101107-1
MDS v3.0 - RAI v1.18.11 - Nursing home discharge (ND) item set during assessment period [CMS Assessment]
Active
Panel Hierarchy
Details for each LOINC in Panel LHC-Forms
LOINC | Name | R/O/C | Cardinality | Example UCUM Units |
---|---|---|---|---|
101107-1 | MDS v3.0 - RAI v1.18.11 - Nursing home discharge (ND) item set during assessment period [CMS Assessment] | |||
Indent101591-6 | Identification Information | |||
Indent Indent58198-3 | Type of Record | |||
Indent Indent54581-4 | Facility Provider Numbers | |||
Indent Indent Indent76468-8 | National Provider Identifier (NPI) | |||
Indent Indent Indent69417-4 | CMS Certification Number (CCN) | |||
Indent Indent Indent45398-5 | State Provider Number | |||
Indent Indent85632-8 | Type of Provider | |||
Indent Indent86524-6 | Type of Assessment | |||
Indent Indent Indent54583-0 | Federal OBRA Reason for Assessment | |||
Indent Indent Indent54584-8 | PPS Assessment | |||
Indent Indent Indent54587-1 | Is this assessment the first assessment (OBRA, Scheduled PPS, or Discharge) since the most recent admission/entry or reentry? | |||
Indent Indent Indent58108-2 | Entry/discharge reporting | |||
Indent Indent Indent71440-2 | Type of discharge | |||
Indent Indent Indent90525-7 | Is this a SNF Part A Interrupted Stay? | |||
Indent Indent Indent86525-3 | Is this a SNF Part A PPS Discharge Assessment? | |||
Indent Indent86526-1 | Unit Certification or Licensure Designation | |||
Indent Indent54503-8 | Legal Name of Resident | |||
Indent Indent Indent45392-8 | First name | |||
Indent Indent Indent45393-6 | Middle initial | |||
Indent Indent Indent45394-4 | Last name | |||
Indent Indent Indent45395-1 | Suffix | |||
Indent Indent45966-9 | Social Security and Medicare Numbers | |||
Indent Indent Indent45396-9 | Social Security Number | |||
Indent Indent Indent45397-7 | Medicare number | |||
Indent Indent45400-9 | Medicaid Number | |||
Indent Indent46098-0 | Gender | |||
Indent Indent21112-8 | Birth Date | {mm/dd/yyyy} | ||
Indent Indent69854-8 | Ethnicity. Are you of Hispanic, Latino/a, or Spanish origin? | 1..4 | ||
Indent Indent103708-4 | Race. What is your race? | 1..14 | ||
Indent Indent93186-5 | Language | |||
Indent Indent Indent54899-0 | What is your preferred language? | |||
Indent Indent Indent54588-9 | Do you need or want an interpreter to communicate with a doctor or health care staff? | |||
Indent Indent45404-1 | Marital Status | |||
Indent Indent101351-5 | Transportation (from NACHC©). Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living? | |||
Indent Indent54506-1 | Optional Resident Items | |||
Indent Indent Indent46106-1 | Medical record number | |||
Indent Indent Indent45403-3 | Room number | |||
Indent Indent Indent52462-9 | Name by which resident prefers to be addressed | |||
Indent Indent Indent21843-8 | Lifetime occupation(s) | |||
Indent Indent86528-7 | Most Recent Admission/Entry or Reentry into this Facility | |||
Indent Indent Indent50786-3 | Entry Date | {mm/dd/yyyy} | ||
Indent Indent Indent54590-5 | Type of Entry | |||
Indent Indent Indent85398-6 | Entered From | |||
Indent Indent52455-3 | Admission Date (Date this episode of care in this facility began) | {mm/dd/yyyy} | ||
Indent Indent52525-3 | Discharge Date | {mm/dd/yyyy} | ||
Indent Indent55128-3 | Discharge Status | |||
Indent Indent93182-4 | Provision of Current Reconciled Medication List to Subsequent Provider at Discharge. At the time of discharge to another provider, did your facility provide the resident's current reconciled medication list to the subsequent provider? | |||
Indent Indent93184-0 | Route of Current Reconciled Medication List Transmission to Subsequent Provider. | 1..5 | ||
