46102-0

Deprecated MDS quarterly assessment form - version 2.0

Deprecated

Status Information

Status: DEPRECATED

Reference Information

Type	Source	Reference
Original Form	Centers for Medicare & Medicaid Services	Original form upon which the LOINC panel is based. MDS quarterly assessment form

Panel Hierarchy

Details for each LOINC in Panel LHC-Forms

LOINC	Name	Example UCUM Units
46102-0	Deprecated MDS quarterly assessment form - version 2.0
Indent45965-1	Resident Name
IndentIndent45394-4	Patient Last (Family) name
IndentIndent45392-8	Patient First (Given) name
IndentIndent45393-6	Middle initial
IndentIndent45395-1	Jr/Sr
Indent45403-3	Room number [Location]
Indent54593-9	Assessment reference date - observation end date	{mm/dd/yyyy}
IndentIndent45453-8	Date of last day of MDS observation period [Minimum Data Set]
IndentIndent45454-6	Original or corrected copy of form # [Minimum Data Set]
Indent45455-3	Date of reentry to facility [Minimum Data Set]
Indent46106-1	Medical record no.
Indent45482-7	Deprecated Comatose [CMS Assessment]
Indent45988-3	Memory Set
IndentIndent45483-5	Short-term memory OK [Minimum Data Set]
IndentIndent45484-3	Long-term memory OK [Minimum Data Set]
Indent45490-0	Cognitive skills for daily decision making [Minimum Data Set]
Indent45990-9	Indicators of delirium - periodic disorded thinking or awareness Set
IndentIndent45491-8	Easily distracted [Minimum Data Set]
IndentIndent45492-6	Periods of altered perception or awareness of surroundings [Minimum Data Set]
IndentIndent45493-4	Episodes of disorganized speech [Minimum Data Set]
IndentIndent45494-2	Periods of restlessness [Minimum Data Set]
IndentIndent45495-9	Periods of lethargy [Minimum Data Set]
IndentIndent45496-7	Mental function varies over the course of the day [Minimum Data Set]
Indent45510-5	Making self understood [Minimum Data Set]
Indent45405-8	Ability to understand others [Minimum Data Set]
Indent45997-4	Indicators of depression, anxiety, sad mood Set
IndentIndent45998-2	Verbal expressions of distress Set
IndentIndentIndent45516-2	Resident made negative statements [Minimum Data Set]
IndentIndentIndent45517-0	Repetitive questions [Minimum Data Set]
IndentIndentIndent45518-8	Repetitive verbalizations [Minimum Data Set]
IndentIndentIndent45519-6	Persistent anger with self or others [Minimum Data Set]
IndentIndentIndent45520-4	Self deprecation [Minimum Data Set]
IndentIndentIndent45521-2	Expression of what appear to be unrealistic fears [Minimum Data Set]
IndentIndentIndent45522-0	Recurrent statements that something terrible is about to happen [Minimum Data Set]
IndentIndentIndent45547-7	Repetitive health complaints [Minimum Data Set]
IndentIndentIndent45548-5	Repetitive anxious complaints or concerns [Minimum Data Set]
IndentIndent45999-0	Sleep-cycle issues Set
IndentIndentIndent45549-3	Unpleasant mood in morning [Minimum Data Set]
IndentIndentIndent45550-1	Insomnia/change in sleeping pattern [Minimum Data Set]
IndentIndent46000-6	Sad, apethetic, anxious appearance Set
IndentIndentIndent45551-9	Sad, pained, or worried facial expressions [Minimum Data Set]
IndentIndentIndent45552-7	Crying or tearfulness [Minimum Data Set]
IndentIndentIndent45553-5	Repetitive physical movements [Minimum Data Set]
IndentIndent46107-9	Loss of interest Set
IndentIndentIndent45554-3	Withdrawal from activities of interest [Minimum Data Set]
IndentIndentIndent45555-0	Reduced social interaction [Minimum Data Set]
Indent45556-8	Mood persistence [Minimum Data Set]
Indent46001-4	Behavioral symptoms Set
IndentIndent45558-4	Frequency of wandering [Minimum Data Set]
IndentIndent45559-2	Alterability of wandering [Minimum Data Set]
IndentIndent45560-0	Frequency of verbally abusive behavioral symptoms [Minimum Data Set]	{#}
IndentIndent45561-8	Alterability of verbally abusive behavioral symptoms [Minimum Data Set]
IndentIndent45562-6	Frequency of physically abusive behavioral symptoms [Minimum Data Set]	{#}
IndentIndent45563-4	Alterability of physically abusive behavioral symptoms [Minimum Data Set]
IndentIndent45564-2	Frequency of socially inappropriate or disruptive behavioral symptoms [Minimum Data Set]	{#}
IndentIndent45565-9	Alterability of socially inappropriate or disruptive behavioral symptoms [Minimum Data Set]
IndentIndent45566-7	Frequency of resists care [Minimum Data Set]	{#}
IndentIndent45567-5	Alterability of resists care [Minimum Data Set]
Indent46147-5	ADL self performance or support (quarterly) Set
IndentIndent45588-1	Bed mobility - self-performance during assessment period
IndentIndent45590-7	Transfer - self-performance during assessment period
IndentIndent45592-3	Walk in room - self-performance during assessment period
IndentIndent45594-9	Walk in corridor - self-performance during assessment period
IndentIndent45596-4	Locomotion on unit - self-performance during assessment period
IndentIndent45598-0	Locomotion off unit - self-performance during assessment period
IndentIndent45600-4	Dressing - self-performance during assessment period
IndentIndent45602-0	Eating - self-performance during assessment period
IndentIndent45604-6	Toilet use - self-performance during assessment period
IndentIndent45606-1	Personal hygiene - self-performance during assessment period
Indent46146-7	Bathing (quarterly)
IndentIndent45608-7	Bathing - self-performance during assessment period
Indent46010-5	Functional limitation in range of motion Set
IndentIndent45524-6	Range of motion Neck [Minimum Data Set]
IndentIndent45525-3	Voluntary movement Neck [Minimum Data Set]
