Version 2.79

45998-2 Verbal expressions of distress Set

Type of Entry

Question expects user entry - requires response [Q]

Fully-Specified Name

Component
Verbal expressions of distress
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 (MIN)
Order vs. Observation
Order
Panel Type
Organizer

Member of these Panels

LOINC Long Common Name
45981-8 Deprecated MDS full assessment form - version 2.0
46102-0 Deprecated MDS quarterly assessment form - version 2.0
46103-8 Deprecated MDS quarterly assessment form - version 2.0 - optional version for RUG-III
46104-6 Deprecated MDS quarterly assessment form - version 2.0 - optional version for RUG-III 1997 update

45516-2 Resident made negative statements [Minimum Data Set]

Term Description

e.g., "Nothing matters;Would rather be dead;What's the use; Regrets having lived so long; Let me die"

Observation ID in Form

E1a

Type of Entry

Question expects user entry - requires response [Q]

Form Consistency Checks

*1. Value must be blank if B1 = 1; value must be 0 (zero) thru 2 or - if B1 not = 1.
*2. See E2 consistency note #2.

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Resident made negative statements
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 (MIN)

Normative Answer List LL20-9

Answer Code Score Answer ID
Indicator not exhibited in last 30 days 0 LA86-4
Indicator of this type exhibited up to five days a week 1 LA87-2
Indicator of this type exhibited daily or almost daily (6, 7 days a week) 2 LA88-0

Member of these Panels

LOINC Long Common Name
45981-8 Deprecated MDS full assessment form - version 2.0
46102-0 Deprecated MDS quarterly assessment form - version 2.0
46103-8 Deprecated MDS quarterly assessment form - version 2.0 - optional version for RUG-III
46104-6 Deprecated MDS quarterly assessment form - version 2.0 - optional version for RUG-III 1997 update

45517-0 Repetitive questions [Minimum Data Set]

Term Description

e.g., "Where do I go;What do I do?"

Observation ID in Form

E1b

Type of Entry

Question expects user entry - requires response [Q]

Form Consistency Checks

*1. Value must be blank if B1 = 1; value must be 0 (zero) thru 2 or - if B1 not = 1.
*2. See E2 consistency note #2.

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Repetitive questions
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 (MIN)

Normative Answer List LL20-9

Answer Code Score Answer ID
Indicator not exhibited in last 30 days 0 LA86-4
Indicator of this type exhibited up to five days a week 1 LA87-2
Indicator of this type exhibited daily or almost daily (6, 7 days a week) 2 LA88-0

Member of these Panels

LOINC Long Common Name
45981-8 Deprecated MDS full assessment form - version 2.0
46102-0 Deprecated MDS quarterly assessment form - version 2.0
46103-8 Deprecated MDS quarterly assessment form - version 2.0 - optional version for RUG-III
46104-6 Deprecated MDS quarterly assessment form - version 2.0 - optional version for RUG-III 1997 update

45518-8 Repetitive verbalizations [Minimum Data Set]

Term Description

e.g., calling out for help, ("God help me")

Observation ID in Form

E1c

Type of Entry

Question expects user entry - requires response [Q]

Form Consistency Checks

*1. Value must be blank if B1 = 1; value must be 0 (zero) thru 2 or - if B1 not = 1.
*2. See E2 consistency note #2.

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Repetitive verbalizations
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 (MIN)

Normative Answer List LL20-9

Answer Code Score Answer ID
Indicator not exhibited in last 30 days 0 LA86-4
Indicator of this type exhibited up to five days a week 1 LA87-2
Indicator of this type exhibited daily or almost daily (6, 7 days a week) 2 LA88-0

Member of these Panels

LOINC Long Common Name
45981-8 Deprecated MDS full assessment form - version 2.0
46102-0 Deprecated MDS quarterly assessment form - version 2.0
46103-8 Deprecated MDS quarterly assessment form - version 2.0 - optional version for RUG-III
46104-6 Deprecated MDS quarterly assessment form - version 2.0 - optional version for RUG-III 1997 update

45519-6 Persistent anger with self or others [Minimum Data Set]

Term Description

e.g., easily annoyed, anger at placement in nursing home; anger at care received

Observation ID in Form

E1d

Type of Entry

Question expects user entry - requires response [Q]

Form Consistency Checks

*1. Value must be blank if B1 = 1; value must be 0 (zero) thru 2 or - if B1 not = 1.
*2. See E2 consistency note #2.