Indent Indent93181-6 | Provision of Current Reconciled Medication List to Resident at Discharge. At the time of discharge, did your facility provide the resident's current reconciled medication list to the resident, family and/or caregiver? | |||
Indent Indent93183-2 | Route of Current Reconciled Medication List Transmission to Resident. | 1..5 | ||
Indent Indent54593-9 | Assessment Reference Date. Observation end date | {mm/dd/yyyy} | ||
Indent Indent54507-9 | Medicare Stay | |||
Indent Indent Indent54594-7 | Has the resident had a Medicare-covered stay since the most recent entry? | |||
Indent Indent Indent54595-4 | Start date of most recent Medicare stay | {mm/dd/yyyy} | ||
Indent Indent Indent54596-2 | End date of most recent Medicare stay | {mm/dd/yyyy} | ||
Indent54508-7 | Hearing, Speech, and Vision | |||
Indent Indent54597-0 | Comatose. Persistent vegetative state/no discernible consciousness | |||
Indent Indent103709-2 | Health Literacy. How often do you need to have someone help you when you read instructions, pamphlets, or other written material from your doctor or pharmacy? | |||
Indent101592-4 | Cognitive Patterns | |||
Indent Indent54605-1 | Should Brief Interview for Mental Status (C0200-C0500) be Conducted? | |||
Indent Indent103694-6 | Brief Interview for Mental Status (BIMS) | |||
Indent Indent Indent103696-1 | Repetition of Three Words. Number of words repeated after first attempt | |||
Indent Indent Indent103702-7 | Temporal Orientation (orientation to year, month, and day) | |||
Indent Indent Indent Indent103697-9 | Able to report correct year | |||
Indent Indent Indent Indent103698-7 | Able to report correct month | |||
Indent Indent Indent Indent103703-5 | Able to report correct day of the week | |||
Indent Indent Indent103695-3 | Recall | |||
Indent Indent Indent Indent103699-5 | Able to recall "sock" | |||
Indent Indent Indent Indent103700-1 | Able to recall "blue" | |||
Indent Indent Indent Indent103701-9 | Able to recall "bed" | |||
Indent Indent Indent103704-3 | BIMS Summary Score | {score} | ||
Indent Indent54615-0 | Should the Staff Assessment for Mental Status (C0700 - C1000) be Conducted? | |||
Indent Indent83241-0 | Staff Assessment for Mental Status | |||
Indent Indent Indent54616-8 | Short-term Memory OK. Seems or appears to recall after 5 minutes. | |||
Indent Indent Indent54624-2 | Cognitive Skills for Daily Decision Making. Made decisions regarding tasks of daily life. | |||
Indent Indent101593-2 | Delirium | |||
Indent Indent95816-5 | Signs and Symptoms of Delirium (from CAM©) | |||
Indent Indent Indent95813-2 | Acute Onset Mental Change | |||
Indent Indent Indent95812-4 | Inattention | |||
Indent Indent Indent95814-0 | Disorganized Thinking | |||
Indent Indent Indent95815-7 | Altered Level of Consciousness | |||
Indent101594-0 | Mood | |||
Indent Indent54634-1 | Should Resident Mood Interview be Conducted? | |||
Indent Indent54635-8 | Resident Mood Interview (PHQ-2 to 9) | |||
Indent Indent Indent86843-0 | Symptom Presence | |||
Indent Indent Indent Indent54636-6 | Little interest or pleasure in doing things | |||
Indent Indent Indent Indent54638-2 | Feeling down, depressed or hopeless | |||
Indent Indent Indent Indent54640-8 | Trouble falling or staying asleep, or sleeping too much | |||
Indent Indent Indent Indent54642-4 | Feeling tired or having little energy | |||
Indent Indent Indent Indent54644-0 | Poor appetite or overeating | |||
Indent Indent Indent Indent54646-5 | Feeling bad about yourself - or that you are a failure or have let yourself or your family down | |||
Indent Indent Indent Indent54648-1 | Trouble concentrating on things, such as reading the newspaper or watching television | |||
