Version 2.76

Panel Hierarchy

Details for each LOINC in Panel LHC-Forms

LOINC Name R/O/C Cardinality Example UCUM Units
101105-5 MDS v3.0 - RAI v1.18.11 - Nursing home comprehensive (NC) item set [CMS Assessment]
Indent101258-2 Identification Information
IndentIndent58198-3 Type of Record
IndentIndent54581-4 Facility Provider Numbers
IndentIndentIndent76468-8 National Provider Identifier (NPI)
IndentIndentIndent69417-4 CMS Certification Number (CCN)
IndentIndentIndent45398-5 State Provider Number
IndentIndent85632-8 Type of Provider
IndentIndent90489-6 Type of Assessment
IndentIndentIndent54583-0 Federal OBRA Reason for Assessment
IndentIndentIndent54584-8 PPS Assessment
IndentIndentIndent54587-1 Is this assessment the first assessment (OBRA, Scheduled PPS, or Discharge) since the most recent admission/entry or reentry?
IndentIndentIndent58108-2 Entry/discharge reporting
IndentIndentIndent71440-2 Type of discharge
IndentIndentIndent90525-7 Is this a SNF Part A Interrupted Stay?
IndentIndentIndent86525-3 Is this a SNF Part A PPS Discharge Assessment?
IndentIndent86526-1 Unit Certification or Licensure Designation
IndentIndent54503-8 Legal Name of Resident
IndentIndentIndent45392-8 First name
IndentIndentIndent45393-6 Middle initial
IndentIndentIndent45394-4 Last name
IndentIndentIndent45395-1 Suffix
IndentIndent45966-9 Social Security and Medicare Numbers
IndentIndentIndent45396-9 Social Security Number
IndentIndentIndent45397-7 Medicare number
IndentIndent45400-9 Medicaid Number
IndentIndent46098-0 Gender
IndentIndent21112-8 Birth Date {mm/dd/yyyy}
IndentIndent69854-8 Ethnicity. Are you of Hispanic, Latino/a, or Spanish origin? 1..4
IndentIndent69855-5 Race. What is your race? 1..14
IndentIndent93186-5 Language
IndentIndentIndent54899-0 What is your preferred language?
IndentIndentIndent54588-9 Do you need or want an interpreter to communicate with a doctor or health care staff?
IndentIndent45404-1 Marital Status
IndentIndent101351-5 Transportation (from NACHC©). Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living?
IndentIndent54506-1 Optional Resident Items
IndentIndentIndent46106-1 Medical record number
IndentIndentIndent45403-3 Room number
IndentIndentIndent52462-9 Name by which resident prefers to be addressed
IndentIndentIndent21843-8 Lifetime occupation(s)
IndentIndent54589-7 Preadmission Screening and Resident Review (PASRR). Is the resident currently considered by the state level II PASRR process to have serious mental illness and/or intellectual disability or a related condition?
IndentIndent71441-0 Level II Preadmission Screening and Resident Review (PASRR) Conditions 1..3
IndentIndent86527-9 Conditions Related to ID/DD Status 1..4
IndentIndent86528-7 Most Recent Admission/Entry or Reentry into this Facility
IndentIndentIndent50786-3 Entry Date {mm/dd/yyyy}
IndentIndentIndent54590-5 Type of Entry
IndentIndentIndent85398-6 Entered From
IndentIndent52455-3 Admission Date (Date this episode of care in this facility began) {mm/dd/yyyy}
IndentIndent52525-3 Discharge Date {mm/dd/yyyy}
IndentIndent55128-3 Discharge Status
IndentIndent93182-4 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?
IndentIndent93184-0 Route of Current Reconciled Medication List Transmission to Subsequent Provider. 1..5
IndentIndent93181-6 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 patient, family and/or caregiver?
IndentIndent93183-2 Route of Current Reconciled Medication List Transmission to Resident. 1..5
IndentIndent54592-1 Previous Assessment Reference Date for Significant Correction {mm/dd/yyyy}
IndentIndent54593-9 Assessment Reference Date. Observation end date {mm/dd/yyyy}
IndentIndent54507-9 Medicare Stay
IndentIndentIndent54594-7 Has the resident had a Medicare-covered stay since the most recent entry?
IndentIndentIndent54595-4 Start date of most recent Medicare stay {mm/dd/yyyy}
IndentIndentIndent54596-2 End date of most recent Medicare stay {mm/dd/yyyy}
Indent101259-0 Hearing, Speech, and Vision
IndentIndent54597-0 Comatose. Persistent vegetative state/no discernible consciousness
IndentIndent95744-9 Hearing. Ability to hear (with hearing aid or hearing appliances if normally used)
IndentIndent54599-6 Hearing Aid. Hearing aid or other hearing appliance used in completing B0200, Hearing
IndentIndent54600-2 Speech Clarity. Select best description of speech pattern
IndentIndent95737-3 Makes Self Understood. Ability to express ideas and wants, consider both verbal and non-verbal expression
IndentIndent54602-8 Ability to Understand Others. Understanding verbal content, however able (with hearing aid or device if used)
IndentIndent95745-6 Vision. Ability to see in adequate light (with glasses or other visual appliances)
IndentIndent54604-4 Corrective Lenses. Corrective lenses (contacts, glasses, or magnifying glass) used in completing B1000, Vision
IndentIndent93157-6 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?
Indent101260-8 Cognitive Patterns
IndentIndent54605-1 Should Brief Interview for Mental Status (C0200-C0500) be Conducted?
