diagnoses 1..3
IndentIndent70115-1 Swallowing - nutritional status
IndentIndentIndent46039-4 Height and weight Set
IndentIndentIndentIndent3137-7 Body height Measured [in_us];cm;m
IndentIndentIndentIndent3141-9 Body weight Measured 0..1 [lb_av];kg
IndentIndent70112-8 Skin conditions
IndentIndentIndent58214-8 Unhealed Pressure Ulcer(s). Does this patient have one or more unhealed pressure ulcer(s) at Stage 1 or higher?
IndentIndentIndent70113-6 Current number of unhealed (non-epithelialized) pressure ulcers at each stage - Long term care hospital [CARE]
IndentIndentIndentIndent54884-2 Number of pressure injuries - stage 1 during assessment period [CMS Assessment] {#}
IndentIndentIndentIndent54886-7 Number of these Stage 2 pressure ulcers that were present upon admission/reentry {#}
IndentIndentIndentIndent58123-1 Date of Pressure injury.oldest non-epithelialized stage 2 [CMS Assessment] {mm/dd/yyyy}
IndentIndentIndentIndent52576-6 Number of pressure ulcers at assessment - stage 3 [CARE]
IndentIndentIndentIndent54887-5 Number of these Stage 3 pressure ulcers that were present upon admission/reentry {#}
IndentIndentIndentIndent52577-4 Number of pressure ulcers at assessment - stage 4 [CARE]
IndentIndentIndentIndent54890-9 Number of these Stage 4 pressure ulcers that were present upon admission/reentry {#}
IndentIndentIndentIndent54893-3 Number of unstageable pressure ulcers due to non-removable dressing/device {#}
IndentIndentIndentIndent54894-1 Number of these unstageable pressure ulcers that were present upon admission/reentry {#}
IndentIndentIndentIndent54946-9 Number of unstageable pressure ulcers due to coverage of wound bed by slough and/or eschar {#}
IndentIndentIndentIndent54947-7 Number of these unstageable pressure ulcers that were present upon admission/reentry {#}
IndentIndentIndentIndent54950-1 Number of unstageable pressure ulcers with suspected deep tissue injury in evolution {#}
IndentIndentIndentIndent54951-9 Number of these unstageable ulcers that were present upon admission/reentry {#}
IndentIndentIndentIndent55073-1 Most Severe Tissue Type for Any Pressure Ulcer
IndentIndentIndentIndent52477-7 Dimensions of unhealed stage 3 or 4 pressure ulcers or eschar - LTCH
IndentIndentIndentIndentIndent52728-3 Pressure Ulcer Length cm
IndentIndentIndentIndentIndent52729-1 Pressure Ulcer Width: cm
IndentIndentIndentIndentIndent57228-9 Pressure Ulcer Depth cm
IndentIndent54952-7 Worsening in pressure ulcer status since last assessment
IndentIndentIndent54953-5 Stage 2 {#}
IndentIndentIndent54954-3 Stage 3 {#}
IndentIndentIndent54955-0 Stage 4 {#}
IndentIndent70119-3 Healed pressure ulcers - Long term care hospital [CARE]
IndentIndentIndent54957-6 Were pressure ulcers present on the prior assessment (OBRA or PPS)?
IndentIndent70120-1 Assessment administration
IndentIndentIndent68995-0 Person completing form name Provider
IndentIndentIndent46500-5 Discipline of Person Completing Assessment
IndentIndentIndent70157-3 Form sections completed Provider
IndentIndentIndent70158-1 Date sections completed Provider
IndentIndentIndent70127-6 Signature of assessment coordinator verifying assessment completion
IndentIndentIndent30947-6 Date form completed {mm/dd/yyyy}
Indent69415-8 Continuity assessment record and evaluation (CARE) tool - Long term care hospital (LTCH) - Expired - version 1.0
IndentIndent70117-7 Administrative information
IndentIndentIndent58198-3 Type of record during assessment period [CMS Assessment]
IndentIndentIndent58200-7 Correction number during assessment period [CMS Assessment] {#}
IndentIndent54581-4 Facility provider numbers
IndentIndentIndent76468-8 National Provider Identifier (NPI)
IndentIndentIndent69417-4 CMS Certification Number (CCN)
IndentIndentIndent45398-5 State provider number for Facility
IndentIndent52714-3 Provider type [CARE]
IndentIndent54593-9 Assessment reference date - observation end date during assessment period [CMS Assessment] {mm/dd/yyyy}
IndentIndent52455-3 Admission date {mm/dd/yyyy}
IndentIndent69418-2 Reason for assessment
IndentIndent52525-3 Discharge date {mm/dd/yyyy}
IndentIndent54503-8 Legal name of patient
IndentIndentIndent45392-8 Patient First (Given) name
IndentIndentIndent45393-6 Middle initial
IndentIndentIndent45394-4 Patient Last (Family) name
IndentIndentIndent45395-1 Suffix
IndentIndent45966-9 Social Security and Medicare numbers
IndentIndentIndent45396-9 Social Security number [Identifier]
IndentIndentIndent45397-7 Medicare or comparable number
IndentIndent45400-9 Medicaid number
IndentIndent46098-0 Gender
IndentIndent21112-8 Birth date O {mm/dd/yyyy}
IndentIndent59362-4 Race/Ethnicity 1..6
IndentIndent52556-8 Payor information 1..13
IndentIndent52721-8 Other (specify)
IndentIndent70118-5 Hearing, speech, vision
IndentIndentIndent45482-7 Persistent vegetative state/no discernible consciousness at time of assessment
IndentIndent69867-0 Active Diagnoses 1..3
IndentIndent70120-1 Assessment administration
IndentIndentIndent68995-0 Person completing form name Provider
IndentIndentIndent46500-5 Discipline of Person Completing Assessment
IndentIndentIndent70157-3 Form sections completed Provider
IndentIndentIndent70158-1 Date sections completed Provider
IndentIndentIndent70127-6 Signature of assessment coordinator verifying assessment completion
IndentIndentIndent30947-6 Date form completed {mm/dd/yyyy}

Fully-Specified Name

Component
Continuity assessment record and evaluation tool - long term care hospital - version 1.0
Property
-
Time
Pt
System
^Patient
Scale
-
Method
CARE

Basic Attributes

Class
PANEL.SURVEY.CARE
Type
Surveys
First Released
Version 2.38
Last Updated
Version 2.77
Panel Type
Panel

LOINC Terminology Service (API) using HL7® FHIR® Get Info

CodeSystem lookup
https://fhir.loinc.org/CodeSystem/$lookup?system=http://loinc.org&code=69412-5
Questionnaire definition
https://fhir.loinc.org/Questionnaire/?url=http://loinc.org/q/69412-5