Indent Indent Indent Indent54650-7 | Moving or speaking so slowly that other people could have noticed. Or the opposite - being so fidgety or restless that you have been moving around a lot more than usual | |||
Indent Indent Indent Indent54652-3 | Thoughts that you would be better off dead, or of hurting yourself in some way | |||
Indent Indent Indent86844-8 | Symptom Frequency | |||
Indent Indent Indent Indent54637-4 | Little interest or pleasure in doing things | |||
Indent Indent Indent Indent54639-0 | Feeling down, depressed or hopeless | |||
Indent Indent Indent Indent54641-6 | Trouble falling or staying asleep, or sleeping too much | |||
Indent Indent Indent Indent54643-2 | Feeling tired or having little energy | |||
Indent Indent Indent Indent54645-7 | Poor appetite or overeating | |||
Indent Indent Indent Indent54647-3 | Feeling bad about yourself - or that you are a failure or have let yourself or your family down | |||
Indent Indent Indent Indent54649-9 | Trouble concentrating on things, such as reading the newspaper or watching television | |||
Indent Indent Indent Indent54651-5 | Moving or speaking so slowly that other people could have noticed. Or the opposite - being so fidgety or restless that you have been moving around a lot more than usual | |||
Indent Indent Indent Indent54653-1 | Thoughts that you would be better off dead, or of hurting yourself in some way | |||
Indent Indent103705-0 | Total Severity Score | {score} | ||
Indent Indent103706-8 | Staff Assessment of Resident Mood (PHQ-9-OV) | |||
Indent Indent Indent86833-1 | Symptom Presence | |||
Indent Indent Indent Indent54658-0 | Little interest or pleasure in doing things | |||
Indent Indent Indent Indent54660-6 | Feeling or appearing down, depressed, or hopeless | |||
Indent Indent Indent Indent54662-2 | Trouble falling or staying asleep, or sleeping too much | |||
Indent Indent Indent Indent54664-8 | Feeling tired or having little energy | |||
Indent Indent Indent Indent54666-3 | Poor appetite or overeating | |||
Indent Indent Indent Indent54668-9 | Indicating that they feel bad about self, are a failure, or have let self or family down | |||
Indent Indent Indent Indent54670-5 | Trouble concentrating on things, such as reading the newspaper or watching television | |||
Indent Indent Indent Indent54672-1 | Moving or speaking so slowly that other people have noticed. Or the opposite-being so fidgety or restless that they have been moving around a lot more than usual | |||
Indent Indent Indent Indent54673-9 | States that life isn't worth living, wishes for death, or attempts to harm self | |||
Indent Indent Indent Indent54675-4 | Being short-tempered, easily annoyed | |||
Indent Indent Indent86891-9 | Symptom Frequency | |||
Indent Indent Indent Indent54659-8 | Little interest or pleasure in doing things | |||
Indent Indent Indent Indent54661-4 | Feeling or appearing down, depressed, or hopeless | |||
Indent Indent Indent Indent54663-0 | Trouble falling or staying asleep, or sleeping too much | |||
Indent Indent Indent Indent54665-5 | Feeling tired or having little energy | |||
Indent Indent Indent Indent54667-1 | Poor appetite or overeating | |||
Indent Indent Indent Indent54669-7 | Indicating that they feel bad about self, are a failure, or have let self or family down | |||
Indent Indent Indent Indent54671-3 | Trouble concentrating on things, such as reading the newspaper or watching television | |||
Indent Indent Indent Indent54904-8 | Moving or speaking so slowly that other people have noticed. Or the opposite-being so fidgety or restless that they have been moving around a lot more than usual | |||
Indent Indent Indent Indent54674-7 | States that life isn't worth living, wishes for death, or attempts to harm self | |||