IndentIndent52491-8 Brief Interview for Mental Status (BIMS)
IndentIndentIndent52731-7 Repetition of Three Words. Number of words repeated after first attempt
IndentIndentIndent54510-3 Temporal Orientation (orientation to year, month, and day)
IndentIndentIndentIndent52732-5 Able to report correct year
IndentIndentIndentIndent52733-3 Able to report correct month
IndentIndentIndentIndent54609-3 Able to report correct day of the week
IndentIndentIndent52493-4 Recall
IndentIndentIndentIndent52735-8 Able to recall "sock"
IndentIndentIndentIndent52736-6 Able to recall "blue"
IndentIndentIndentIndent52737-4 Able to recall "bed"
IndentIndentIndent54614-3 BIMS Summary Score {score}
IndentIndent54615-0 Should the Staff Assessment for Mental Status (C0700 - C1000) be Conducted?
IndentIndent96908-9 Staff assessment for mental status
IndentIndentIndent54616-8 Short-term Memory OK. Seems or appears to recall after 5 minutes.
IndentIndentIndent54617-6 Long-term Memory OK. Seems or appears to recall long past.
IndentIndentIndent95743-1 Memory/Recall Ability. 1..4
IndentIndentIndent54624-2 Cognitive Skills for Daily Decision Making. Made decisions regarding tasks of daily life.
IndentIndent96901-4 Delirium
IndentIndentIndent95816-5 Signs and symptoms of delirium (from CAM)
IndentIndentIndentIndent95813-2 Acute Onset Mental Change
IndentIndentIndentIndent95812-4 Inattention
IndentIndentIndentIndent95814-0 Disorganized Thinking
IndentIndentIndentIndent95815-7 Altered Level of Consciousness
Indent101261-6 Mood
IndentIndent54634-1 Should Resident Mood Interview be Conducted?
IndentIndent54635-8 Resident Mood Interview (PHQ-2 to 9)
IndentIndentIndent86843-0 Symptom Presence
IndentIndentIndentIndent54636-6 Little interest or pleasure in doing things
IndentIndentIndentIndent54638-2 Feeling down, depressed or hopeless
IndentIndentIndentIndent54640-8 Trouble falling or staying asleep, or sleeping too much
IndentIndentIndentIndent54642-4 Feeling tired or having little energy
IndentIndentIndentIndent54644-0 Poor appetite or overeating
IndentIndentIndentIndent54646-5 Feeling bad about yourself - or that you are a failure or have let yourself or your family down
IndentIndentIndentIndent54648-1 Trouble concentrating on things, such as reading the newspaper or watching television
IndentIndentIndentIndent54650-7 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
IndentIndentIndentIndent54652-3 Thoughts that you would be better off dead, or of hurting yourself in some way
IndentIndentIndent86844-8 Symptom Frequency
IndentIndentIndentIndent54637-4 Little interest or pleasure in doing things
IndentIndentIndentIndent54639-0 Feeling down, depressed or hopeless
IndentIndentIndentIndent54641-6 Trouble falling or staying asleep, or sleeping too much
IndentIndentIndentIndent54643-2 Feeling tired or having little energy
IndentIndentIndentIndent54645-7 Poor appetite or overeating
IndentIndentIndentIndent54647-3 Feeling bad about yourself - or that you are a failure or have let yourself or your family down
IndentIndentIndentIndent54649-9 Trouble concentrating on things, such as reading the newspaper or watching television
IndentIndentIndentIndent54651-5 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
IndentIndentIndentIndent54653-1 Thoughts that you would be better off dead, or of hurting yourself in some way
IndentIndent54654-9 Total Severity Score {score}
IndentIndent54657-2 Staff Assessment of Resident Mood (PHQ-9-OV)
IndentIndentIndent86833-1 Symptom Presence
IndentIndentIndentIndent54658-0 Little interest or pleasure in doing things
IndentIndentIndentIndent54660-6 Feeling or appearing down, depressed, or hopeless
IndentIndentIndentIndent54662-2 Trouble falling or staying asleep, or sleeping too much
IndentIndentIndentIndent54664-8 Feeling tired or having little energy
IndentIndentIndentIndent54666-3 Poor appetite or overeating
IndentIndentIndentIndent54668-9 Indicating that they feel bad about self, is a failure, or have let self or family down
IndentIndentIndentIndent54670-5 Trouble concentrating on things, such as reading the newspaper or watching television
IndentIndentIndentIndent54672-1 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
IndentIndentIndentIndent54673-9 States that life isn't worth living, wishes for death, or attempts to harm self
IndentIndentIndentIndent54675-4 Being short-tempered, easily annoyed
IndentIndentIndent86891-9 Symptom Frequency
IndentIndentIndentIndent54659-8 Little interest or pleasure in doing things
IndentIndentIndentIndent54661-4 Feeling or appearing down, depressed, or hopeless
IndentIndentIndentIndent54663-0 Trouble falling or staying asleep, or sleeping too much
IndentIndentIndentIndent54665-5 Feeling tired or having little energy
IndentIndentIndentIndent54667-1 Poor appetite or overeating
IndentIndentIndentIndent54669-7 Indicating that they feel bad about self, is a failure, or have let self or family down
IndentIndentIndentIndent54671-3 Trouble concentrating on things, such as reading the newspaper or watching television
IndentIndentIndentIndent54904-8 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
IndentIndentIndentIndent54674-7 States that life isn't worth living, wishes for death, or attempts to harm self
IndentIndentIndentIndent54676-2 Being short-tempered, easily annoyed
IndentIndent54677-0 Total Severity Score {score}
IndentIndent93159-2 Social Isolation. How often do you feel lonely or isolated from those around you?
Indent101262-4 Behavior
IndentIndent86597-2 Potential Indicators of Psychosis 1..2
IndentIndent54514-5 Behavioral Symptom - Presence & Frequency
IndentIndentIndent54682-0 Physical behavioral symptoms directed toward others d/(7.d)
IndentIndentIndent54683-8 Verbal behavioral symptoms directed toward others d/(7.d)
IndentIndentIndent54684-6 Other behavioral symptoms not directed toward others d/(7.d)
IndentIndent54685-3 Overall Presence of Behavioral Symptoms.Were any behavioral symptoms in questions E0200 coded 1, 2, or 3?
