Version 2.77

Status Information


Reference Information

Type Source Reference
Original Form Centers for Medicare & Medicaid Services Original form upon which the LOINC panel is based. MDS background information at admission form

Panel Hierarchy

Details for each LOINC in Panel LHC-Forms

LOINC Name R/O/C Cardinality Example UCUM Units
45969-3 Deprecated MDS background information at admission form - version 2.0
Indent45970-1 Demographic information section
IndentIndent50786-3 Date of entry {mm/dd/yyyy}
IndentIndent45410-8 Immediately preceeding this admission, where was the patient?
IndentIndent45411-6 Lived alone prior to admission [Minimum Data Set]
IndentIndent52539-4 Zip code of prior primary residence
IndentIndent45971-9 Residential history 5 years prior to entry Set
IndentIndentIndent45412-4 History of prior stay at this nursing home [Minimum Data Set]
IndentIndentIndent45413-2 History of stay in other nursing home [Minimum Data Set]
IndentIndentIndent45414-0 History of stay in other residential facility [Minimum Data Set]
IndentIndentIndent45415-7 History of stay at mental health/psychiatric setting [Minimum Data Set]
IndentIndentIndent45416-5 History of stay in mental retardation and developmental disabilities setting [Minimum Data Set]
IndentIndentIndent45417-3 None of above
IndentIndent21843-8 History of Usual occupation
IndentIndent82589-3 Highest level of education
IndentIndent45972-7 Language Set
IndentIndentIndent45402-5 Language.primary
IndentIndentIndent45419-9 Language.other [Minimum Data Set]
IndentIndent45420-7 Mental health history [Minimum Data Set]
IndentIndent45973-5 Conditions related to mental retardation and developmental disabilities status Set
IndentIndentIndent45421-5 No mental retardation and developmental disabilities [Minimum Data Set]
IndentIndentIndent45974-3 Mental retardation and developmental disabilities with organic condition Set
IndentIndentIndentIndent45422-3 Down's syndrome [Minimum Data Set]
IndentIndentIndentIndent45423-1 Autism [Minimum Data Set]
IndentIndentIndentIndent45424-9 Epilepsy [Minimum Data Set]
IndentIndentIndentIndent45425-6 Other organic condition related to mental retardation and developmental disabilities [Minimum Data Set]
IndentIndentIndentIndent45426-4 Mental retardation and developmental disabilities with no organic condition [Minimum Data Set]
IndentIndent45427-2 Date background information form completed [Minimum Data Set]
Indent45975-0 Customary routine section
IndentIndent45976-8 Customary routine in year prior to date of entry Set
IndentIndentIndent45977-6 Cycle of daily events Set
IndentIndentIndentIndent45428-0 Stays up late at night [Minimum Data Set]
IndentIndentIndentIndent45429-8 Naps regularly during day [Minimum Data Set]
IndentIndentIndentIndent45430-6 Goes out 1 or more days a week [Minimum Data Set]
IndentIndentIndentIndent45431-4 Stays busy with hobbies, reading or fixed daily routine [Minimum Data Set]
IndentIndentIndentIndent45432-2 Spends most time alone or watching TV [Minimum Data Set]
IndentIndentIndentIndent45433-0 Moves independently indoors [Minimum Data Set]
IndentIndentIndentIndent45434-8 Use of tobacco products at least daily [Minimum Data Set]
IndentIndentIndentIndent45435-5 None of above
IndentIndentIndent45978-4 Eating patterns Set
IndentIndentIndentIndent45436-3 Distinct food preferences [Minimum Data Set]
IndentIndentIndentIndent45437-1 Eats between meals all or most days [Minimum Data Set]
IndentIndentIndentIndent45438-9 Use of alcohol at least weekly [Minimum Data Set]
IndentIndentIndentIndent45439-7 None of above
IndentIndentIndent45979-2 ADL patterns Set
IndentIndentIndentIndent45440-5 In bedclothes much of day [Minimum Data Set]
IndentIndentIndentIndent45441-3 Wakens to toilet all or most nights [Minimum Data Set]
IndentIndentIndentIndent45442-1 Has irregular bowel movement pattern [Minimum Data Set]
IndentIndentIndentIndent45443-9 Showers for bathing [Minimum Data Set]
IndentIndentIndentIndent45444-7 Bathing in PM [Minimum Data Set]
IndentIndentIndentIndent45445-4 None of above
IndentIndentIndent45980-0 Involvement patterns Set
IndentIndentIndentIndent45446-2 Daily contact with relatives/close friends [Minimum Data Set]
IndentIndentIndentIndent45447-0 Usually attends church, temple, etc. [Minimum Data Set]
IndentIndentIndentIndent45448-8 Finds strength in faith [Minimum Data Set]
IndentIndentIndentIndent45449-6 Daily animal companion/presence [Minimum Data Set]
IndentIndentIndentIndent45450-4 Involved in group activities [Minimum Data Set]
IndentIndentIndentIndent45451-2 None of above
IndentIndentIndent45452-0 Unknown customary routine - resident/family unable to provide information [Minimum Data Set]

Fully-Specified Name

MDS background information at admission form - version 2.0

Basic Attributes

First Released
Version 2.17
Last Updated
Version 2.73
Change Reason
Release 2.73: Status: LOINC will keep most current version and one prior version of CMS assessments active and discourage all older versions.;
Order vs. Observation
Panel Type

LOINC Terminology Service (API) using HL7® FHIR® Get Info

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