45964-4 Identification information section

Observation ID in Form

AA

Type of Entry

Question expects user entry - requires response [Q]

Fully-Specified Name

Component

Identification information section

Property

-

Time

Pt

System

^Patient

Scale

-

Method

Basic Attributes

Class

PANEL.SURVEY.MDS

Type

Surveys

First Released

Version 2.17

Last Updated

Version 2.68

Order vs. Observation

Order

Panel Type

Panel

Member of these Panels

Related Names

• Pan
• Panel
• Panl
• Pnl
• Point in time
• Random
• Survey
• SURVEY.MDS

Copyright

Organization

interRAI

Copyright

InterRAI holds the copyright to Version 2.0 of the RAI for long term care outside of the US. Supplemental help and contextual information for MDS items in LOINC was derived from Version 2.0 of the RAI/MDS manual, and should not be reproduced outside of the United States without permission of InterRAI. Within the US, Version 2.0 is in the public domain.

Terms of Use

As a not for profit corporation under the US Tax Code, interRAI holds the copyright to a number of assessment systems, including the Resident Assessment Instrument (RAI) for long term care facilities outside of the US (the RAI is in the public domain within the US), as well as the assessment systems for Home Care (HC), Assisted Living (AL), Palliative Care (PC), Mental Health (MH) (outside of Canada), and Acute Care (RAI-AC). The scales, algorithms, and case-mix measures based on these assessment instruments cannot be copyrighted and are thus available to everyone (although the individual items on which they are based are usually copyrighted). The major clauses of our royalty-free licenses follow: * the instrument is not to be changed substantially (excepting individual identifiers and demographics); * the license is limited to non-commercial use (i.e., the instrument will not be not incorporated into products to be sold to others); * no royalties will be charged; * the organization will make appropriate efforts to inform others of the copyright status of the instrument; * interRAI's logo and copyright notice are to appear on the form; * authors, author institutions, and translators (as appropriate) are to be acknowledged in any document where authors would regularly be indicated (e.g., publication of a training manual); * publication of any training manual is limited to the period until a commercially-published version is available; * data from use of the instrument are to be shared with interRAI, subject to existing laws on confidentiality. Commercial use usually requires royalties. In this instance, interRAI may omit the data requirement, but retains the other requirements for a logo, attribution, etc. We will be pleased in any contract negotiations to acknowledge the participation of individuals or organizations which have played a substantial role in getting the instrument to the point of implementation. For more information on licensing with interRAI, please contact the president of the Board: Brant E. Fries, Ph.D. Institute of Gerontology University of Michigan 300 North Ingalls Ann Arbor, Michigan USA 48109 Email: bfries@umich.edu

URL

http://www.interrai.org

45965-1 Resident Name

Type of Entry

Question expects user entry - requires response [Q]

Fully-Specified Name

Component

Name

Property

-

Time

Pt

System

^Patient

Scale

Set

Method

Basic Attributes

Class

PANEL.SURVEY.MDS

Type

Surveys

First Released

Version 2.17

Last Updated

Version 2.73

Order vs. Observation

Order

Panel Type

Organizer

HL7^® Attributes

HL7^® Field ID

PID-5

Member of these Panels

Related Names

• Pan
• Panel
• Panl
• Pnl
• Point in time
• Random
• Survey
• SURVEY.MDS

45394-4 Patient Last (Family) name

Observation ID in Form

AA1c

Type of Entry

Question expects user entry - requires response [Q]

Fully-Specified Name

Component

Last name

Property

Pn

Time

Pt

System

^Patient

Scale

Nom

Method

Additional Names

Short Name

Patient Last name

Basic Attributes

Class

ADMIN.PATIENT

Type

Clinical

First Released

Version 2.17

Last Updated

Version 2.70

Change Reason

Release 2.70: LONG_COMMON_NAME: Added "Patient" to distinguish from the general "Last name" term that does not distinguish between various subjects (patient, provider, contact, etc.).; SHORTNAME: Added "Patient" to distinguish from the general "Last name" term that does not distinguish between various subjects (patient, provider, contact, etc.).;

Order vs. Observation

Both

HL7^® Attributes

HL7^® Field ID

PID-5.1

Member of these Panels

Language Variants Get Info

Related Names

• ADMIN
• ADMIN.PATIENT
• Nominal
• Past
• Person name
• Point in time
• Random

Related Codes

45392-8 Patient First (Given) name

Observation ID in Form

AA1a

Type of Entry

Question expects user entry - requires response [Q]

Fully-Specified Name

Component

First name

Property

Pn

Time

Pt

System

^Patient

Scale

Nom

Method

Additional Names

Short Name

Patient First name

Basic Attributes

Class

ADMIN.PATIENT

Type

Clinical

First Released

Version 2.17

Last Updated

Version 2.70

Change Reason

Release 2.70: LONG_COMMON_NAME: Added "Patient" to distinguish from the general "First name" term that does not distinguish between various subjects (patient, provider, contact, etc.).; SHORTNAME: Added "Patient" to distinguish from the general "First name" term that does not distinguish between various subjects (patient, provider, contact, etc.).;

