Version 2.78

Panel Hierarchy

Details for each LOINC in Panel LHC-Forms

LOINC Name R/O/C Cardinality Example UCUM Units
104606-9 MDS v3.0 - RAI v1.19.1 - Nursing home discharge (ND) item set during assessment period [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 1..4
IndentIndent103708-4 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©) 1..2
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)
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 {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
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
IndentIndent93183-2 Route of Current Reconciled Medication List Transmission to Resident 1..5
IndentIndent54593-9 Assessment Reference 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
IndentIndent103709-2 Health Literacy
Indent101260-8 Cognitive Patterns
IndentIndent54605-1 Should Brief Interview for Mental Status (C0200-C0500) be Conducted?
IndentIndent103694-6 Brief Interview for Mental Status (BIMS)
IndentIndentIndent103696-1 Repetition of Three Words
IndentIndentIndent103702-7 Temporal Orientation
IndentIndentIndentIndent103697-9 Able to report correct year
IndentIndentIndentIndent103698-7 Able to report correct month
IndentIndentIndentIndent103703-5 Able to report correct day of the week
IndentIndentIndent103695-3 Recall
IndentIndentIndentIndent103699-5 Able to recall "sock"
IndentIndentIndentIndent103700-1 Able to recall "blue"
IndentIndentIndentIndent103701-9 Able to recall "bed"
IndentIndentIndent103704-3 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
IndentIndentIndent54624-2 Cognitive Skills for Daily Decision Making
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
IndentIndent103705-0 Total Severity Score {score}
IndentIndent103706-8 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, are 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, are 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
IndentIndent103707-6 Total Severity Score {score}
IndentIndent93159-2 Social Isolation
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)
IndentIndent54692-9 Rejection of Care - Presence & Frequency d/(7.d)
IndentIndent54693-7 Wandering - Presence & Frequency d/(7.d)
Indent101264-0 Functional Abilities
IndentIndent101266-5 Functional Abilities - Discharge
IndentIndentIndent101429-9 Self-Care - Discharge Performance
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
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
Indent101268-1 Bladder and Bowel
IndentIndent86624-4 Appliances 1..4
IndentIndent95735-7 Urinary Continence
IndentIndent95736-5 Bowel Continence
Indent101601-3 Active Diagnoses
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
IndentIndent86674-9 Other Health Conditions
IndentIndentIndent86675-6 Shortness of Breath (dyspnea) 1..3
IndentIndentIndent54846-1 Prognosis
IndentIndentIndent86676-4 Problem Conditions 1..4
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
Indent101271-5 Swallowing &or Nutritional Status
IndentIndent54567-3 Height and Weight
IndentIndentIndent103692-0 Height (in inches) [in_us];cm;m
IndentIndentIndent103693-8 Weight (in pounds) [lb_av];kg
IndentIndent54863-6 Weight Loss
IndentIndent86678-0 Weight Gain
IndentIndent54568-1 Nutritional Approaches
IndentIndentIndent71445-1 Nutritional Approaches. While a Resident 1..4
IndentIndentIndent101328-3 Nutritional Approaches. At Discharge 1..4
Indent101273-1 Skin Conditions
IndentIndent101608-8 Determination of Pressure Ulcer/Injury Risk 1..1
IndentIndent58214-8 Unhealed Pressure Ulcers/Injuries
IndentIndent88961-8 Current Number of Unhealed Pressure Ulcers/Injuries at Each Stage
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 {#}
Indent101274-9 Medications
IndentIndent93155-0 High-Risk Drug Classes: Use and Indication
IndentIndentIndent93153-5 Is taking 1..11
IndentIndentIndent93154-3 Indication noted 1..11
IndentIndent57256-0 Medication Intervention
Indent101275-6 Special Treatments, Procedures, and Programs
IndentIndent101346-5 Special Treatments, Procedures, and Programs
IndentIndentIndent86761-4 Special Treatments, Procedures, and Programs - While a Resident 1..1
IndentIndentIndent93185-7 Special Treatments, Procedures, and Programs - At Discharge 1..30
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:
IndentIndent103569-0 Resident’s COVID-19 vaccination is up to date
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 {#}
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)
Indent101277-2 Participation in Assessment and Goal Setting
IndentIndent101436-4 Discharge Plan
IndentIndentIndent58146-2 Is active discharge planning already occurring for the resident to return to the community?
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
Indent101279-8 Correction Request
IndentIndent85632-8 Type of Provider
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
IndentIndentIndentIndent70127-6 Signature:
IndentIndentIndentIndent87222-6 Attestation date {mm/dd/yyyy}
Indent101280-6 Assessment Administration
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 v1.19.1 - 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 2.78
Last Updated
Version 2.78
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=104606-9
Questionnaire definition
https://fhir.loinc.org/Questionnaire/?url=http://loinc.org/q/104606-9