IndentIndent54515-2 Impact on Resident
IndentIndentIndent54686-1 Did any of the identified symptom(s): Put the resident at significant risk for physical illness or injury?
IndentIndentIndent54687-9 Did any of the identified symptom(s): Significantly interfere with the resident's care?
IndentIndentIndent54688-7 Did any of the identified symptom(s): Significantly interfere with the resident's participation in activities or social interactions?
IndentIndent54516-0 Impact on Others
IndentIndentIndent54689-5 Did any of the identified symptom(s): Put others at significant risk for physical injury?
IndentIndentIndent54690-3 Did any of the identified symptom(s): Significantly intrude on the privacy or activity of others?
IndentIndentIndent54691-1 Did any of the identified symptom(s): Significantly disrupt care or living environment?
IndentIndent54692-9 Rejection of Care - Presence & Frequency d/(7.d)
IndentIndent54693-7 Wandering - Presence & Frequency d/(7.d)
IndentIndent54517-8 Wandering - Impact
IndentIndentIndent54694-5 Does the wandering place the resident at significant risk of getting to a potentially dangerous place?
IndentIndentIndent54695-2 Does the wandering significantly intrude on the privacy or activities of others?
IndentIndent54696-0 Change in Behavior or Other Symptoms.How does resident's current behavior status, care rejection, or wandering compare to prior assessment (OBRA or Scheduled PPS)?
Indent101263-2 Preferences for Customary Routine and Activities
IndentIndent54697-8 Should Interview for Daily and Activity Preferences be Conducted?
IndentIndent54519-4 Interview for Daily Preferences
IndentIndentIndent54698-6 While you are in this facility how important is it to you to choose what clothes to wear?
IndentIndentIndent54699-4 While you are in this facility how important is it to you to take care of your personal belongings or things?
IndentIndentIndent54700-0 While you are in this facility how important is it to you to choose between a tub bath, shower, bed bath, or sponge bath?
IndentIndentIndent54701-8 While you are in this facility how important is it to you to have snacks available between meals?
IndentIndentIndent54702-6 While you are in this facility how important is it to you to choose your own bedtime?
IndentIndentIndent54703-4 While you are in this facility how important is it to you to have your family or a close friend involved in discussions about your care?
IndentIndentIndent54704-2 While you are in this facility how important is it to you to be able to use the phone in private?
IndentIndentIndent54705-9 While you are in this facility how important is it to you to have a place to lock your things to keep them safe?
IndentIndent54520-2 Interview for Activity Preferences
IndentIndentIndent54706-7 While you are in this facility how important is it to you to have books, newspapers, and magazines to read?
IndentIndentIndent54707-5 While you are in this facility how important is it to you to listen to music you like?
IndentIndentIndent54708-3 While you are in this facility how important is it to you to be around animals such as pets?
IndentIndentIndent54709-1 While you are in this facility how important is it to you to keep up with the news?
IndentIndentIndent54710-9 While you are in this facility how important is it to you to do things with groups of people?
IndentIndentIndent54711-7 While you are in this facility how important is it to you to do your favorite activities?
IndentIndentIndent54712-5 While you are in this facility how important is it to you to go outside to get fresh air when the weather is good?
IndentIndentIndent54713-3 While you are in this facility how important is it to you to participate in religious services or practices?
IndentIndent54714-1 Daily and Activity Preferences Primary Respondent. Indicate primary respondent for Daily and Activity Preferences (F0400 and F0500)
IndentIndent54715-8 Should the Staff Assessment of Daily and Activity Preferences be Conducted?
IndentIndent86599-8 Staff Assessment of Daily and Activity Preferences. Resident Prefers: 1..21
Indent101264-0 Functional Abilities and Goals
IndentIndent83239-4 Prior Functioning: Everyday Activities
IndentIndentIndent85070-1 Self-Care
IndentIndentIndent85071-9 Indoor Mobility (Ambulation)
IndentIndentIndent85072-7 Stairs
IndentIndentIndent85073-5 Functional Cognition
IndentIndent83234-5 Prior Device Use 1..5
IndentIndent92908-3 Functional Limitation in Range of Motion
IndentIndentIndent92850-7 Upper extremity (shoulder, elbow, wrist, hand)
IndentIndentIndent92851-5 Lower extremity (hip, knee, ankle, foot)
IndentIndent86602-0 Mobility Devices 1..4
IndentIndent101265-7 Functional Abilities and Goals - Admission
IndentIndentIndent101321-8 Self-Care - Admission Performance (Assessment period is the first 3 days of the stay)
IndentIndentIndentIndent95019-6 Eating
IndentIndentIndentIndent95018-8 Oral hygiene
IndentIndentIndentIndent95017-0 Toileting hygiene
IndentIndentIndentIndent95015-4 Shower/bathe self
IndentIndentIndentIndent95014-7 Upper body dressing
IndentIndentIndentIndent95013-9 Lower body dressing
IndentIndentIndentIndent95012-1 Putting on/taking off footwear
IndentIndentIndentIndent45606-1 Personal hygiene
IndentIndentIndent101322-6 Self-Care - Discharge Goal (Assessment period is the first 3 days of the stay)
IndentIndentIndentIndent89409-7 Eating
IndentIndentIndentIndent89404-8 Oral hygiene
IndentIndentIndentIndent89389-1 Toileting hygiene
IndentIndentIndentIndent89396-6 Shower/bathe self
IndentIndentIndentIndent89387-5 Upper body dressing
IndentIndentIndentIndent89406-3 Lower body dressing
IndentIndentIndentIndent89400-6 Putting on/taking off footwear
IndentIndentIndentIndent45606-1 Personal hygiene
IndentIndentIndent101323-4 Mobility - Admission Performance (Assessment period is the first 3 days of the stay)
IndentIndentIndentIndent95011-3 Roll left and right
IndentIndentIndentIndent95010-5 Sit to lying
IndentIndentIndentIndent95009-7 Lying to sitting on side of bed
IndentIndentIndentIndent95008-9 Sit to stand
IndentIndentIndentIndent95007-1 Chair/bed-to-chair transfer
IndentIndentIndentIndent95006-3 Toilet transfer
IndentIndentIndentIndent101325-9 Tub/shower transfer
IndentIndentIndentIndent95005-5 Car transfer
IndentIndentIndentIndent95004-8 Walk 10 feet
IndentIndentIndentIndent95003-0 Walk 50 feet with two turns
IndentIndentIndentIndent95002-2 Walk 150 feet
IndentIndentIndentIndent95001-4 Walking 10 feet on uneven surfaces
IndentIndentIndentIndent95000-6 1 step (curb)
IndentIndentIndentIndent94999-0 4 steps
IndentIndentIndentIndent94998-2 12 steps
IndentIndentIndentIndent94997-4 Picking up object
IndentIndentIndentIndent95738-1 Does the resident use a wheelchair and/or scooter?