Indent Indent Indent Indent54676-2 | Being short-tempered, easily annoyed | |||
Indent Indent103707-6 | Total Severity Score | {score} | ||
Indent Indent93159-2 | Social Isolation. How often do you feel lonely or isolated from those around you? | |||
Indent86596-4 | Behavior | |||
Indent Indent86597-2 | Potential Indicators of Psychosis | 1..2 | ||
Indent54514-5 | Behavioral Symptom - Presence & Frequency | |||
Indent Indent54682-0 | Physical behavioral symptoms directed toward others | d/(7.d) | ||
Indent Indent54683-8 | Verbal behavioral symptoms directed toward others | d/(7.d) | ||
Indent Indent54684-6 | Other behavioral symptoms not directed toward others | d/(7.d) | ||
Indent54692-9 | Rejection of Care - Presence & Frequency | d/(7.d) | ||
Indent54693-7 | Wandering - Presence & Frequency | d/(7.d) | ||
Indent101595-7 | Functional Abilities and Goals | |||
Indent Indent92908-3 | Functional Limitation in Range of Motion | |||
Indent Indent Indent92850-7 | Upper extremity (shoulder, elbow, wrist, hand) | |||
Indent Indent Indent92851-5 | Lower extremity (hip, knee, ankle, foot) | |||
Indent Indent86602-0 | Mobility Devices | 1..4 | ||
Indent Indent88483-3 | Functional Abilities and Goals - Discharge | |||
Indent Indent Indent83254-3 | Self-Care - Discharge Performance (Assessment period is the last 3 days of the stay) | |||
Indent Indent Indent Indent89409-7 | Eating | |||
Indent Indent Indent Indent89404-8 | Oral hygiene | |||
Indent Indent Indent Indent89389-1 | Toileting hygiene | |||
Indent Indent Indent Indent89396-6 | Shower/bathe self | |||
Indent Indent Indent Indent89387-5 | Upper body dressing | |||
Indent Indent Indent Indent89406-3 | Lower body dressing | |||
Indent Indent Indent Indent89400-6 | Putting on/taking off footwear | |||
Indent Indent Indent Indent45606-1 | Personal hygiene | |||
Indent Indent Indent88331-4 | Mobility - Discharge Performance (Assessment period is the last 3 days of the stay) | |||
Indent Indent Indent Indent89398-2 | Roll left and right | |||
Indent Indent Indent Indent89394-1 | Sit to lying | |||
Indent Indent Indent Indent95009-7 | Lying to sitting on side of bed | |||
Indent Indent Indent Indent89392-5 | Sit to stand | |||
Indent Indent Indent Indent89414-7 | Chair/bed-to-chair transfer | |||
Indent Indent Indent Indent89390-9 | Toilet transfer | |||
Indent Indent Indent Indent101597-3 | Tub/shower transfer | |||
Indent Indent Indent Indent89412-1 | Car transfer | |||
Indent Indent Indent Indent89385-9 | Walk 10 feet | |||
Indent Indent Indent Indent89381-8 | Walk 50 feet with two turns | |||
Indent Indent Indent Indent89383-4 | Walk 150 feet | |||
Indent Indent Indent Indent89379-2 | Walking 10 feet on uneven surfaces | |||
Indent Indent Indent Indent95000-6 | 1 step (curb) | |||
Indent Indent Indent Indent89416-2 | 4 steps | |||
Indent Indent Indent Indent89418-8 | 12 steps | |||
Indent Indent Indent Indent89402-2 | Picking up object | |||
Indent Indent Indent Indent95738-1 | Does the resident use a wheelchair and/or scooter? | |||
Indent Indent Indent Indent94992-5 | Wheel 50 feet with two turns | |||
Indent Indent Indent Indent95739-9 | Indicate the type of wheelchair or scooter used | |||
Indent Indent Indent Indent94991-7 | Wheel 150 feet | |||
Indent Indent Indent Indent95739-9 | Indicate the type of wheelchair or scooter used | |||
Indent83237-8 | Bladder and Bowel | |||
Indent Indent86624-4 | Appliances | 1..4 | ||
Indent Indent95735-7 | Urinary Continence | 1..1 | ||
Indent Indent95736-5 | Bowel Continence | 1..1 | ||
Indent101601-3 | Active Diagnoses | |||
Indent Indent86671-5 | Active Diagnoses in the last 7 days | 1..* | ||
Indent Indent52797-8 | Additional active diagnoses | 0..10 | ||
