Version 2.78

45976-8 Customary routine in year prior to date of entry Set

Type of Entry

Question expects user entry - requires response [Q]

Fully-Specified Name

Component
Customary routine in year prior to date of entry
Property
-
Time
Pt
System
^Patient
Scale
Set
Method

Basic Attributes

Class
PANEL.SURVEY.MDS
Type
Surveys
First Released
Version 2.17
Last Updated
Version 2.52
Order vs. Observation
Order
Panel Type
Organizer

Member of these Panels

LOINC Long Common Name
45969-3 Deprecated MDS background information at admission form - version 2.0

45977-6 Cycle of daily events Set

Type of Entry

Question expects user entry - requires response [Q]

Fully-Specified Name

Component
Cycle of daily events
Property
-
Time
Pt
System
^Patient
Scale
Set
Method

Basic Attributes

Class
PANEL.SURVEY.MDS
Type
Surveys
First Released
Version 2.17
Last Updated
Version 2.52
Order vs. Observation
Order
Panel Type
Organizer

Member of these Panels

LOINC Long Common Name
45969-3 Deprecated MDS background information at admission form - version 2.0

45428-0 Stays up late at night [Minimum Data Set]

Term Description

(e.g., after 9 pm)
Source: Regenstrief LOINC

Observation ID in Form

AC1a

Type of Entry

Question expects user entry - requires response [Q]

Form Consistency Checks

1. For the RECTYPEs listed as facility option, the field may be submitted under the optional submission provision given in the Section AB General Notes.

*2. See AC1h consistency note #3.
*3. See AC1y consistency note #2.

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Stays up late at night
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
MDS

Basic Attributes

Class
SURVEY.MDS
Type
Surveys
First Released
Version 2.17
Last Updated
Version 2.50

Normative Answer List LL50-6

Answer Code Score Answer ID
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) 0 LA32-8
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) 1 LA33-6
UTD LA1-0

Member of these Panels

LOINC Long Common Name
45969-3 Deprecated MDS background information at admission form - version 2.0

45429-8 Naps regularly during day [Minimum Data Set]

Term Description

(at least 1 hour)
Source: Regenstrief LOINC

Observation ID in Form

AC1b

Type of Entry

Question expects user entry - requires response [Q]

Form Consistency Checks

1. For the RECTYPEs listed as facility option, the field may be submitted under the optional submission provision given in the Section AB General Notes.

*2. See AC1h consistency note #3.
*3. See AC1y consistency note #2.

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Naps regularly during day
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
MDS

Basic Attributes

Class
SURVEY.MDS
Type
Surveys
First Released
Version 2.17
Last Updated
Version 2.50

Normative Answer List LL50-6

Answer Code Score Answer ID
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) 0 LA32-8
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) 1 LA33-6
UTD LA1-0

Member of these Panels

LOINC Long Common Name
45969-3 Deprecated MDS background information at admission form - version 2.0

45430-6 Goes out 1 or more days a week [Minimum Data Set]

Observation ID in Form

AC1c

Type of Entry

Question expects user entry - requires response [Q]

Form Consistency Checks

1. For the RECTYPEs listed as facility option, the field may be submitted under the optional submission provision given in the Section AB General Notes.

*2. See AC1h consistency note #3.
*3. See AC1y consistency note #2.

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Goes out 1 or more D a W
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
MDS

Basic Attributes

Class
SURVEY.MDS
Type
Surveys
First Released
Version 2.17
Last Updated
Version 2.50

Normative Answer List LL50-6

Answer Code Score Answer ID
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) 0 LA32-8
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) 1 LA33-6
UTD LA1-0

Member of these Panels

LOINC Long Common Name
45969-3 Deprecated MDS background information at admission form - version 2.0

45431-4 Stays busy with hobbies, reading or fixed daily routine [Minimum Data Set]

Observation ID in Form

AC1d

Type of Entry

Question expects user entry - requires response [Q]

Form Consistency Checks

1. For the RECTYPEs listed as facility option, the field may be submitted under the optional submission provision given in the Section AB General Notes.

