103946-0
Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Planned Discharge - version 5.1 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 |
|---|---|---|---|---|
| 103946-0 | Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Planned Discharge - version 5.1 during assessment period [CMS Assessment] | |||
| Indent93217-8 | Administrative 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 Medicaid Provider Number | |||
| Indent Indent85632-8 | Type of Provider | |||
| Indent Indent54593-9 | Assessment Reference Date. Observation end date | {mm/dd/yyyy} | ||
| Indent Indent52455-3 | Admission Date | {mm/dd/yyyy} | ||
| Indent Indent52454-6 | Reason for Assessment | |||
| Indent Indent52525-3 | Discharge Date | {mm/dd/yyyy} | ||
| Indent Indent93230-1 | Patient Demographic Information | |||
| Indent Indent Indent54503-8 | Legal Name of Patient | |||
| Indent Indent Indent Indent45392-8 | Patient First (Given) name | |||
| Indent Indent Indent Indent45393-6 | Middle initial | |||
| Indent Indent Indent Indent45394-4 | Patient Last (Family) name | |||
| Indent Indent Indent Indent45395-1 | Suffix | |||
| Indent Indent Indent45966-9 | Social Security and Medicare numbers | |||
| Indent Indent Indent Indent45396-9 | Social Security Number | |||
| Indent Indent Indent Indent45397-7 | Medicare number (or comparable railroad insurance number) | |||
| Indent Indent Indent45400-9 | Medicaid Number | |||
| Indent Indent Indent46098-0 | Gender | |||
| Indent Indent Indent21112-8 | Birth Date | {mm/dd/yyyy} | ||
| Indent Indent Indent101351-5 | Transportation | |||
| Indent Indent Indent52556-8 | Payer Information | 1..12 | ||
| Indent Indent55128-3 | Discharge Location | |||
| Indent Indent93182-4 | Provision of Current Reconciled Medication List to Subsequent Provider at Discharge | |||
| Indent Indent93184-0 | Route of Current Reconciled Medication List Transmission to Subsequent Provider. Indicate the route(s) of transmission of the current reconciled medication list to the subsequent provider | 1..5 | ||
| Indent Indent93181-6 | Provision of Current Reconciled Medication List to Patient at Discharge | |||
| Indent Indent93183-2 | Route of Current Reconciled Medication List Transmission to Patient. Indicate the route(s) of transmission of the current reconciled medication list to the patient/family/caregiver | 1..5 | ||
| Indent93214-5 | Hearing, Speech, and Vision | |||
| Indent Indent54597-0 | Comatose | |||
| Indent Indent103709-2 | Health Literacy | |||
| Indent Indent95737-3 | Expression of Ideas and Wants | |||
| Indent Indent95740-7 | Understanding Verbal and Non-Verbal Content | |||
| Indent93213-7 | 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 | |||
| Indent Indent Indent103702-7 | Temporal Orientation | |||
| 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 Indent95816-5 | Signs and Symptoms of Delirium (from CAM) | |||
| Indent Indent Indent95813-2 | Acute Onset Mental Status Change. Is there evidence of an acute change in mental status from the patient's baseline? | |||
| Indent Indent Indent95812-4 | Inattention - Did the patient have difficulty focusing attention, for example, being easily distractible or having difficulty keeping track of what was being said? | |||
| Indent Indent Indent95814-0 | Disorganized thinking - Was the patient's thinking disorganized or incoherent (rambling or irrelevant conversation, unclear or illogical flow of ideas, or unpredictable switching from subject to subject)? | |||
| Indent Indent Indent95815-7 | Altered level of consciousness - Did the patient have altered level of consciousness, as indicated by any of the following criteria? | |||
| Indent93170-9 | Mood | |||
| Indent Indent54635-8 | Patient Mood Interview (PHQ-2 to 9) (from Pfizer Inc.©) | |||
| 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 Indent93159-2 | Social Isolation | |||
| Indent103999-9 | Functional Abilities - Planned Discharge | |||
| Indent Indent95861-1 | Self-Care - Discharge Performance | |||
| Indent Indent Indent95019-6 | Eating | |||
| Indent Indent Indent95018-8 | Oral hygiene | |||
| Indent Indent Indent95017-0 | Toileting hygiene | |||
| Indent Indent96100-3 | Mobility - Discharge Performance | |||
| Indent Indent Indent95011-3 | Roll left and right | |||
| Indent Indent Indent95010-5 | Sit to lying | |||
| Indent Indent Indent95009-7 | Lying to sitting on side of bed | |||
| Indent Indent Indent95008-9 | Sit to stand | |||
| Indent Indent Indent95007-1 | Chair/bed-to-chair transfer | |||
| Indent Indent Indent95006-3 | Toilet transfer | |||
| Indent Indent Indent95005-5 | Car transfer | |||
| Indent Indent Indent95004-8 | Walk 10 feet | |||
| Indent Indent Indent95003-0 | Walk 50 feet with two turns | |||
| Indent Indent Indent95002-2 | Walk 150 feet | |||
| Indent Indent Indent95001-4 | Walking 10 feet on uneven surfaces | |||