IndentIndent45526-1	Range of motion Upper extremity [Minimum Data Set]
IndentIndent45527-9	Voluntary movement Upper extremity [Minimum Data Set]
IndentIndent45528-7	Range of motion Hand [Minimum Data Set]
IndentIndent45529-5	Voluntary movement Hand [Minimum Data Set]
IndentIndent45530-3	Range of motion Lower extremity [Minimum Data Set]
IndentIndent45531-1	Voluntary movement Lower extremity [Minimum Data Set]
IndentIndent45532-9	Range of motion Foot [Minimum Data Set]
IndentIndent45533-7	Voluntary movement Foot [Minimum Data Set]
IndentIndent45534-5	Other limitation or loss - range of motion [Minimum Data Set]
IndentIndent45535-2	Other limitation or loss - voluntary movement [Minimum Data Set]
Indent46145-9	Modes of transfer (quarterly) Set
IndentIndent45541-0	Bedfast all or most of the time [Minimum Data Set]
IndentIndent45542-8	Bed rails used for bed mobility or transfer [Minimum Data Set]
IndentIndent45546-9	No mode of transfer [Minimum Data Set]
Indent46015-4	Continence self-control categories Set
IndentIndent45619-4	Bladder continence [Minimum Data Set]
IndentIndent45618-6	Bowel continence [Minimum Data Set]
Indent46144-2	Bowel elimination pattern (quarterly) Set
IndentIndent45623-6	Fecal impaction [Minimum Data Set]
IndentIndent45624-4	Bowel elimination pattern - none of above [Minimum Data Set]
Indent46143-4	Continence appliances and programs (quarterly) Set
IndentIndent45625-1	Any scheduled toileting plan [Minimum Data Set]
IndentIndent45626-9	Bladder retraining program [Minimum Data Set]
IndentIndent45627-7	External catheter [Minimum Data Set]
IndentIndent45628-5	Indwelling catheter [Minimum Data Set]
IndentIndent45633-5	Ostomy present [Minimum Data Set]
IndentIndent45634-3	Continence appliances and programs - none of above [Minimum Data Set]
Indent46142-6	Infections (quarterly) Set
IndentIndent45689-7	Urinary tract infection in last 30 days [Minimum Data Set]
IndentIndent45692-1	Infections - none of above [Minimum Data Set]
Indent46141-8	Other current diagnoses and ICD9 codes (quarterly) Set
IndentIndent45693-9	Other current or more detailed diagnoses and ICD9 codes [Minimum Data Set]
IndentIndent45958-6	Other current or more detailed diagnoses and ICD9 codes # 2 [Minimum Data Set]
Indent46140-0	Problem conditions (quarterly) Set
IndentIndent45696-2	Dehydrated [Minimum Data Set]
IndentIndent45702-8	Hallucinations [Minimum Data Set]
IndentIndent45709-3	Problem conditions - none of above [Minimum Data Set]
Indent46033-7	Pain symptoms Set
IndentIndent45710-1	Pain frequency [Minimum Data Set]
IndentIndent45711-9	Pain intensity [Minimum Data Set]
Indent46035-2	Accidents Set
IndentIndent45722-6	Fell in past 30 days [Minimum Data Set]
IndentIndent45723-4	Fell in past 31-180 days [Minimum Data Set]
IndentIndent45724-2	Hip fracture in last 180 days [Minimum Data Set]
IndentIndent45725-9	Other fracture in last 180 days [Minimum Data Set]
IndentIndent45726-7	Accidents - none of above [Minimum Data Set]
Indent46036-0	Stability of conditions Set
IndentIndent45727-5	Conditions/diseases make resident's cognitive, ADL, mood or behavior patterns unstable [Minimum Data Set]
IndentIndent45728-3	Resident experiencing an acute episode or a flare-up of a recurrent or chronic problem [Minimum Data Set]
IndentIndent45729-1	End-Stage disease, 6 or fewer months to live [Minimum Data Set]
IndentIndent45730-9	Stability of conditions - none of above [Minimum Data Set]
Indent46040-2	Weight change Set
IndentIndent45735-8	Weight loss [Minimum Data Set]
IndentIndent45736-6	Weight gain [Minimum Data Set]
Indent46139-2	Nutritional approaches (quarterly) Set
IndentIndent45742-4	Feeding tube [Minimum Data Set]
IndentIndent45748-1	On a planned weight change program [Minimum Data Set]
IndentIndent45749-9	Nutritional approaches - none of above [Minimum Data Set]
Indent46047-7	Ulcers Set
IndentIndent45776-2	Ulcers.stage 1 # [Minimum Data Set]	{#}
IndentIndent45777-0	Ulcers.stage 2 # [Minimum Data Set]	{#}
IndentIndent45778-8	Ulcers.stage 3 # [Minimum Data Set]	{#}
IndentIndent45779-6	Ulcers.stage 4 # [Minimum Data Set]	{#}
Indent46048-5	Type of ulcer Set
IndentIndent45780-4	Pressure injury stage [Minimum Data Set]
IndentIndent45781-2	Stasis ulcer stage [Minimum Data Set]
Indent46053-5	Time awake Set
IndentIndent45808-3	Awake in morning [Minimum Data Set]
IndentIndent45809-1	Awake in afternoon [Minimum Data Set]
IndentIndent45810-9	Awake in evening [Minimum Data Set]
IndentIndent45811-7	Time awake - none of above [Minimum Data Set]
Indent45812-5	Average time involved in activities [Minimum Data Set]
Indent45833-1	Number of medications [Minimum Data Set]	{#}
Indent46058-4	Days received the following medication Set
IndentIndent45836-4	Number of days antipsychotic medication received [Minimum Data Set]	d
IndentIndent45837-2	Number of days antianxiety medication received [Minimum Data Set]	d
IndentIndent45838-0	Number of days antidepressant medication received [Minimum Data Set]	d
IndentIndent45839-8	Number of days hypnotic medication received [Minimum Data Set]	d
IndentIndent45840-6	Number of days diuretic medication received [Minimum Data Set]	d
Indent46067-5	Devices and restraints Set
IndentIndent45870-3	Bed rails - full bed rails on all open sides of bed [Minimum Data Set]
IndentIndent45871-1	Bed rails - other types of side rails used [Minimum Data Set]
IndentIndent45872-9	Trunk restraint [Minimum Data Set]
IndentIndent45873-7	Limb restraint [Minimum Data Set]
IndentIndent45874-5	Chair prevents rising [Minimum Data Set]
Indent45883-6	Overall change in care needs [Minimum Data Set]