*2. See AC1h consistency note #3.
*3. See AC1y consistency note #2.

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Stays busy with hobbies, reading or fixed daily routine
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
MDS

Basic Attributes

Class
SURVEY.MDS
Type
Surveys
First Released
Version 2.17
Last Updated
Version 2.50

Normative Answer List LL50-6

Answer Code Score Answer ID
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) 0 LA32-8
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) 1 LA33-6
UTD LA1-0

Member of these Panels

LOINC Long Common Name
45969-3 Deprecated MDS background information at admission form - version 2.0

45432-2 Spends most time alone or watching TV [Minimum Data Set]

Observation ID in Form

AC1e

Type of Entry

Question expects user entry - requires response [Q]

Form Consistency Checks

1. For the RECTYPEs listed as facility option, the field may be submitted under the optional submission provision given in the Section AB General Notes.

*2. See AC1h consistency note #3.
*3. See AC1y consistency note #2.

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Spends most time alone or watching TV
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
MDS

Basic Attributes

Class
SURVEY.MDS
Type
Surveys
First Released
Version 2.17
Last Updated
Version 2.50

Normative Answer List LL50-6

Answer Code Score Answer ID
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) 0 LA32-8
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) 1 LA33-6
UTD LA1-0

Member of these Panels

LOINC Long Common Name
45969-3 Deprecated MDS background information at admission form - version 2.0

45433-0 Moves independently indoors [Minimum Data Set]

Term Description

(with appliances, if used)
Source: Regenstrief LOINC

Observation ID in Form

AC1f

Type of Entry

Question expects user entry - requires response [Q]

Form Consistency Checks

1. For the RECTYPEs listed as facility option, the field may be submitted under the optional submission provision given in the Section AB General Notes.

*2. See AC1h consistency note #3.
*3. See AC1y consistency note #2.

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Moves independently indoors
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
MDS

Basic Attributes

Class
SURVEY.MDS
Type
Surveys
First Released
Version 2.17
Last Updated
Version 2.50

Normative Answer List LL50-6

Answer Code Score Answer ID
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) 0 LA32-8
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) 1 LA33-6
UTD LA1-0

Member of these Panels

LOINC Long Common Name
45969-3 Deprecated MDS background information at admission form - version 2.0

45434-8 Use of tobacco products at least daily [Minimum Data Set]

Observation ID in Form

AC1g

Type of Entry

Question expects user entry - requires response [Q]

Form Consistency Checks

1. For the RECTYPEs listed as facility option, the field may be submitted under the optional submission provision given in the Section AB General Notes.

*2. See AC1h consistency note #3.
*3. See AC1y consistency note #2.

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Use of tobacco products at least daily
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
MDS

Basic Attributes

Class
SURVEY.MDS
Type
Surveys
First Released
Version 2.17
Last Updated
Version 2.50

Normative Answer List LL50-6

Answer Code Score Answer ID
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) 0 LA32-8
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) 1 LA33-6
UTD LA1-0

Member of these Panels

LOINC Long Common Name
45969-3 Deprecated MDS background information at admission form - version 2.0

Member of these Groups Get Info

LOINC Group Group Name
LG41856-2 Smoking-related terms

45435-5 None of above

Observation ID in Form

AC1h

Type of Entry

Question expects user entry - requires response [Q]

Form Consistency Checks

1. For the RECTYPEs listed as facility option, the field may be submitted under the optional submission provision given in the Section AB General Notes.

*2. See AC1y consistency note #2.

*3. Value must be 0 (zero) if any AC1a thru AC1g = 1; value must be 1 if each AC1a thru AC1g = 0 (zero); value must be - if any AC1a thru AC1g = - and no AC1a thru AC1g = 1.

