106933-5
Hospice Outcomes and Patient Evaluation (HOPE) Update Visit v1.0 [CMS Assessment]
Active
Panel Hierarchy
Details for each LOINC in Panel LHC-Forms
| LOINC | Name | R/O/C | Cardinality | Example UCUM Units |
|---|---|---|---|---|
| 106933-5 | Hospice Outcomes and Patient Evaluation (HOPE) Update Visit v1.0 [CMS Assessment] | |||
| Indent106935-0 | 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 Indent52455-3 | Admission Date | {mm/dd/yyyy} | ||
| Indent Indent52454-6 | Reason for Record | |||
| Indent Indent54503-8 | Legal Name of Patient | |||
| 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 Indent52556-8 | Payer Information | 1..9 | ||
| Indent99170-3 | Health Conditions | |||
| Indent Indent106664-6 | Death is Imminent | |||
| Indent Indent106685-1 | Symptom Impact Screening | |||
| Indent Indent Indent106684-4 | Was a symptom impact screening completed? | |||
| Indent Indent Indent106683-6 | Date of symptom impact screening: | {mm/dd/yyyy} | ||
| Indent Indent106682-8 | Symptom Impact | |||
| Indent Indent Indent106688-5 | Pain | |||
| Indent Indent Indent106689-3 | Shortness of breath | |||
| Indent Indent Indent106690-1 | Anxiety | |||
| Indent Indent Indent106692-7 | Nausea | |||
| Indent Indent Indent106691-9 | Vomiting | |||
| Indent Indent Indent106693-5 | Diarrhea | |||
| Indent Indent Indent106694-3 | Constipation | |||
| Indent Indent Indent106695-0 | Agitation | |||
| Indent Indent106704-0 | Symptom Follow-up Visit (SFV) | |||
| Indent Indent Indent106705-7 | Was an in-person SFV completed? | |||
| Indent Indent Indent106706-5 | Date of in-person SFV | {mm/dd/yyyy} | ||
| Indent Indent Indent106707-3 | Reason SFV Not Completed | |||
| Indent Indent106708-1 | SFV Symptom Impact | |||
| Indent Indent Indent106703-2 | Pain | |||
| Indent Indent Indent106702-4 | Shortness of breath | |||
| Indent Indent Indent106701-6 | Anxiety | |||
| Indent Indent Indent106700-8 | Nausea | |||
| Indent Indent Indent106699-2 | Vomiting | |||
| Indent Indent Indent106698-4 | Diarrhea | |||
| Indent Indent Indent106697-6 | Constipation | |||
| Indent Indent Indent106696-8 | Agitation | |||
| Indent54572-3 | Skin conditions | |||
| Indent Indent106709-9 | Skin Conditions. Does the patient have one or more skin conditions? | |||
| Indent Indent106710-7 | Types of Skin Conditions | 1..8 | ||
| Indent Indent106711-5 | Skin and Ulcer or Injury Treatments | 1..10 | ||
| Indent88962-6 | Medications | |||
| Indent Indent106718-0 | Scheduled Opioid | |||
| Indent Indent Indent106719-8 | Was a scheduled opioid initiated or continued? | |||
| Indent Indent Indent106720-6 | Date scheduled opioid initiated or continued: | {mm/dd/yyyy} | ||
| Indent Indent106717-2 | PRN Opioid | |||
| Indent Indent Indent106716-4 | Was a PRN opioid initiated or continued | |||
| Indent Indent Indent106714-9 | Date PRN opioid initiated or continued: | {mm/dd/yyyy} | ||
| Indent Indent106715-6 | Bowel Regimen | |||
| Indent Indent Indent106713-1 | Was a bowel regimen initiated or continued? | |||
| Indent Indent Indent106712-3 | Date bowel regimen initiated or continued: | {mm/dd/yyyy} | ||
| Indent101280-6 | Assessment Administration | |||
| Indent Indent46501-3 | Date Assessment was Completed | {mm/dd/yyyy} | ||
| Indent Indent85648-4 | Signature(s) of Person(s) Completing the Record | |||
| Indent Indent70127-6 | Signature of Person Verifying Record Completion | |||
| Indent Indent Indent70127-6 | Signature: | |||
| Indent Indent Indent30947-6 | Date | {mm/dd/yyyy} |
Fully-Specified Name
- Component
- Hospice Outcomes and Patient Evaluation (HOPE) Update Visit v1.0
- Property
- -
- Time
- RptPeriod
- System
- ^Patient
- Scale
- -
- Method
- CMS Assessment
Basic Attributes
- Class
- PANEL.SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.80
- Last Updated
- Version 2.80 (ADD)
- 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=106933-5
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://