LOINC Names Get Info

Fully-Specified Name: MDS quarterly assessment form - version 2.0:-:Pt:^Patient:-:
Long Common Name: Deprecated MDS quarterly assessment form - version 2.0

Part Model Get Info

Component
MDS quarterly assessment form - version 2.0
LP75086-6
- Analyte
  MDS quarterly assessment form - version 2.0
  LP75086-6
  - Component Numerator
    MDS quarterly assessment form - version 2.0
    LP75086-6
    - Component Numerator Core
      MDS quarterly assessment form - version 2.0
      LP75086-6
    - Component Numerator Core Suffix
      NULL
  - Component Denominator
    NULL
    - Component Denominator Core
      NULL
    - Component Denominator Core Suffix
      NULL
- Challenge
  NULL
- Adjustment
  NULL
- Count
  NULL
Property
-
LP6769-6
Time
Pt
LP6960-1
- Time Core
  Pt
  LP6960-1
- Time Modifier
  NULL
System
^Patient
LP310005-6
- System Core
  NULL
- Super System
  Patient
  LP6985-8
Scale
-
LP7747-1
Method
NULL

Basic Attributes

Class: PANEL.SURVEY.MDS
Type: Surveys
First Released: Version 2.17
Last Updated: Version 2.73 (DEL)
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: Order
Panel Type: Panel

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

CodeSystem lookup: https://fhir.loinc.org/CodeSystem/$lookup?system=http://loinc.org&code=46102-0
Questionnaire definition: https://fhir.loinc.org/Questionnaire/?url=http://loinc.org/q/46102-0

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: [email protected]
URL: http://www.interrai.org

LOINC Copyright

Copyright © 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://loinc.org/license for the full LOINC copyright and license.