Order vs. Observation

Both

HL7^® Attributes

HL7^® Field ID

PID-5.2

Member of these Panels

Language Variants Get Info

Related Names

• ADMIN
• ADMIN.PATIENT
• Given name
• Nominal
• Person name
• Point in time
• Random

Related Codes

45393-6 Middle initial

Observation ID in Form

AA1b

Type of Entry

Question expects user entry - requires response [Q]

Fully-Specified Name

Component

Middle initial

Property

Pn

Time

Pt

System

^Patient

Scale

Nom

Method

Additional Names

Short Name

Middle initial

Basic Attributes

Class

ADMIN.PATIENT

Type

Clinical

First Released

Version 2.17

Last Updated

Version 2.66

Change Reason

Change PROPERTY from ID to Pn to match convention for other name terms

Order vs. Observation

Both

HL7^® Attributes

HL7^® Field ID

PID-5.3

Member of these Panels

Language Variants Get Info

Related Names

• ADMIN
• ADMIN.PATIENT
• Nominal
• Person name
• Point in time
• Random

Related Codes

45395-1 Jr/Sr

Observation ID in Form

AA1d

Type of Entry

Question expects user entry - requires response [Q]

Fully-Specified Name

Component

Name suffix

Property

Pn

Time

Pt

System

^Patient

Scale

Nom

Method

Additional Names

Short Name

Patient Name suffix

Basic Attributes

Class

ADMIN.PATIENT

Type

Clinical

First Released

Version 2.17

Last Updated

Version 2.70

Change Reason

Release 2.70: SHORTNAME: Added "Patient" to distinguish from the general "Name suffix" term that does not distinguish between various subjects (patient, provider, contact, etc.).; LONG_COMMON_NAME: Added "Patient" to distinguish from the general "Name suffix" term that does not distinguish between various subjects (patient, provider, contact, etc.).; Previous Releases: Changed CLASS to ADMIN

Order vs. Observation

Both

HL7^® Attributes

HL7^® Field ID

PID-5.4

Member of these Panels

Language Variants Get Info

Related Names

• ADMIN
• ADMIN.PATIENT
• Nominal
• Person name
• Point in time
• Random

Related Codes

46098-0 Gender

Part Descriptions

LP101395-4   Sex
In LOINC, sex refers to the biological sex of an organism, which is most commonly determined based on anatomy and physiology or genetic (chromosome) analysis. Our definition is based on the World Health Organization's definition of sex and gender: sex (male, female) refers to biological and physiological characteristics, and gender (masculine, feminine) refers to socially constructed roles, behaviors, activities, and attributes. (http://www.who.int/gender/whatisgender/en) Source: Regenstrief LOINC, WHO: gender

Observation ID in Form

AA2

Type of Entry

Question expects user entry - requires response [Q]

Fully-Specified Name

Component

Sex

Property

Type

Time

Pt

System

^Patient

Scale

Nom

Method

Additional Names

Short Name

Sex

Basic Attributes

Class

ADMIN.PATIENT.DEMOG

Type

Clinical

First Released

Version 2.17

Last Updated

Version 2.73

Change Reason

Changed Component from 'Gender' to 'Sex' to align with the World Health Organization (WHO) definition of this concept.

Order vs. Observation

Both

Common Test Rank Get Info

2086

HL7^® Attributes

HL7^® Field ID

PID-8

Example Answer List LL1-9

Member of these Panels

Language Variants Get Info

Related Names

• ADMIN
• ADMIN.PATIENT
• ADMIN.PT.DEMOG
• AOEObservation
• Gender
• Nominal
• Point in time
• Random
• Typ

Related Codes

21112-8 Birth date

Observation ID in Form

AA3

Type of Entry

Question expects user entry - requires response [Q]

Description

Coding: Fill in the boxes with the appropriate number. Do not leave any boxes blank. If the month or day contains only a single digit, fill the first box in with a "0". For example: January 2, 1918 should be entered as:

01/02/1918 (Month/Day/Year)

Form Consistency Checks

*1. This date must be earlier than or the same as all of following dates that are present in the record (not blank): P_REC_DT, AT6, AB1, AB11, A3a, A4a, R2b, R4, VB2, and VB4. This date must also be earlier than or the same as the current date.

*2. The birthdate (AA3) cannot be more than 140 years earlier than the assessment reference date (A3a).