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Persistent anger with self or others
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 (MIN)

Normative Answer List LL20-9

Answer Code Score Answer ID
Indicator not exhibited in last 30 days 0 LA86-4
Indicator of this type exhibited up to five days a week 1 LA87-2
Indicator of this type exhibited daily or almost daily (6, 7 days a week) 2 LA88-0

Member of these Panels

LOINC Long Common Name
45981-8 Deprecated MDS full assessment form - version 2.0
46102-0 Deprecated MDS quarterly assessment form - version 2.0
46103-8 Deprecated MDS quarterly assessment form - version 2.0 - optional version for RUG-III
46104-6 Deprecated MDS quarterly assessment form - version 2.0 - optional version for RUG-III 1997 update

45520-4 Self deprecation [Minimum Data Set]

Term Description

e.g., "I am nothing; I am of no use to anyone"

Observation ID in Form

E1e

Type of Entry

Question expects user entry - requires response [Q]

Form Consistency Checks

*1. Value must be blank if B1 = 1; value must be 0 (zero) thru 2 or - if B1 not = 1.
*2. See E2 consistency note #2.

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Self deprecation
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 (MIN)

Normative Answer List LL20-9

Answer Code Score Answer ID
Indicator not exhibited in last 30 days 0 LA86-4
Indicator of this type exhibited up to five days a week 1 LA87-2
Indicator of this type exhibited daily or almost daily (6, 7 days a week) 2 LA88-0

Member of these Panels

LOINC Long Common Name
45981-8 Deprecated MDS full assessment form - version 2.0
46102-0 Deprecated MDS quarterly assessment form - version 2.0
46103-8 Deprecated MDS quarterly assessment form - version 2.0 - optional version for RUG-III
46104-6 Deprecated MDS quarterly assessment form - version 2.0 - optional version for RUG-III 1997 update

45521-2 Expression of what appear to be unrealistic fears [Minimum Data Set]

Term Description

e.g., fear of being abandoned, left alone, being with others

Observation ID in Form

E1f

Type of Entry

Question expects user entry - requires response [Q]

Form Consistency Checks

*1. Value must be blank if B1 = 1; value must be 0 (zero) thru 2 or - if B1 not = 1.
*2. See E2 consistency note #2.

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Expression of what appear to be unrealistic fears
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 (MIN)

Normative Answer List LL20-9

Answer Code Score Answer ID
Indicator not exhibited in last 30 days 0 LA86-4
Indicator of this type exhibited up to five days a week 1 LA87-2
Indicator of this type exhibited daily or almost daily (6, 7 days a week) 2 LA88-0

Member of these Panels

LOINC Long Common Name
45981-8 Deprecated MDS full assessment form - version 2.0
46102-0 Deprecated MDS quarterly assessment form - version 2.0
46103-8 Deprecated MDS quarterly assessment form - version 2.0 - optional version for RUG-III
46104-6 Deprecated MDS quarterly assessment form - version 2.0 - optional version for RUG-III 1997 update

45522-0 Recurrent statements that something terrible is about to happen [Minimum Data Set]

Term Description

e.g., believes he or she is about to die, have a heart attack

Observation ID in Form

E1g

Type of Entry

Question expects user entry - requires response [Q]

Form Consistency Checks

*1. Value must be blank if B1 = 1; value must be 0 (zero) thru 2 or - if B1 not = 1.
*2. See E2 consistency note #2.