IndentIndentIndentIndent94992-5 Wheel 50 feet with two turns
IndentIndentIndentIndent95739-9 Indicate the type of wheelchair or scooter used
IndentIndentIndentIndent94991-7 Wheel 150 feet
IndentIndentIndentIndent95739-9 Indicate the type of wheelchair or scooter used
IndentIndentIndent101324-2 Mobility - Discharge Goal (Assessment period is the first 3 days of stay)
IndentIndentIndentIndent89398-2 Roll left and right
IndentIndentIndentIndent89394-1 Sit to lying
IndentIndentIndentIndent85927-2 Lying to sitting on side of bed
IndentIndentIndentIndent89392-5 Sit to stand
IndentIndentIndentIndent89414-7 Chair/bed-to-chair transfer
IndentIndentIndentIndent89390-9 Toilet transfer
IndentIndentIndentIndent101325-9 Tub/shower transfer
IndentIndentIndentIndent89412-1 Car transfer
IndentIndentIndentIndent89385-9 Walk 10 feet
IndentIndentIndentIndent89381-8 Walk 50 feet with two turns
IndentIndentIndentIndent89383-4 Walk 150 feet
IndentIndentIndentIndent89379-2 Walking 10 feet on uneven surfaces
IndentIndentIndentIndent89420-4 1 step (curb)
IndentIndentIndentIndent89416-2 4 steps
IndentIndentIndentIndent89418-8 12 steps
IndentIndentIndentIndent89402-2 Picking up object
IndentIndentIndentIndent94992-5 Wheel 50 feet with two turns
IndentIndentIndentIndent94991-7 Wheel 150 feet
IndentIndent101266-5 Functional Abilities and Goals - Discharge
IndentIndentIndent101429-9 Self-Care - Discharge Performance (Assessment period is the last 3 days of the stay)
IndentIndentIndentIndent89409-7 Eating
IndentIndentIndentIndent89404-8 Oral hygiene
IndentIndentIndentIndent89389-1 Toileting hygiene
IndentIndentIndentIndent89396-6 Shower/bathe self
IndentIndentIndentIndent89387-5 Upper body dressing
IndentIndentIndentIndent89406-3 Lower body dressing
IndentIndentIndentIndent89400-6 Putting on/taking off footwear
IndentIndentIndentIndent45606-1 Personal hygiene
IndentIndentIndent101431-5 Mobility - Discharge Performance (Assessment period is the last 3 days of the stay)
IndentIndentIndentIndent89398-2 Roll left and right
IndentIndentIndentIndent89394-1 Sit to lying
IndentIndentIndentIndent85927-2 Lying to sitting on side of bed
IndentIndentIndentIndent89392-5 Sit to stand
IndentIndentIndentIndent89414-7 Chair/bed-to-chair transfer
IndentIndentIndentIndent89390-9 Toilet transfer
IndentIndentIndentIndent101325-9 Tub/shower transfer
IndentIndentIndentIndent89412-1 Car transfer
IndentIndentIndentIndent89385-9 Walk 10 feet
IndentIndentIndentIndent89381-8 Walk 50 feet with two turns
IndentIndentIndentIndent89383-4 Walk 150 feet
IndentIndentIndentIndent89379-2 Walking 10 feet on uneven surfaces
IndentIndentIndentIndent89420-4 1 step (curb)
IndentIndentIndentIndent89416-2 4 steps
IndentIndentIndentIndent89418-8 12 steps
IndentIndentIndentIndent89402-2 Picking up object
IndentIndentIndentIndent95738-1 Does the resident use a wheelchair and/or scooter?