Indent101602-1 | Health Conditions | |||
Indent Indent54557-4 | Pain Management | |||
Indent Indent Indent71447-7 | At any time in the last 5 days, has the resident: Received scheduled pain medication regimen? | |||
Indent Indent Indent71448-5 | At any time in the last 5 days, has the resident: Received PRN pain medications OR was offered and declined? | |||
Indent Indent Indent71449-3 | At any time in the last 5 days, has the resident: Received non-medication intervention for pain? | |||
Indent Indent54828-9 | Should Pain Assessment Interview be Conducted? | |||
Indent Indent101603-9 | Pain Assessment Interview | |||
Indent Indent Indent54829-7 | Pain Presence | |||
Indent Indent Indent54830-5 | Pain Frequency | |||
Indent Indent Indent93156-8 | Pain Effect on Sleep | |||
Indent Indent Indent93160-0 | Pain Interference with Therapy Activities | |||
Indent Indent Indent93158-4 | Pain Interference with Day-to-Day Activities | |||
Indent Indent Indent54560-8 | Pain Intensity | |||
Indent Indent Indent Indent54833-9 | Numeric Rating Scale (00-10) | |||
Indent Indent Indent Indent54834-7 | Verbal Descriptor Scale | |||
Indent Indent86674-9 | Other Health Conditions | |||
Indent Indent Indent86675-6 | Shortness of Breath (dyspnea) | 1..3 | ||
Indent Indent Indent54846-1 | Prognosis. Does the resident have a condition or chronic disease that may result in a life expectancy of less than 6 months? | |||
Indent Indent Indent86676-4 | Problem Conditions | 1..4 | ||
Indent Indent Indent54853-7 | Any Falls Since Admission/Entry or Reentry or Prior Assessment (OBRA or Scheduled PPS), whichever is more recent | |||
Indent Indent Indent54854-5 | Number of Falls Since Admission/Entry or Reentry or Prior Assessment (OBRA or Scheduled PPS), whichever is more recent | |||
Indent Indent Indent Indent54855-2 | No injury | |||
Indent Indent Indent Indent54856-0 | Injury (except major) | |||
Indent Indent Indent Indent54857-8 | Major injury | |||
Indent101604-7 | Swallowing &or Nutritional Status | |||
Indent Indent54567-3 | Height and Weight | |||
Indent Indent Indent103692-0 | Height (in inches) | [in_us];cm;m | ||
Indent Indent Indent103693-8 | Weight (in pounds) | [lb_av];kg | ||
Indent Indent54863-6 | Weight Loss | |||
Indent Indent86678-0 | Weight Gain | |||
Indent Indent54568-1 | Nutritional Approaches | |||
Indent Indent Indent71445-1 | Nutritional Approaches. While a Resident | 1..4 | ||
Indent Indent Indent101605-4 | Nutritional Approaches. At Discharge. | 1..4 | ||
Indent101607-0 | Skin Conditions | |||
Indent Indent101608-8 | Determination of Pressure Ulcer/Injury Risk | 1..3 | ||
Indent Indent58214-8 | Unhealed Pressure Ulcers/Injuries. Does this resident have one or more unhealed pressure ulcers/injuries? | |||
Indent Indent101611-2 | Current Number of Unhealed Pressure Ulcers/Injuries at Each Stage | |||
Indent Indent Indent55124-2 | Number of Stage 2 pressure ulcers | {#} | ||
Indent Indent Indent54886-7 | Number of these Stage 2 pressure ulcers that were present upon admission/entry or reentry | {#} | ||
Indent Indent Indent55125-9 | Number of Stage 3 pressure ulcers | {#} | ||
Indent Indent Indent54887-5 | Number of these Stage 3 pressure ulcers that were present upon admission/entry or reentry | {#} | ||
Indent Indent Indent55126-7 | Number of Stage 4 pressure ulcers | {#} | ||
Indent Indent Indent54890-9 | Number of these Stage 4 pressure ulcers that were present upon admission/entry or reentry | {#} | ||
Indent Indent Indent54893-3 | Number of unstageable pressure ulcers/injuries due to non-removable dressing/device | {#} | ||
Indent Indent Indent54894-1 | Number of these unstageable pressure ulcers/injuries that were present upon admission/entry or reentry | {#} | ||