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Recurrent statements that something terrible is about to happen
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 (MIN)

Normative Answer List LL20-9

Answer Code Score Answer ID
Indicator not exhibited in last 30 days 0 LA86-4
Indicator of this type exhibited up to five days a week 1 LA87-2
Indicator of this type exhibited daily or almost daily (6, 7 days a week) 2 LA88-0

Member of these Panels

LOINC Long Common Name
45981-8 Deprecated MDS full assessment form - version 2.0
46102-0 Deprecated MDS quarterly assessment form - version 2.0
46103-8 Deprecated MDS quarterly assessment form - version 2.0 - optional version for RUG-III
46104-6 Deprecated MDS quarterly assessment form - version 2.0 - optional version for RUG-III 1997 update

45547-7 Repetitive health complaints [Minimum Data Set]

Term Description

e.g., persistently seeks medical attention, obsessive concern with body functions

Observation ID in Form

E1h

Type of Entry

Question expects user entry - requires response [Q]

Form Consistency Checks

*1. Value must be blank if B1 = 1; value must be 0 (zero) thru 2 or - if B1 not = 1.
*2. See E2 consistency note #2.

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Repetitive health complaints
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 (MIN)

Normative Answer List LL20-9

Answer Code Score Answer ID
Indicator not exhibited in last 30 days 0 LA86-4
Indicator of this type exhibited up to five days a week 1 LA87-2
Indicator of this type exhibited daily or almost daily (6, 7 days a week) 2 LA88-0

Member of these Panels

LOINC Long Common Name
45981-8 Deprecated MDS full assessment form - version 2.0
46102-0 Deprecated MDS quarterly assessment form - version 2.0
46103-8 Deprecated MDS quarterly assessment form - version 2.0 - optional version for RUG-III
46104-6 Deprecated MDS quarterly assessment form - version 2.0 - optional version for RUG-III 1997 update

45548-5 Repetitive anxious complaints or concerns [Minimum Data Set]

Term Description

e.g., persistently seeks attention/reassurance regarding schedules, meals, laundry, clothing, relationship issues - non health related

Observation ID in Form

E1i

Type of Entry

Question expects user entry - requires response [Q]

Form Consistency Checks

*1. Value must be blank if B1 = 1; value must be 0 (zero) thru 2 or - if B1 not = 1.
*2. See E2 consistency note #2.

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Repetitive anxious complaints or concerns
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 (MIN)

Normative Answer List LL20-9

Answer Code Score Answer ID
Indicator not exhibited in last 30 days 0 LA86-4
Indicator of this type exhibited up to five days a week 1 LA87-2
Indicator of this type exhibited daily or almost daily (6, 7 days a week) 2 LA88-0

Member of these Panels

LOINC Long Common Name
45981-8 Deprecated MDS full assessment form - version 2.0
46102-0 Deprecated MDS quarterly assessment form - version 2.0
46103-8 Deprecated MDS quarterly assessment form - version 2.0 - optional version for RUG-III
46104-6 Deprecated MDS quarterly assessment form - version 2.0 - optional version for RUG-III 1997 update

45999-0 Sleep-cycle issues Set

Type of Entry

Question expects user entry - requires response [Q]

Fully-Specified Name

Component
Sleep-cycle issues
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 (MIN)
Order vs. Observation
Order
Panel Type
Organizer

Member of these Panels

LOINC Long Common Name
45981-8 Deprecated MDS full assessment form - version 2.0
46102-0 Deprecated MDS quarterly assessment form - version 2.0
46103-8 Deprecated MDS quarterly assessment form - version 2.0 - optional version for RUG-III
46104-6 Deprecated MDS quarterly assessment form - version 2.0 - optional version for RUG-III 1997 update

45549-3 Unpleasant mood in morning [Minimum Data Set]

Observation ID in Form

E1j

Type of Entry

Question expects user entry - requires response [Q]

Form Consistency Checks

*1. Value must be blank if B1 = 1; value must be 0 (zero) thru 2 or - if B1 not = 1.
*2. See E2 consistency note #2.