IndentIndentIndentIndent94992-5 Wheel 50 feet with two turns
IndentIndentIndentIndent95739-9 Indicate the type of wheelchair or scooter used
IndentIndentIndentIndent94991-7 Wheel 150 feet
IndentIndentIndentIndent95739-9 Indicate the type of wheelchair or scooter used
IndentIndent101267-3 Functional Abilities and Goals - OBRA &or Interim
IndentIndentIndent101430-7 Self-Care - OBRA/Interim Performance (Assessment period is the ARD plus 2 previous calendar days)
IndentIndentIndentIndent89409-7 Eating
IndentIndentIndentIndent89404-8 Oral hygiene
IndentIndentIndentIndent89389-1 Toileting hygiene
IndentIndentIndentIndent89396-6 Shower/bathe self
IndentIndentIndentIndent89387-5 Upper body dressing
IndentIndentIndentIndent89406-3 Lower body dressing
IndentIndentIndentIndent89400-6 Putting on/taking off footwear
IndentIndentIndentIndent45606-1 Personal hygiene
IndentIndentIndent101432-3 Mobility - OBRA/Interim Performance (Assessment period is the ARD plus 2 previous calendar days)
IndentIndentIndentIndent89398-2 Roll left and right
IndentIndentIndentIndent89394-1 Sit to lying
IndentIndentIndentIndent85927-2 Lying to sitting on side of bed
IndentIndentIndentIndent89392-5 Sit to stand
IndentIndentIndentIndent89414-7 Chair/bed-to-chair transfer
IndentIndentIndentIndent89390-9 Toilet transfer
IndentIndentIndentIndent101325-9 Tub/shower transfer
IndentIndentIndentIndent89412-1 Car transfer
IndentIndentIndentIndent89385-9 Walk 10 feet
IndentIndentIndentIndent89381-8 Walk 50 feet with two turns
IndentIndentIndentIndent89383-4 Walk 150 feet
IndentIndentIndentIndent95738-1 Does the resident use a wheelchair and/or scooter?
IndentIndentIndentIndent94992-5 Wheel 50 feet with two turns
IndentIndentIndentIndent95739-9 Indicate the type of wheelchair or scooter used
IndentIndentIndentIndent94991-7 Wheel 150 feet
IndentIndentIndentIndent95739-9 Indicate the type of wheelchair or scooter used
Indent101268-1 Bladder and Bowel
IndentIndent86624-4 Appliances 1..4
IndentIndent54530-1 Urinary Toileting Program
IndentIndentIndent54767-9 Has a trial of a toileting program been attempted on admission/entry or reentry or since urinary incontinence was noted in this facility?
IndentIndentIndent54768-7 Response - What was the resident's response to the trial program?
IndentIndentIndent54769-5 Current toileting program or trial - Is a toileting program currently being used to manage the resident's urinary continence?
IndentIndent95735-7 Urinary Continence 1..1
IndentIndent95736-5 Bowel Continence 1..1
IndentIndent88695-2 Bowel Toileting Program. Is a toileting program currently being used to manage the resident's bowel continence?
IndentIndent54773-7 Bowel Patterns. Constipation present?
Indent101269-9 Active Diagnoses
IndentIndent89045-9 Indicate the resident's primary medical condition category 1..1
IndentIndent52797-8 ICD Code
IndentIndent86671-5 Active Diagnoses in the last 7 days 1..*
IndentIndent52797-8 Additional active diagnoses 0..10
Indent101270-7 Health Conditions
IndentIndent54557-4 Pain Management
IndentIndentIndent71447-7 At any time in the last 5 days, has the resident: Received scheduled pain medication regimen?
IndentIndentIndent71448-5 At any time in the last 5 days, has the resident: Received PRN pain medications OR was offered and declined?
IndentIndentIndent71449-3 At any time in the last 5 days, has the resident: Received non-medication intervention for pain?
IndentIndent54828-9 Should Pain Assessment Interview be Conducted?
IndentIndent101326-7 Pain Assessment Interview
IndentIndentIndent54829-7 Pain Presence
IndentIndentIndent54830-5 Pain Frequency
IndentIndentIndent93156-8 Pain Effect on Sleep
IndentIndentIndent93160-0 Pain Interference with Therapy Activities
IndentIndentIndent93158-4 Pain Interference with Day-to-Day Activities
IndentIndentIndent54560-8 Pain Intensity
IndentIndentIndentIndent54833-9 Numeric Rating Scale (00-10)
IndentIndentIndentIndent54834-7 Verbal Descriptor Scale
IndentIndent58117-3 Should the Staff Assessment for Pain be Conducted?
IndentIndent86672-3 Staff Assessment for Pain
IndentIndentIndent86673-1 Indicators of Pain or Possible Pain in the last 5 days 1..4
IndentIndentIndent58118-1 Frequency of Indicator of Pain or Possible Pain in the last 5 days. d/(5.d)
IndentIndent86674-9 Other Health Conditions
IndentIndentIndent86675-6 Shortness of Breath (dyspnea) 1..3
IndentIndentIndent54845-3 Current Tobacco Use
IndentIndentIndent54846-1 Prognosis. Does the resident have a condition or chronic disease that may result in a life expectancy of less than 6 months?
IndentIndentIndent86676-4 Problem Conditions 1..4
IndentIndentIndent54849-5 Fall History on Admission/Entry or Reentry
IndentIndentIndentIndent54850-3 Did the resident have a fall any time in the last month prior to admission/entry or reentry?
IndentIndentIndentIndent54851-1 Did the resident have a fall any time in the last 2-6 months prior to admission/entry or reentry?
IndentIndentIndentIndent54852-9 Did the resident have any fracture related to a fall in the 6 months prior to admission/entry or reentry?
IndentIndentIndent54853-7 Any Falls Since Admission/Entry or Reentry or Prior Assessment (OBRA or Scheduled PPS), whichever is more recent
IndentIndentIndent54854-5 Number of Falls Since Admission/Entry or Reentry or Prior Assessment (OBRA or Scheduled PPS), whichever is more recent
IndentIndentIndentIndent54855-2 No injury
IndentIndentIndentIndent54856-0 Injury (except major)
IndentIndentIndentIndent54857-8 Major injury
IndentIndent83274-1 Prior Surgery. Did the resident have major surgery during the 100 days prior to admission?
IndentIndent90542-2 Recent Surgery Requiring Active SNF Care-Did the resident have a major surgical procedure during the prior inpatient hospital stay that requires active care during the SNF stay?