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
None of the listed cycle of daily events
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
MDS

Basic Attributes

Class
SURVEY.MDS
Type
Surveys
First Released
Version 2.17
Last Updated
Version 2.50

Normative Answer List LL50-6

Answer Code Score Answer ID
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) 0 LA32-8
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) 1 LA33-6
UTD LA1-0

Member of these Panels

LOINC Long Common Name
45969-3 Deprecated MDS background information at admission form - version 2.0

45978-4 Eating patterns Set

Type of Entry

Question expects user entry - requires response [Q]

Fully-Specified Name

Component
Eating patterns
Property
-
Time
Pt
System
^Patient
Scale
Set
Method

Basic Attributes

Class
PANEL.SURVEY.MDS
Type
Surveys
First Released
Version 2.17
Last Updated
Version 2.52
Order vs. Observation
Order
Panel Type
Organizer

Member of these Panels

LOINC Long Common Name
45969-3 Deprecated MDS background information at admission form - version 2.0

45436-3 Distinct food preferences [Minimum Data Set]

Observation ID in Form

AC1i

Type of Entry

Question expects user entry - requires response [Q]

Form Consistency Checks

1. For the RECTYPEs listed as facility option, the field may be submitted under the optional submission provision given in the Section AB General Notes.

*2. See AC1l consistency note #3.
*3. See AC1y consistency note #2.

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Distinct food preferences
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
MDS

Basic Attributes

Class
SURVEY.MDS
Type
Surveys
First Released
Version 2.17
Last Updated
Version 2.50

Normative Answer List LL50-6

Answer Code Score Answer ID
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) 0 LA32-8
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) 1 LA33-6
UTD LA1-0

Member of these Panels

LOINC Long Common Name
45969-3 Deprecated MDS background information at admission form - version 2.0

45437-1 Eats between meals all or most days [Minimum Data Set]

Observation ID in Form

AC1j

Type of Entry

Question expects user entry - requires response [Q]

Form Consistency Checks

1. For the RECTYPEs listed as facility option, the field may be submitted under the optional submission provision given in the Section AB General Notes.

*2. See AC1l consistency note #3.
*3. See AC1y consistency note #2.

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Eats between meals all or most D
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
MDS

Basic Attributes

Class
SURVEY.MDS
Type
Surveys
First Released
Version 2.17
Last Updated
Version 2.50

Normative Answer List LL50-6

Answer Code Score Answer ID
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) 0 LA32-8
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) 1 LA33-6
UTD LA1-0

Member of these Panels

LOINC Long Common Name
45969-3 Deprecated MDS background information at admission form - version 2.0

45438-9 Use of alcohol at least weekly [Minimum Data Set]

Observation ID in Form

AC1k

Type of Entry

Question expects user entry - requires response [Q]

Form Consistency Checks

1. For the RECTYPEs listed as facility option, the field may be submitted under the optional submission provision given in the Section AB General Notes.

*2. See AC1l consistency note #3.
*3. See AC1y consistency note #2.

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Use of alcohol at least weekly
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
MDS

Basic Attributes

Class
SURVEY.MDS
Type
Surveys
First Released
Version 2.17
Last Updated
Version 2.50

Normative Answer List LL50-6

Answer Code Score Answer ID
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) 0 LA32-8
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) 1 LA33-6
UTD LA1-0

Member of these Panels

LOINC Long Common Name
45969-3 Deprecated MDS background information at admission form - version 2.0

45439-7 None of above

Observation ID in Form

AC1l

Type of Entry

Question expects user entry - requires response [Q]

Form Consistency Checks

1. For the RECTYPEs listed as facility option, the field may be submitted under the optional submission provision given in the Section AB General Notes.

*2. See AC1y consistency note #2.

*3. Value must be 0 (zero) if any AC1i thru AC1k = 1; value must be 1 if each AC1i thru AC1k = 0 (zero); value must be - if any AC1i thru AC1k = - and no Ac1i thru AC1k = 1.