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Unpleasant mood in morning
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 (MIN)

Normative Answer List LL20-9

Answer Code Score Answer ID
Indicator not exhibited in last 30 days 0 LA86-4
Indicator of this type exhibited up to five days a week 1 LA87-2
Indicator of this type exhibited daily or almost daily (6, 7 days a week) 2 LA88-0

Member of these Panels

LOINC Long Common Name
45981-8 Deprecated MDS full assessment form - version 2.0
46102-0 Deprecated MDS quarterly assessment form - version 2.0
46103-8 Deprecated MDS quarterly assessment form - version 2.0 - optional version for RUG-III
46104-6 Deprecated MDS quarterly assessment form - version 2.0 - optional version for RUG-III 1997 update

45550-1 Insomnia/change in sleeping pattern [Minimum Data Set]

Observation ID in Form

E1k

Type of Entry

Question expects user entry - requires response [Q]

Form Consistency Checks

*1. Value must be blank if B1 = 1; value must be 0 (zero) thru 2 or - if B1 not = 1.
*2. See E2 consistency note #2.

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Insomnia &or change in sleeping 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 (MIN)

Normative Answer List LL20-9

Answer Code Score Answer ID
Indicator not exhibited in last 30 days 0 LA86-4
Indicator of this type exhibited up to five days a week 1 LA87-2
Indicator of this type exhibited daily or almost daily (6, 7 days a week) 2 LA88-0

Member of these Panels

LOINC Long Common Name
45981-8 Deprecated MDS full assessment form - version 2.0
46102-0 Deprecated MDS quarterly assessment form - version 2.0
46103-8 Deprecated MDS quarterly assessment form - version 2.0 - optional version for RUG-III
46104-6 Deprecated MDS quarterly assessment form - version 2.0 - optional version for RUG-III 1997 update

46000-6 Sad, apethetic, anxious appearance Set

Type of Entry

Question expects user entry - requires response [Q]

Fully-Specified Name

Component
Sad, apethetic, anxious appearance
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 (MIN)
Order vs. Observation
Order
Panel Type
Organizer

Member of these Panels

LOINC Long Common Name
45981-8 Deprecated MDS full assessment form - version 2.0
46102-0 Deprecated MDS quarterly assessment form - version 2.0
46103-8 Deprecated MDS quarterly assessment form - version 2.0 - optional version for RUG-III
46104-6 Deprecated MDS quarterly assessment form - version 2.0 - optional version for RUG-III 1997 update

45551-9 Sad, pained, or worried facial expressions [Minimum Data Set]

Term Description

e.g., furrowed brows

Observation ID in Form

E1l

Type of Entry

Question expects user entry - requires response [Q]

Form Consistency Checks

*1. Value must be blank if B1 = 1; value must be 0 (zero) thru 2 or - if B1 not = 1.
*2. See E2 consistency note #2.

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Sad, pained, or worried facial expressions
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 (MIN)

Normative Answer List LL20-9

Answer Code Score Answer ID
Indicator not exhibited in last 30 days 0 LA86-4
Indicator of this type exhibited up to five days a week 1 LA87-2
Indicator of this type exhibited daily or almost daily (6, 7 days a week) 2 LA88-0

Member of these Panels

LOINC Long Common Name
45981-8 Deprecated MDS full assessment form - version 2.0
46102-0 Deprecated MDS quarterly assessment form - version 2.0
46103-8 Deprecated MDS quarterly assessment form - version 2.0 - optional version for RUG-III
46104-6 Deprecated MDS quarterly assessment form - version 2.0 - optional version for RUG-III 1997 update

45552-7 Crying or tearfulness [Minimum Data Set]

Observation ID in Form

E1m

Type of Entry

Question expects user entry - requires response [Q]

Form Consistency Checks

*1. Value must be blank if B1 = 1; value must be 0 (zero) thru 2 or - if B1 not = 1.
*2. See E2 consistency note #2.