Fully-Specified Name

Component

Birth date

Property

TmStp

Time

Pt

System

^Patient

Scale

Qn

Method

Additional Names

Short Name

Birth date

Display Name

Birth date [Date/time]

Consumer Name Alpha Get Info

Birth date

Basic Attributes

Class

MISC

Type

Laboratory

First Released

Version 1.0m

Last Updated

Version 2.73

Order vs. Observation

Observation

Common Test Rank Get Info

1746

HL7^® Attributes

HL7^® Field ID

PID-7.1

Member of these Panels

Language Variants Get Info

Related Names

• Birthdate
• Date and time
• Date of birth
• DOB
• MISC
• Point in time
• QNT
• Quan
• Quant
• Quantitative
• Random
• Time stamp
• Timestamp

Example Units

Related Codes

32624-9 Race

Observation ID in Form

AA4

Type of Entry

Question expects user entry - requires response [Q]

Description

Process: Enter the race or ethnic category the resident uses to identify him- or herself. Consult the resident, as necessary. For example, if parents are of two different races, consult with resident to determine how he or she wishes to be classified.

Coding: Choose only one answer.

Fully-Specified Name

Component

Race

Property

Type

Time

Pt

System

^Patient

Scale

Nom

Method

Additional Names

Short Name

Race

Basic Attributes

Class

CLIN

Type

Clinical

First Released

Version 2.09

Last Updated

Version 2.73

Common Test Rank Get Info

1224

HL7^® Attributes

HL7^® Field ID

PID-10

Example Answer List LL2858-0

Member of these Panels

Language Variants Get Info

Related Names

• AOEObservation
• CLIN
• Ethnicity
• Nominal
• Point in time
• Random
• Typ

Third Party Copyright

This material includes SNOMED Clinical Terms® (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO) under license. All rights reserved. SNOMED CT® was originally created by The College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHTSDO.

This material includes content from the US Edition to SNOMED CT, which is developed and maintained by the U.S. National Library of Medicine and is available to authorized UMLS Metathesaurus Licensees from the UTS Downloads site at https://uts.nlm.nih.gov.

Use of SNOMED CT content is subject to the terms and conditions set forth in the SNOMED CT Affiliate License Agreement. It is the responsibility of those implementing this product to ensure they are appropriately licensed and for more information on the license, including how to register as an Affiliate Licensee, please refer to http://www.snomed.org/snomed-ct/get-snomed-ct or info@snomed.org<mailto:info@snomed.org>. This may incur a fee in SNOMED International non-Member countries.

45966-9 Social Security and Medicare numbers

Type of Entry

Question expects user entry - requires response [Q]

Form Coding Instructions

[C in 1st box if non med. no.]

Fully-Specified Name

Component

Social Security & Medicare numbers

Property

-

Time

Pt

System

^Patient

Scale

-

Method

Basic Attributes

Class

PANEL.SURVEY.CMS

Type

Surveys

First Released

Version 2.17

Last Updated

Version 2.67

Change Reason

Scale was updated from "Set" to "-" adhere to current panel conventions;Changed CLASS to PANEL.SURVEY.CMS because term is used across CMS assessments

Order vs. Observation

Order

Panel Type

Organizer

HL7^® Attributes

HL7^® Field ID

PID-3;PID-19

Member of these Panels

Related Names

• Pan
• Panel
• PANEL.SURVEY.CMS
• Panl
• Pnl
• Point in time
• Random
• Social Security & Medicare #s
• Survey

Related Codes

45396-9 Social Security number [Identifier]

Observation ID in Form

AA5a

Type of Entry

Question expects user entry - requires response [Q]

Form Consistency Checks

*1. On a Medicare PPS assessment (AA8b = 1,2,3,4,5,7, or 8), either an SSN (AA5a) or a Medicare number or comparable railroad insurance number (AA5b) must be present. Any Medicare PPS assessment (AA8b = 1,2,3,4,5,7, or 8) is rejected if both of the following conditions occur:
a. The SSN (AA5a) is missing with a blank value of sp(9) or an "unable to
determine" value of -(9).
AND
b. The resident Medicare number or comparable railroad insurance number
(AA5b) is missing with a blank value of sp(9) or an "unable to
determine" value of -(9).

*2. Value must be 9 digits, 9 dashes (unable to determine), or 9 spaces (blank). Value cannot start with 000. Value cannot be 111111111, 333333333, or 123456789.

Fully-Specified Name

Component

Social Security number

Property

ID

Time

Pt

System

^Patient

Scale

Nom

Method

Additional Names

Short Name

Social Security #

Basic Attributes

Class

ADMIN.PATIENT.ID

Type

Clinical

First Released

Version 2.17

Last Updated

Version 2.73

Change Reason

Updated Class from SURVEY.MDS to ADMIN; Capitalized Security in Component

Order vs. Observation

Both

Common Test Rank Get Info

6170

HL7^® Attributes

HL7^® Field ID

PID-19

Member of these Panels

Language Variants Get Info

Related Names

• ADMIN
• ADMIN.PATIENT
• ADMIN.PATIENT.ID
• Ident
• Identifier
• Intradermal
• No
• Nominal
• Num
• Point in time
• Random
• Social Security #

Related Codes

45397-7 Medicare or comparable number

Observation ID in Form

AA5b

Type of Entry

Question expects user entry - requires response [Q]

Form Consistency Checks

*1. See AA5a consistency note #1.