IndentIndent90745-1 Surgical Procedures 1..*
Indent101271-5 Swallowing &or Nutritional Status
IndentIndent86677-2 Swallowing Disorder 1..4
IndentIndent54567-3 Height and Weight
IndentIndentIndent3137-7 Height (in inches) [in_us];cm;m
IndentIndentIndent3141-9 Weight (in pounds) [lb_av];kg
IndentIndent54863-6 Weight Loss
IndentIndent86678-0 Weight Gain
IndentIndent54568-1 Nutritional Approaches
IndentIndentIndent101327-5 Nutritional Approaches. On Admission. 1..4
IndentIndentIndent71444-4 Nutritional Approaches. While NOT a Resident 1..2
IndentIndentIndent71445-1 Nutritional Approaches. While a Resident 1..4
IndentIndentIndent101328-3 Nutritional Approaches. At Discharge. 1..4
IndentIndent90543-0 Percent Intake by Artificial Route
IndentIndentIndent86681-4 Proportion of total calories the resident received through parenteral or tube feeding. While a Resident
IndentIndentIndent86687-1 Proportion of total calories the resident received through parenteral or tube feeding. During Entire 7 Days
IndentIndentIndent86683-0 Average fluid intake per day by IV or tube feeding. While a Resident mL/d;L/d
IndentIndentIndent86684-8 Average fluid intake per day by IV or tube feeding. During Entire 7 Days mL/d;L/d
Indent101272-3 Ora/Dental Status
IndentIndent86706-9 Dental 1..7
Indent101273-1 Skin Conditions
IndentIndent101333-3 Determination of Pressure Ulcer/Injury Risk. 1..3
IndentIndent57280-0 Risk of Pressure Ulcers/Injuries. Is this resident at risk of developing pressure ulcers/injuries?
IndentIndent58214-8 Unhealed Pressure Ulcers/Injuries. Does this resident have one or more unhealed pressure ulcers/injuries?
IndentIndent88961-8 Current Number of Unhealed Pressure Ulcers/Injuries at Each Stage
IndentIndentIndent54884-2 Number of Stage 1 pressure injuries {#}
IndentIndentIndent55124-2 Number of Stage 2 pressure ulcers {#}
IndentIndentIndent54886-7 Number of these Stage 2 pressure ulcers that were present upon admission/entry or reentry {#}
IndentIndentIndent55125-9 Number of Stage 3 pressure ulcers {#}
IndentIndentIndent54887-5 Number of these Stage 3 pressure ulcers that were present upon admission/entry or reentry {#}
IndentIndentIndent55126-7 Number of Stage 4 pressure ulcers {#}
IndentIndentIndent54890-9 Number of these Stage 4 pressure ulcers that were present upon admission/entry or reentry {#}
IndentIndentIndent54893-3 Number of unstageable pressure ulcers/injuries due to non-removable dressing/device {#}
IndentIndentIndent54894-1 Number of these unstageable pressure ulcers/injuries that were present upon admission/entry or reentry {#}
IndentIndentIndent54946-9 Number of unstageable pressure ulcers due to coverage of wound bed by slough and/or eschar {#}
IndentIndentIndent54947-7 Number of these unstageable pressure ulcers that were present upon admission/entry or reentry {#}
IndentIndentIndent54950-1 Number of unstageable pressure injuries presenting as deep tissue injury {#}
IndentIndentIndent54951-9 Number of these unstageable pressure injuries that were present upon admission/entry or reentry {#}
IndentIndent101330-9 Number of Venous and Arterial Ulcers {#}
IndentIndent101331-7 Other Ulcers, Wounds and Skin Problems 1..8
IndentIndent86748-1 Skin and Ulcer/Injury Treatments 1..9
Indent101274-9 Medications
IndentIndent54982-4 Injections. d/(7.d)
IndentIndent58217-1 Insulin
IndentIndentIndent58127-2 Insulin injections d/(7.d)
IndentIndentIndent58128-0 Orders for insulin d/(7.d)
IndentIndent93155-0 High-Risk Drug Classes: Use and Indication
IndentIndentIndent93153-5 Is taking 1..10
IndentIndentIndent93154-3 Indication noted 1..10
IndentIndent88295-1 Antipsychotic Medication Review
IndentIndentIndent88296-9 Did the resident receive antipsychotic medications since admission/entry or reentry or the prior OBRA assessment, whichever is more recent?
IndentIndentIndent88297-7 Has a gradual dose reduction (GDR) been attempted?
IndentIndentIndent88298-5 Date of last attempted GDR {mm/dd/yyyy}
IndentIndentIndent88299-3 Physician documented GDR as clinically contraindicated
IndentIndentIndent88300-9 Date physician documented GDR as clinically contraindicated {mm/dd/yyyy}
IndentIndent57255-2 Drug Regimen Review
IndentIndent57281-8 Medication Follow-up
IndentIndent57256-0 Medication Intervention
Indent101275-6 Special Treatments, Procedures, and Programs
IndentIndent101346-5 Special Treatments, Procedures, and Programs
IndentIndentIndent83252-7 Special Treatments, Procedures, and Programs - On Admission 1..30
IndentIndentIndent86761-4 Special Treatments, Procedures, and Programs - While a Resident 1..14
IndentIndentIndent93185-7 Special Treatments, Procedures, and Programs - At Discharge 1..31
IndentIndent69339-0 Influenza Vaccine
IndentIndentIndent55019-4 Did the resident receive the influenza vaccine in this facility for this year's influenza vaccination season?
IndentIndentIndent58131-4 Date influenza vaccine received {mm/dd/yyyy}
IndentIndentIndent55020-2 If influenza vaccine not received, state reason:
IndentIndent55021-0 Pneumococcal Vaccine
IndentIndentIndent55022-8 Is the resident's Pneumococcal vaccination up to date?