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Crying or tearfulness
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 (MIN)

Normative Answer List LL20-9

Answer Code Score Answer ID
Indicator not exhibited in last 30 days 0 LA86-4
Indicator of this type exhibited up to five days a week 1 LA87-2
Indicator of this type exhibited daily or almost daily (6, 7 days a week) 2 LA88-0

Member of these Panels

LOINC Long Common Name
45981-8 Deprecated MDS full assessment form - version 2.0
46102-0 Deprecated MDS quarterly assessment form - version 2.0
46103-8 Deprecated MDS quarterly assessment form - version 2.0 - optional version for RUG-III
46104-6 Deprecated MDS quarterly assessment form - version 2.0 - optional version for RUG-III 1997 update

45553-5 Repetitive physical movements [Minimum Data Set]

Term Description

e.g., pacing, hand wringing, restlessness, fidgeting, picking

Observation ID in Form

E1n

Type of Entry

Question expects user entry - requires response [Q]

Form Consistency Checks

*1. Value must be blank if B1 = 1; value must be 0 (zero) thru 2 or - if B1 not = 1.
*2. See E2 consistency note #2.

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Repetitive physical movements
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 (MIN)

Normative Answer List LL20-9

Answer Code Score Answer ID
Indicator not exhibited in last 30 days 0 LA86-4
Indicator of this type exhibited up to five days a week 1 LA87-2
Indicator of this type exhibited daily or almost daily (6, 7 days a week) 2 LA88-0

Member of these Panels

LOINC Long Common Name
45981-8 Deprecated MDS full assessment form - version 2.0
46102-0 Deprecated MDS quarterly assessment form - version 2.0
46103-8 Deprecated MDS quarterly assessment form - version 2.0 - optional version for RUG-III
46104-6 Deprecated MDS quarterly assessment form - version 2.0 - optional version for RUG-III 1997 update

46107-9 Loss of interest Set

Type of Entry

Question expects user entry - requires response [Q]

Fully-Specified Name

Component
Loss of interest
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 (MIN)
Order vs. Observation
Order
Panel Type
Organizer

Member of these Panels

LOINC Long Common Name
45981-8 Deprecated MDS full assessment form - version 2.0
46102-0 Deprecated MDS quarterly assessment form - version 2.0
46103-8 Deprecated MDS quarterly assessment form - version 2.0 - optional version for RUG-III
46104-6 Deprecated MDS quarterly assessment form - version 2.0 - optional version for RUG-III 1997 update

45554-3 Withdrawal from activities of interest [Minimum Data Set]

Term Description

e.g., no interest in long standing activities or being with family/friends

Observation ID in Form

E1o

Type of Entry

Question expects user entry - requires response [Q]

Form Consistency Checks

*1. Value must be blank if B1 = 1; value must be 0 (zero) thru 2 or - if B1 not = 1.
*2. See E2 consistency note #2.

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Withdrawal from activities of interest
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 (MIN)

Normative Answer List LL20-9

Answer Code Score Answer ID
Indicator not exhibited in last 30 days 0 LA86-4
Indicator of this type exhibited up to five days a week 1 LA87-2
Indicator of this type exhibited daily or almost daily (6, 7 days a week) 2 LA88-0

Member of these Panels

LOINC Long Common Name
45981-8 Deprecated MDS full assessment form - version 2.0
46102-0 Deprecated MDS quarterly assessment form - version 2.0
46103-8 Deprecated MDS quarterly assessment form - version 2.0 - optional version for RUG-III
46104-6 Deprecated MDS quarterly assessment form - version 2.0 - optional version for RUG-III 1997 update

45555-0 Reduced social interaction [Minimum Data Set]

Observation ID in Form

E1p

Type of Entry

Question expects user entry - requires response [Q]

Form Consistency Checks

*1. Value must be blank if B1 = 1; value must be 0 (zero) thru 2 or - if B1 not = 1.
*2. See E2 consistency note #2.

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Reduced social interaction
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 (MIN)

Normative Answer List LL20-9

Answer Code Score Answer ID
Indicator not exhibited in last 30 days 0 LA86-4
Indicator of this type exhibited up to five days a week 1 LA87-2
Indicator of this type exhibited daily or almost daily (6, 7 days a week) 2 LA88-0

Member of these Panels

LOINC Long Common Name
45981-8 Deprecated MDS full assessment form - version 2.0
46102-0 Deprecated MDS quarterly assessment form - version 2.0
46103-8 Deprecated MDS quarterly assessment form - version 2.0 - optional version for RUG-III
46104-6 Deprecated MDS quarterly assessment form - version 2.0 - optional version for RUG-III 1997 update