*2. If the first character is numeric, then the first 9 characters must be digits (0-9).

*3 If the first character is a C, it must be at least 2 characters long (the C and one or more other characters).

*4. If the first character is a letter, but not a C, then there must 1-3 alphabetic characters followed by 6 or 9 numbers followed by spaces up to the field length of 12.

Fully-Specified Name

Component

Medicare or comparable number

Property

ID

Time

Pt

System

^Patient

Scale

Nom

Method

Additional Names

Short Name

Medicare or comparable #

Basic Attributes

Class

ADMIN.PATIENT.ID

Type

Clinical

First Released

Version 2.17

Last Updated

Version 2.66

Change Reason

Changed CLASS to ADMIN

Order vs. Observation

Both

HL7^® Attributes

HL7^® Field ID

PID-3

Member of these Panels

Language Variants Get Info

Related Names

• ADMIN
• ADMIN.PATIENT
• ADMIN.PATIENT.ID
• Ident
• Identifier
• Intradermal
• Medicare or comparable #
• No
• Nominal
• Num
• Point in time
• Random

Related Codes

45967-7 Facility provider numbers Set

Type of Entry

Question expects user entry - requires response [Q]

Fully-Specified Name

Component

Facility provider numbers

Property

-

Time

Pt

System

Facility

Scale

Set

Method

Basic Attributes

Class

PANEL.SURVEY.MDS

Type

Surveys

First Released

Version 2.17

Last Updated

Version 2.52

Order vs. Observation

Order

Panel Type

Organizer

Member of these Panels

Related Names

• Admin
• Facility provider #s
• Pan
• Panel
• Panl
• Pnl
• Point in time
• Random
• Survey
• SURVEY.MDS

Copyright

Organization

interRAI

Copyright

InterRAI holds the copyright to Version 2.0 of the RAI for long term care outside of the US. Supplemental help and contextual information for MDS items in LOINC was derived from Version 2.0 of the RAI/MDS manual, and should not be reproduced outside of the United States without permission of InterRAI. Within the US, Version 2.0 is in the public domain.

Terms of Use

As a not for profit corporation under the US Tax Code, interRAI holds the copyright to a number of assessment systems, including the Resident Assessment Instrument (RAI) for long term care facilities outside of the US (the RAI is in the public domain within the US), as well as the assessment systems for Home Care (HC), Assisted Living (AL), Palliative Care (PC), Mental Health (MH) (outside of Canada), and Acute Care (RAI-AC). The scales, algorithms, and case-mix measures based on these assessment instruments cannot be copyrighted and are thus available to everyone (although the individual items on which they are based are usually copyrighted). The major clauses of our royalty-free licenses follow: * the instrument is not to be changed substantially (excepting individual identifiers and demographics); * the license is limited to non-commercial use (i.e., the instrument will not be not incorporated into products to be sold to others); * no royalties will be charged; * the organization will make appropriate efforts to inform others of the copyright status of the instrument; * interRAI's logo and copyright notice are to appear on the form; * authors, author institutions, and translators (as appropriate) are to be acknowledged in any document where authors would regularly be indicated (e.g., publication of a training manual); * publication of any training manual is limited to the period until a commercially-published version is available; * data from use of the instrument are to be shared with interRAI, subject to existing laws on confidentiality. Commercial use usually requires royalties. In this instance, interRAI may omit the data requirement, but retains the other requirements for a logo, attribution, etc. We will be pleased in any contract negotiations to acknowledge the participation of individuals or organizations which have played a substantial role in getting the instrument to the point of implementation. For more information on licensing with interRAI, please contact the president of the Board: Brant E. Fries, Ph.D. Institute of Gerontology University of Michigan 300 North Ingalls Ann Arbor, Michigan USA 48109 Email: bfries@umich.edu

URL

http://www.interrai.org

45398-5 State provider number for Facility

Observation ID in Form

AA6a

Type of Entry

Question expects user entry - requires response [Q]

Fully-Specified Name

Component

State provider number

Property

ID

Time

Pt

System

Facility

Scale

Nom

Method

Additional Names

Short Name

State provider # Facility

Basic Attributes

Class

ADMIN.FACILITY

Type

Clinical

First Released

Version 2.17

Last Updated

Version 2.66

Change Reason

Removed Copyright Info because this is a generic term;Changed CLASS to ADMIN

Order vs. Observation

Both

Member of these Panels

Language Variants Get Info