Indent Indent Indent54946-9 | Number of unstageable pressure ulcers due to coverage of wound bed by slough and/or eschar | {#} | ||
Indent Indent Indent54947-7 | Number of these unstageable pressure ulcers that were present upon admission/entry or reentry | {#} | ||
Indent Indent Indent54950-1 | Number of unstageable pressure injuries presenting as deep tissue injury | {#} | ||
Indent Indent Indent54951-9 | Number of these unstageable pressure injuries that were present upon admission/entry or reentry | {#} | ||
Indent86749-9 | Medications | |||
Indent Indent101612-0 | High-Risk Drug Classes: Use and Indication | |||
Indent Indent Indent93153-5 | Is taking | 1..10 | ||
Indent Indent Indent93154-3 | Indication noted | 1..10 | ||
Indent Indent57256-0 | Medication Intervention | |||
Indent101613-8 | Special Treatments, Procedures, and Programs | |||
Indent Indent101614-6 | Special Treatments, Procedures, and Programs | |||
Indent Indent Indent86761-4 | Special Treatments, Procedures, and Programs - While a Resident | 1..1 | ||
Indent Indent Indent93185-7 | Special Treatments, Procedures, and Programs - At Discharge | 1..30 | ||
Indent Indent69339-0 | Influenza Vaccine | |||
Indent Indent Indent55019-4 | Did the resident receive the influenza vaccine in this facility for this year's influenza vaccination season? | |||
Indent Indent Indent58131-4 | Date influenza vaccine received | {mm/dd/yyyy} | ||
Indent Indent Indent55020-2 | If influenza vaccine not received, state reason: | |||
Indent Indent55021-0 | Pneumococcal Vaccine | |||
Indent Indent Indent55022-8 | Is the resident's Pneumococcal vaccination up to date? | |||
Indent Indent Indent45956-0 | If Pneumococcal vaccine not received, state reason: | |||
Indent Indent90544-8 | Part A Therapies | |||
Indent Indent Indent90545-5 | Speech-Language Pathology and Audiology Services | |||
Indent Indent Indent Indent90539-8 | Individual minutes | min | ||
Indent Indent Indent Indent90536-4 | Concurrent minutes | min | ||
Indent Indent Indent Indent90538-0 | Group minutes | min | ||
Indent Indent Indent Indent90537-2 | Co-treatment minutes | min | ||
Indent Indent Indent Indent90551-3 | Days | d/{#} | ||
Indent Indent Indent90546-3 | Occupational Therapy | |||
Indent Indent Indent Indent90531-5 | Individual minutes | min | ||
Indent Indent Indent Indent90527-3 | Concurrent minutes | min | ||
Indent Indent Indent Indent90529-9 | Group minutes | min | ||
Indent Indent Indent Indent90528-1 | Co-treatment minutes | min | ||
Indent Indent Indent Indent90530-7 | Days | d/{#} | ||
Indent Indent Indent90547-1 | Physical Therapy | |||
Indent Indent Indent Indent90535-6 | Individual minutes | min | ||
Indent Indent Indent Indent90532-3 | Concurrent minutes | min | ||
Indent Indent Indent Indent90534-9 | Group minutes | min | ||
Indent Indent Indent Indent90533-1 | Co-treatment minutes | min | ||
Indent Indent Indent Indent90550-5 | Days | d/{#} | ||
Indent Indent90548-9 | Distinct Calendar Days of Part A Therapy | {#} | ||
Indent88307-4 | Restraints and Alarms | |||
Indent Indent86785-3 | Physical Restraints | |||
Indent Indent Indent86786-1 | Used in Bed. Bed rail | d/(7.d) | ||
Indent Indent Indent86787-9 | Used in Bed. Trunk restraint | d/(7.d) | ||
Indent Indent Indent86788-7 | Used in Bed. Limb restraint | d/(7.d) | ||
Indent Indent Indent86789-5 | Used in Bed. Other | d/(7.d) | ||
Indent Indent Indent86790-3 | Used in Chair or Out of Bed. Trunk restraint | d/(7.d) | ||
Indent Indent Indent86791-1 | Used in Chair or Out of Bed. Limb restraint | d/(7.d) | ||
Indent Indent Indent86792-9 | Used in Chair or Out of Bed. Chair prevents rising | d/(7.d) | ||