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
None of the listed eating patterns
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
MDS

Basic Attributes

Class
SURVEY.MDS
Type
Surveys
First Released
Version 2.17
Last Updated
Version 2.50

Normative Answer List LL50-6

Answer Code Score Answer ID
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) 0 LA32-8
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) 1 LA33-6
UTD LA1-0

Member of these Panels

LOINC Long Common Name
45969-3 Deprecated MDS background information at admission form - version 2.0

45979-2 ADL patterns Set

Type of Entry

Question expects user entry - requires response [Q]

Fully-Specified Name

Component
ADL patterns
Property
-
Time
Pt
System
^Patient
Scale
Set
Method

Basic Attributes

Class
PANEL.SURVEY.MDS
Type
Surveys
First Released
Version 2.17
Last Updated
Version 2.52
Order vs. Observation
Order
Panel Type
Organizer

Member of these Panels

LOINC Long Common Name
45969-3 Deprecated MDS background information at admission form - version 2.0

45440-5 In bedclothes much of day [Minimum Data Set]

Observation ID in Form

AC1m

Type of Entry

Question expects user entry - requires response [Q]

Form Consistency Checks

1. For the RECTYPEs listed as facility option, the field may be submitted under the optional submission provision given in the Section AB General Notes.

*2. See AC1r consistency note #3.
*3. See AC1y consistency note #2.

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
In bedclothes much of day
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
MDS

Basic Attributes

Class
SURVEY.MDS
Type
Surveys
First Released
Version 2.17
Last Updated
Version 2.50

Normative Answer List LL50-6

Answer Code Score Answer ID
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) 0 LA32-8
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) 1 LA33-6
UTD LA1-0

Member of these Panels

LOINC Long Common Name
45969-3 Deprecated MDS background information at admission form - version 2.0

45441-3 Wakens to toilet all or most nights [Minimum Data Set]

Observation ID in Form

AC1n

Type of Entry

Question expects user entry - requires response [Q]

Form Consistency Checks

1. For the RECTYPEs listed as facility option, the field may be submitted under the optional submission provision given in the Section AB General Notes.

*2. See AC1r consistency note #3.
*3. See AC1y consistency note #2.

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Wakens to toilet all or most nights
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
MDS

Basic Attributes

Class
SURVEY.MDS
Type
Surveys
First Released
Version 2.17
Last Updated
Version 2.50

Normative Answer List LL50-6

Answer Code Score Answer ID
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) 0 LA32-8
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) 1 LA33-6
UTD LA1-0

Member of these Panels

LOINC Long Common Name
45969-3 Deprecated MDS background information at admission form - version 2.0

45442-1 Has irregular bowel movement pattern [Minimum Data Set]

Observation ID in Form

AC1o

Type of Entry

Question expects user entry - requires response [Q]

Form Consistency Checks

1. For the RECTYPEs listed as facility option, the field may be submitted under the optional submission provision given in the Section AB General Notes.

*2. See AC1r consistency note #3.
*3. See AC1y consistency note #2.

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Has irregular bowel movement pattern
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
MDS

Basic Attributes

Class
SURVEY.MDS
Type
Surveys
First Released
Version 2.17
Last Updated
Version 2.50

Normative Answer List LL50-6

Answer Code Score Answer ID
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) 0 LA32-8
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) 1 LA33-6
UTD LA1-0

Member of these Panels

LOINC Long Common Name
45969-3 Deprecated MDS background information at admission form - version 2.0

45443-9 Showers for bathing [Minimum Data Set]

Observation ID in Form

AC1p

Type of Entry

Question expects user entry - requires response [Q]

Form Consistency Checks

1. For the RECTYPEs listed as facility option, the field may be submitted under the optional submission provision given in the Section AB General Notes.

*2. See AC1r consistency note #3.
*3. See AC1y consistency note #2.

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Showers for bathing
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
MDS

Basic Attributes

Class
SURVEY.MDS
Type
Surveys
First Released
Version 2.17
Last Updated
Version 2.50

Normative Answer List LL50-6

Answer Code Score Answer ID
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) 0 LA32-8
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) 1 LA33-6
UTD LA1-0

Member of these Panels

LOINC Long Common Name
45969-3 Deprecated MDS background information at admission form - version 2.0

45444-7 Bathing in PM [Minimum Data Set]

Observation ID in Form

AC1q

Type of Entry

Question expects user entry - requires response [Q]

Form Consistency Checks

1. For the RECTYPEs listed as facility option, the field may be submitted under the optional submission provision given in the Section AB General Notes.