| Indent Indent Indent95000-6 | 1 step (curb) | |||
| Indent Indent Indent94999-0 | 4 steps | |||
| Indent Indent Indent94998-2 | 12 steps | |||
| Indent Indent Indent94997-4 | Picking up object | |||
| Indent Indent Indent95738-1 | Does the patient use a wheelchair and/or scooter? | |||
| Indent Indent Indent94992-5 | Wheel 50 feet with two turns | |||
| Indent Indent Indent95739-9 | Indicate the type of wheelchair or scooter used | |||
| Indent Indent Indent94991-7 | Wheel 150 feet | |||
| Indent Indent Indent95739-9 | Indicate the type of wheelchair or scooter used | |||
| Indent95863-7 | Bladder and Bowel | |||
| Indent Indent95735-7 | Bladder Continence | |||
| Indent93177-4 | Health Conditions | |||
| Indent Indent93156-8 | Pain Effect on Sleep. Over the past 5 days, how much of the time has pain made it hard for you to sleep at night? | |||
| Indent Indent93160-0 | Pain Interference with Therapy Activities. Over the past 5 days, how often have you limited your participation in rehabilitation therapy sessions due to pain? | |||
| Indent Indent93158-4 | Pain Interference with Day-to-Day Activities. Over the past 5 days, how often have you limited your day-to-day activities (excluding rehabilitation therapy sessions) because of pain? | |||
| Indent Indent83280-8 | Any Falls Since Admission. Has the patient had any falls since admission? | |||
| Indent Indent54854-5 | Number of Falls Since Admission | |||
| Indent Indent Indent54855-2 | No injury | |||
| Indent Indent Indent54856-0 | Injury (except major) | |||
| Indent Indent Indent54857-8 | Major injury | |||
| Indent93176-6 | Swallowing/Nutritional Status | |||
| Indent Indent93180-8 | Nutritional Approaches | |||
| Indent Indent Indent71445-1 | Nutritional Approaches - Last 7 Days. Check all of the nutritional approaches that were received in the last 7 days | 1..4 | ||
| Indent Indent Indent93178-2 | Nutritional Approaches - At Discharge. Check all of the nutritional approaches that were being received at discharge | 1..4 | ||
| Indent87500-5 | Skin Conditions | |||
| Indent Indent58214-8 | Unhealed Pressure Ulcers/Injuries | |||
| Indent Indent83256-8 | Current Number of Unhealed Pressure Ulcers/Injuries at Each Stage | |||
| Indent Indent Indent54884-2 | Number of Stage 1 pressure injuries | {#} | ||
| 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 | {#} | ||
| 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 | {#} | ||
| 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 | {#} | ||
| 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 | {#} | ||
| 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 | {#} | ||
| 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 | {#} | ||
| Indent93169-1 | Medications | |||
| Indent Indent93155-0 | High-Risk Drug Classes: Use and Indication | |||
| Indent Indent Indent93153-5 | Is taking. Check if the patient is taking any medications by pharmacological classification, not how it is used, in the following classes | 1..6 | ||
| Indent Indent Indent93154-3 | Indication noted. If column 1 [Is Taking] is checked, check if there is an indication noted for all medications in the drug class | 0..6 | ||
| Indent Indent57256-0 | Did the facility contact and complete physician (or physician-designee) prescribed/recommended actions by midnight of the next calendar day each time potential clinically significant medication issues were identified since the admission? | |||
| Indent93204-6 | Special Treatments, Procedures, and Programs | |||
| Indent Indent93185-7 | Special Treatments, Procedures, and Programs - At Discharge. | |||
| Indent Indent106220-7 | Ventilator Liberation Rate | |||
| Indent Indent Indent86851-3 | Invasive Mechanical Ventilator: Liberation Status at Discharge | |||
| Indent Indent103568-2 | Patient’s COVID-19 vaccination is up to date. | |||
| Indent87223-4 | Assessment Administration | |||
| Indent Indent85648-4 | Signature of Persons Completing the Assessment | |||
| Indent Indent70127-6 | Signature of Person Verifying Assessment Completion | |||
| Indent Indent Indent70127-6 | Signature: | |||
| Indent Indent Indent30947-6 | LTCH CARE Data Set Completion Date: | {mm/dd/yyyy} |
Fully-Specified Name
- Component
- Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Planned Discharge - version 5.1
- Property
- -
- Time
- RptPeriod
- System
- ^Patient
- Scale
- -
- Method
- CMS Assessment
Basic Attributes
- Class
- PANEL.SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.77
- Last Updated
- Version 2.78 (PANEL)
- 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=103946-0 - Questionnaire definition
- https:
//fhir.loinc.org/Questionnaire/?url=http: //loinc.org/q/103946-0
LOINC Copyright
Copyright © 2025 Regenstrief Institute, Inc. All Rights Reserved. To the extent included herein, the LOINC table and LOINC codes are copyright © Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee. See https://