Indent Indent Indent86793-7 | Used in Chair or Out of Bed. Other | d/(7.d) | ||
Indent101615-3 | Participation in Assessment and Goal Setting | |||
Indent Indent101617-9 | Discharge Plan | |||
Indent Indent Indent58146-2 | Is active discharge planning already occurring for the resident to return to the community? | |||
Indent Indent101619-5 | Referral | |||
Indent Indent Indent101620-3 | Has a referral been made to the Local Contact Agency (LCA)? | |||
Indent Indent101621-1 | Reason Referral to Local Contact Agency (LCA) Not Made | |||
Indent101622-9 | Correction Request | |||
Indent Indent85632-8 | Type of Provider | |||
Indent Indent87226-7 | Name of Resident | |||
Indent Indent Indent45392-8 | First name | |||
Indent Indent Indent45394-4 | Last name | |||
Indent Indent46098-0 | Gender | |||
Indent Indent21112-8 | Birth Date | {mm/dd/yyyy} | ||
Indent Indent45396-9 | Social Security Number | |||
Indent Indent86524-6 | Type of Assessment | |||
Indent Indent Indent54583-0 | Federal OBRA Reason for Assessment | |||
Indent Indent Indent54584-8 | PPS Assessment | |||
Indent Indent Indent58108-2 | Entry/discharge reporting | |||
Indent Indent Indent86525-3 | Is this a SNF Part A PPS Discharge Assessment? | |||
Indent Indent87216-8 | Date on existing record to be modified/inactivated | |||
Indent Indent Indent54593-9 | Assessment Reference Date | {mm/dd/yyyy} | ||
Indent Indent Indent52525-3 | Discharge Date | {mm/dd/yyyy} | ||
Indent Indent Indent50786-3 | Entry Date | {mm/dd/yyyy} | ||
Indent87209-3 | Correction Attestation Section | |||
Indent Indent58200-7 | Correction Number | {#} | ||
Indent Indent87217-6 | Reasons for Modification | 1..5 | ||
Indent Indent87225-9 | Reasons for Inactivation | 1..2 | ||
Indent Indent87218-4 | RN Assessment Coordinator Attestation of Completion | |||
Indent Indent Indent87219-2 | Attesting individual's first name | |||
Indent Indent Indent87220-0 | Attesting individual's last name | |||
Indent Indent Indent87221-8 | Attesting individual's title | |||
Indent Indent Indent87222-6 | Attestation date | {mm/dd/yyyy} | ||
Indent87223-4 | Assessment Administration | |||
Indent Indent55070-7 | Insurance Billing | |||
Indent Indent Indent55071-5 | Billing code | |||
Indent Indent Indent55081-4 | Billing version | |||
Indent Indent85648-4 | Signature of Persons Completing the Assessment or Entry/Death Reporting | |||
Indent Indent70127-6 | Signature of RN Assessment Coordinator Verifying Assessment Completion | |||
Indent Indent Indent70127-6 | Signature: | |||
Indent Indent Indent30947-6 | Date RN Assessment Coordinator signed assessment as complete: | {mm/dd/yyyy} |
Fully-Specified Name
- Component
- MDS v3.0 - RAI v1.18.11 - Nursing home discharge (ND) item set
- Property
- -
- Time
- RptPeriod
- System
- ^Patient
- Scale
- -
- Method
- CMS Assessment
Basic Attributes
- Class
- PANEL.SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.75
- Last Updated
- Version 2.77
- Change Reason
- Release 2.77: TIME_ASPCT: Decision by CMS to update the Timing to RptPeriod from Pt for all CMS Assessments;
- Order vs. Observation
- Order
- Panel Type
- Panel
LOINC Terminology Service (API) using HL7® FHIR® Get Info
Requests to this service require a free LOINC username and password. Below is a sample of the possible capabilities. See the LOINC Terminology Service documentation for more information.
- CodeSystem lookup
- https:
//fhir.loinc.org/CodeSystem/$lookup?system=http: //loinc.org&code=101107-1 - Questionnaire definition
- https:
//fhir.loinc.org/Questionnaire/?url=http: //loinc.org/q/101107-1
LOINC Copyright
Copyright © 2024 Regenstrief Institute, Inc. All Rights Reserved. To the extent included herein, the LOINC table and LOINC codes are copyright