IndentIndentIndent45956-0 If Pneumococcal vaccine not received, state reason:
IndentIndent86762-2 Therapies
IndentIndentIndent86763-0 Speech-Language Pathology and Audiology Services
IndentIndentIndentIndent58218-9 Individual minutes min
IndentIndentIndentIndent58133-0 Concurrent minutes min
IndentIndentIndentIndent58134-8 Group minutes min
IndentIndentIndentIndent86765-5 Co-treatment minutes min
IndentIndentIndentIndent45760-6 Days d/(7.d)
IndentIndentIndentIndent55025-1 Therapy start date {mm/dd/yyyy}
IndentIndentIndentIndent55026-9 Therapy end date {mm/dd/yyyy}
IndentIndentIndent86767-1 Occupational Therapy
IndentIndentIndentIndent58219-7 Individual minutes min
IndentIndentIndentIndent58136-3 Concurrent minutes min
IndentIndentIndentIndent58137-1 Group minutes min
IndentIndentIndentIndent86764-8 Co-treatment minutes min
IndentIndentIndentIndent45762-2 Days d/(7.d)
IndentIndentIndentIndent55027-7 Therapy start date {mm/dd/yyyy}
IndentIndentIndentIndent55028-5 Therapy end date {mm/dd/yyyy}
IndentIndentIndent86768-9 Physical Therapy
IndentIndentIndentIndent58220-5 Individual minutes min
IndentIndentIndentIndent58139-7 Concurrent minutes min
IndentIndentIndentIndent58140-5 Group minutes min
IndentIndentIndentIndent86766-3 Co-treatment minutes min
IndentIndentIndentIndent45764-8 Days d/(7.d)
IndentIndentIndentIndent55029-3 Therapy start date {mm/dd/yyyy}
IndentIndentIndentIndent55030-1 Therapy end date {mm/dd/yyyy}
IndentIndentIndent58141-3 Respiratory Therapy
IndentIndentIndentIndent45767-1 Total minutes min
IndentIndentIndentIndent45766-3 Days d/(7.d)
IndentIndentIndent58142-1 Psychological Therapy (by any licensed mental health professional)
IndentIndentIndentIndent45852-1 Total minutes min
IndentIndentIndentIndent45768-9 Days d/(7.d)
IndentIndentIndent58143-9 Recreational Therapy (includes recreational and music therapy)
IndentIndentIndentIndent55035-0 Total minutes min
IndentIndentIndentIndent55036-8 Days d/(7.d)
IndentIndent86769-7 Distinct Calendar Days of Therapy d
IndentIndent90544-8 Part A Therapies
IndentIndentIndent90545-5 Speech-Language Pathology and Audiology Services
IndentIndentIndentIndent90539-8 Individual minutes min
IndentIndentIndentIndent90536-4 Concurrent minutes min
IndentIndentIndentIndent90538-0 Group minutes min
IndentIndentIndentIndent90537-2 Co-treatment minutes min
IndentIndentIndentIndent90551-3 Days d/{#}
IndentIndentIndent90546-3 Occupational Therapy
IndentIndentIndentIndent90531-5 Individual minutes min
IndentIndentIndentIndent90527-3 Concurrent minutes min
IndentIndentIndentIndent90529-9 Group minutes min
IndentIndentIndentIndent90528-1 Co-treatment minutes min
IndentIndentIndentIndent90530-7 Days d/{#}
IndentIndentIndent90547-1 Physical Therapy
IndentIndentIndentIndent90535-6 Individual minutes min
IndentIndentIndentIndent90532-3 Concurrent minutes min
IndentIndentIndentIndent90534-9 Group minutes min
IndentIndentIndentIndent90533-1 Co-treatment minutes min
IndentIndentIndentIndent90550-5 Days d/{#}
IndentIndent90548-9 Distinct Calendar Days of Part A Therapy {#}
IndentIndent86773-9 Restorative Nursing Programs
IndentIndentIndent86774-7 Technique. Range of motion (passive) d/(7.d)
IndentIndentIndent86775-4 Technique. Range of motion (active) d/(7.d)
IndentIndentIndent86776-2 Technique. Splint or brace assistance d/(7.d)
IndentIndentIndent86777-0 Training and Skill Practice In: Bed mobility d/(7.d)
IndentIndentIndent86778-8 Training and Skill Practice In: Transfer d/(7.d)
IndentIndentIndent86779-6 Training and Skill Practice In: Walking d/(7.d)
IndentIndentIndent86780-4 Training and Skill Practice In: Dressing and/or grooming d/(7.d)
IndentIndentIndent86781-2 Training and Skill Practice In: Eating and/or swallowing d/(7.d)
IndentIndentIndent86782-0 Training and Skill Practice In: Amputation/prostheses care d/(7.d)
IndentIndentIndent86783-8 Training and Skill Practice In: Communication d/(7.d)
Indent101276-4 Restraints and Alarms
IndentIndent86785-3 Physical Restraints
IndentIndentIndent86786-1 Used in Bed. Bed rail d/(7.d)
IndentIndentIndent86787-9 Used in Bed. Trunk restraint d/(7.d)
IndentIndentIndent86788-7 Used in Bed. Limb restraint d/(7.d)
IndentIndentIndent86789-5 Used in Bed. Other d/(7.d)
IndentIndentIndent86790-3 Used in Chair or Out of Bed. Trunk restraint d/(7.d)
IndentIndentIndent86791-1 Used in Chair or Out of Bed. Limb restraint d/(7.d)
IndentIndentIndent86792-9 Used in Chair or Out of Bed. Chair prevents rising d/(7.d)
IndentIndentIndent86793-7 Used in Chair or Out of Bed. Other d/(7.d)
IndentIndent88309-0 Alarms
IndentIndentIndent88310-8 Bed alarm
IndentIndentIndent88311-6 Chair alarm
IndentIndentIndent88312-4 Floor mat alarm
IndentIndentIndent88313-2 Motion sensor alarm
IndentIndentIndent88314-0 Wander/elopement alarm
IndentIndentIndent88308-2 Other alarm
Indent101277-2 Participation in Assessment and Goal Setting
IndentIndent101329-1 Participation in Assessment and Goal Setting 1..5
IndentIndent55056-6 Resident's Overall Goal
IndentIndentIndent55057-4 Resident's overall goal for discharge established during the assessment process.