*2. See AC1r consistency note #3.
*3. See AC1y consistency note #2.

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Bathing in PM
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
MDS

Basic Attributes

Class
SURVEY.MDS
Type
Surveys
First Released
Version 2.17
Last Updated
Version 2.50

Normative Answer List LL50-6

Answer Code Score Answer ID
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) 0 LA32-8
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) 1 LA33-6
UTD LA1-0

Member of these Panels

LOINC Long Common Name
45969-3 Deprecated MDS background information at admission form - version 2.0

45445-4 None of above

Observation ID in Form

AC1r

Type of Entry

Question expects user entry - requires response [Q]

Form Consistency Checks

1. For the RECTYPEs listed as facility option, the field may be submitted under the optional submission provision given in the Section AB General Notes.

*2. See AC1y consistency note #2.

*3. Value must be 0 (zero) if any AC1m thru AC1q = 1; value must be 1 if each AC1m thru AC1q = 0 (zero); value must be - if any AC1m thru AC1q = - and no AC1m thru AC1q = 1.

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
None of the listed additional ADL patterns
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
MDS

Basic Attributes

Class
SURVEY.MDS
Type
Surveys
First Released
Version 2.17
Last Updated
Version 2.50

Normative Answer List LL50-6

Answer Code Score Answer ID
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) 0 LA32-8
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) 1 LA33-6
UTD LA1-0

Member of these Panels

LOINC Long Common Name
45969-3 Deprecated MDS background information at admission form - version 2.0

45980-0 Involvement patterns Set

Type of Entry

Question expects user entry - requires response [Q]

Fully-Specified Name

Component
Involvement patterns
Property
-
Time
Pt
System
^Patient
Scale
Set
Method

Basic Attributes

Class
PANEL.SURVEY.MDS
Type
Surveys
First Released
Version 2.17
Last Updated
Version 2.52
Order vs. Observation
Order
Panel Type
Organizer

Member of these Panels

LOINC Long Common Name
45969-3 Deprecated MDS background information at admission form - version 2.0

45446-2 Daily contact with relatives/close friends [Minimum Data Set]

Observation ID in Form

AC1s

Type of Entry

Question expects user entry - requires response [Q]

Form Consistency Checks

1. For the RECTYPEs listed as facility option, the field may be submitted under the optional submission provision given in the Section AB General Notes.

*2. See AC1x consistency note #3.
*3. See AC1y consistency note #2.

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Daily contact with relatives &or close friends
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
MDS

Basic Attributes

Class
SURVEY.MDS
Type
Surveys
First Released
Version 2.17
Last Updated
Version 2.50

Normative Answer List LL50-6

Answer Code Score Answer ID
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) 0 LA32-8
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) 1 LA33-6
UTD LA1-0

Member of these Panels

LOINC Long Common Name
45969-3 Deprecated MDS background information at admission form - version 2.0

45447-0 Usually attends church, temple, etc. [Minimum Data Set]

Observation ID in Form

AC1t

Type of Entry

Question expects user entry - requires response [Q]

Form Consistency Checks

1. For the RECTYPEs listed as facility option, the field may be submitted under the optional submission provision given in the Section AB General Notes.

*2. See AC1x consistency note #3.
*3. See AC1y consistency note #2.

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Usually attends church, temple, etc.
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
MDS

Basic Attributes

Class
SURVEY.MDS
Type
Surveys
First Released
Version 2.17
Last Updated
Version 2.50

Normative Answer List LL50-6

Answer Code Score Answer ID
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) 0 LA32-8
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) 1 LA33-6
UTD LA1-0

Member of these Panels

LOINC Long Common Name
45969-3 Deprecated MDS background information at admission form - version 2.0

45448-8 Finds strength in faith [Minimum Data Set]

Observation ID in Form

AC1u

Type of Entry

Question expects user entry - requires response [Q]

Form Consistency Checks

1. For the RECTYPEs listed as facility option, the field may be submitted under the optional submission provision given in the Section AB General Notes.