IndentIndentIndent55058-2 Indicate information source for Q0310A
IndentIndent101436-4 Discharge Plan
IndentIndentIndent58146-2 Is active discharge planning already occurring for the resident to return to the community?
IndentIndent86795-2 Resident's Documented Preference to Avoid Being Asked Question Q0500B. Does the resident's clinical record document a request that this question be asked only on comprehensive assessments?
IndentIndent101347-3 Return to Community
IndentIndentIndent58149-6 Do you want to talk to someone about the possiblity of leaving this facility and returning to live and receive services in the community?
IndentIndentIndent86798-6 Indicate information source for Q0500B
IndentIndent86796-0 Resident's Preference to Avoid Being Asked Question Q0500B Again
IndentIndentIndent86797-8 Does resident (or family or significant other or guardian or legally authorized representative only if resident is unable to understand or respond) want to be asked about returning to the community on all assessments?
IndentIndentIndent86798-6 Indicate information source for Q0550A
IndentIndent101435-6 Referral
IndentIndentIndent101374-7 Has a referral been made to the Local Contact Agency (LCA)?
IndentIndent101332-5 Reason Referral to Local Contact Agency (LCA) Not Made.
Indent101278-0 Care Area Assessment (CAA) Summary
IndentIndent87208-5 Items From the Most Recent Prior OBRA or Scheduled PPS Assessment
IndentIndentIndent54583-0 Prior Assessment Federal OBRA Reason for Assessment
IndentIndentIndent54584-8 Prior Assessment PPS Reason for Assessment
IndentIndentIndent54593-9 Prior Assessment Reference Date {mm/dd/yyyy}
IndentIndentIndent54614-3 Prior Assessment Brief Interview for Mental Status (BIMS) Summary Score {score}
IndentIndentIndent54654-9 Prior Assessment Resident Mood Interview (PHQ-2 to 9©) Total Severity Score {score}
IndentIndentIndent54677-0 Prior Assessment Staff Assessment of Resident Mood (PHQ-9-OV) Total Severity Score {score}
IndentIndent87210-1 CAAs and Care Planning 0..20
IndentIndentIndent87211-9 CAA Results
IndentIndentIndentIndent87212-7 Care Area Triggered 1..20
IndentIndentIndentIndent87213-5 Care Planning Decision 1..20
Indent101279-8 Correction Request
IndentIndent85632-8 Type of Provider 1..1
IndentIndent87226-7 Name of Resident
IndentIndentIndent45392-8 First name
IndentIndentIndent45394-4 Last name
IndentIndent46098-0 Gender
IndentIndent21112-8 Birth Date {mm/dd/yyyy}
IndentIndent45396-9 Social Security Number
IndentIndent90492-0 Type of Assessment
IndentIndentIndent54583-0 Federal OBRA Reason for Assessment
IndentIndentIndent54584-8 PPS Assessment
IndentIndentIndent58108-2 Entry/discharge reporting
IndentIndentIndent86525-3 Is this a SNF Part A PPS Discharge Assessment?
IndentIndent87216-8 Date on existing record to be modified/inactivated
IndentIndentIndent54593-9 Assessment Reference Date {mm/dd/yyyy}
IndentIndentIndent52525-3 Discharge Date {mm/dd/yyyy}
IndentIndentIndent50786-3 Entry Date {mm/dd/yyyy}
IndentIndent87209-3 Correction Attestation Section
IndentIndentIndent58200-7 Correction Number {#}
IndentIndentIndent87217-6 Reasons for Modification 1..5
IndentIndentIndent87225-9 Reasons for Inactivation 1..2
IndentIndentIndent87218-4 RN Assessment Coordinator Attestation of Completion
IndentIndentIndentIndent87219-2 Attesting individual's first name
IndentIndentIndentIndent87220-0 Attesting individual's last name
IndentIndentIndentIndent87221-8 Attesting individual's title
IndentIndentIndentIndent87222-6 Attestation date {mm/dd/yyyy}
Indent101280-6 Assessment Administration
IndentIndent90498-7 Medicare Part A Billing
IndentIndentIndent55065-7 Medicare Part A HIPPS code
IndentIndentIndent55081-4 Version code
IndentIndent93053-7 State Medicaid Billing (if required by the state)
IndentIndentIndent55068-1 Case Mix group
IndentIndentIndent55081-4 Version code
IndentIndent93052-9 Alternate State Medicaid Billing (if required by the state)
IndentIndentIndent58212-2 Case Mix group
IndentIndentIndent55081-4 Version code
IndentIndent93051-1 Insurance Billing
IndentIndentIndent55071-5 Billing code
IndentIndentIndent55081-4 Billing version
IndentIndent85648-4 Signature of Persons Completing the Assessment or Entry/Death Reporting
IndentIndent70127-6 Signature of RN Assessment Coordinator Verifying Assessment Completion
IndentIndentIndent70127-6 Signature:
IndentIndentIndent30947-6 Date RN Assessment Coordinator signed assessment as complete: {mm/dd/yyyy}

Fully-Specified Name

Component
MDS v3.0 - RAI v1.18.11 - Nursing home comprehensive (NC) item set
Property
-
Time
Pt
System
^Patient
Scale
-
Method
CMS Assessment

Basic Attributes

Class
PANEL.SURVEY.CMS
Type
Surveys
First Released
Version 2.74
Last Updated
Version 2.75
Order vs. Observation
Order
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=101105-5
Questionnaire definition
https://fhir.loinc.org/Questionnaire/?url=http://loinc.org/q/101105-5