*2. See AC1x consistency note #3.
*3. See AC1y consistency note #2.

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Finds strength in faith
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
MDS

Basic Attributes

Class
SURVEY.MDS
Type
Surveys
First Released
Version 2.17
Last Updated
Version 2.50

Normative Answer List LL50-6

Answer Code Score Answer ID
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) 0 LA32-8
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) 1 LA33-6
UTD LA1-0

Member of these Panels

LOINC Long Common Name
45969-3 Deprecated MDS background information at admission form - version 2.0

45449-6 Daily animal companion/presence [Minimum Data Set]

Observation ID in Form

AC1v

Type of Entry

Question expects user entry - requires response [Q]

Form Consistency Checks

1. For the RECTYPEs listed as facility option, the field may be submitted under the optional submission provision given in the Section AB General Notes.

*2. See AC1x consistency note #3.
*3. See AC1y consistency note #2.

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Daily animal companion &or presence
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
MDS

Basic Attributes

Class
SURVEY.MDS
Type
Surveys
First Released
Version 2.17
Last Updated
Version 2.50

Normative Answer List LL50-6

Answer Code Score Answer ID
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) 0 LA32-8
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) 1 LA33-6
UTD LA1-0

Member of these Panels

LOINC Long Common Name
45969-3 Deprecated MDS background information at admission form - version 2.0

45450-4 Involved in group activities [Minimum Data Set]

Observation ID in Form

AC1w

Type of Entry

Question expects user entry - requires response [Q]

Form Consistency Checks

1. For the RECTYPEs listed as facility option, the field may be submitted under the optional submission provision given in the Section AB General Notes.

*2. See AC1x consistency note #3.
*3. See AC1y consistency note #2.

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Involved in group activities
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
MDS

Basic Attributes

Class
SURVEY.MDS
Type
Surveys
First Released
Version 2.17
Last Updated
Version 2.50

Normative Answer List LL50-6

Answer Code Score Answer ID
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) 0 LA32-8
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) 1 LA33-6
UTD LA1-0

Member of these Panels

LOINC Long Common Name
45969-3 Deprecated MDS background information at admission form - version 2.0

45451-2 None of above

Observation ID in Form

AC1x

Type of Entry

Question expects user entry - requires response [Q]

Form Consistency Checks

1. For the RECTYPEs listed as facility option, the field may be submitted under the optional submission provision given in the Section AB General Notes.

*2. See AC1y consistency note #2.

*3. Value must be 0 (zero) if any AC1s thru AC1w = 1; value must be 1 if each AC1s thru AC1w = 0 (zero); value must be - if any AC1s thru AC1w = - and no AC1s thru AC1w = 1.

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
None of the listed involvement patterns
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
MDS

Basic Attributes

Class
SURVEY.MDS
Type
Surveys
First Released
Version 2.17
Last Updated
Version 2.50

Normative Answer List LL50-6

Answer Code Score Answer ID
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) 0 LA32-8
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) 1 LA33-6
UTD LA1-0

Member of these Panels

LOINC Long Common Name
45969-3 Deprecated MDS background information at admission form - version 2.0

45452-0 Unknown customary routine - resident/family unable to provide information [Minimum Data Set]

Observation ID in Form

AC1y

Type of Entry

Question expects user entry - requires response [Q]

Form Consistency Checks

1. For the RECTYPEs listed as facility option, the field may be submitted under the optional submission provision given in the Section AB General Notes.

*2. If value = 1, then each AC1a thru AC1x must be blank or = -; if value = 0 (zero) then at least 1 of AC1a thru AC1x must = 0 (zero) or 1.

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Unknown customary routine - resident &or family unable to provide information
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
MDS

Basic Attributes

Class
SURVEY.MDS
Type
Surveys
First Released
Version 2.17
Last Updated
Version 2.50

Normative Answer List LL50-6

Answer Code Score Answer ID
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) 0 LA32-8
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) 1 LA33-6
UTD LA1-0

Member of these Panels

LOINC Long Common Name
45969-3 Deprecated MDS background information at admission form - version 2.0