Version 2.78

52652-5 Does this patient primarily use a wheelchair for mobility?

Observation ID in Form

B5

Skip Logic

If No, code B5a for the longest distance completed. If Yes, code B5b for the longest distance completed.

Fully-Specified Name

Component
Primarily uses wheelchair for mobility during 2D assessment period
Property
Find
Time
2D
System
^Patient
Scale
Ord
Method
CARE

Basic Attributes

Class
SURVEY.CARE
Type
Surveys
First Released
Version 2.26
Last Updated
Version 2.64

Survey Question

Text
Does this patient primarily use a wheelchair for mobility?
Source
CARE I.b05

Normative Answer List LL251-0

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

Member of these Panels

LOINC Long Common Name
52745-7 Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Discharge
52743-2 Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Acute Care
52748-1 Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Home Health Admission
52746-5 Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Interim
52744-0 Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Admission

52517-0 Select the longest distance the patient walks and code his/her level of independence (Level 1-6) on that distance. Observe performance. (Select only one.)

Observation ID in Form

B5a

Fully-Specified Name

Component
Level of independence on longest distance walked
Property
-
Time
Pt
System
^Patient
Scale
-
Method

Basic Attributes

Class
SURVEY.CARE
Type
Surveys
First Released
Version 2.26
Last Updated
Version 2.64
Panel Type
Panel

Survey Question

Text
Select the longest distance the patient walks and code his/her level of independence (Level 1-6) on that distance. Observe performance. (Select only one.)
Source
CARE I.b05a

Normative Answer List LL586-9

Answer Code Score Answer ID
Independent - Patient completes the activity by themself with no assistance from a helper. 6 LA9983-3
Setup or clean-up assistance - Helper sets up or cleans up; patient completes activity. Helper assists only prior to or following the activity. 5 LA10073-7
Supervision or touching assistance - Helper provides verbal cues or touching/steadying assistance as patient completes activity. Assistance may be provided throughout the activity or intermittently. 4 LA11757-4
Partial/moderate assistance - Helper does less than half the effort. Helper lifts, holds or supports trunk or limbs, but provides less than half the effort. 3 LA10055-4
Substantial/maximal assistance – Helper does MORE THAN HALF the effort. Helper lifts or holds trunk or limbs and provides more than half the effort. 2 LA10090-1
Dependent - Helper does all of the effort. Patient does none of the effort to complete the task. 1 LA9964-3
Not attempted due to medical condition M LA10039-8
Not attempted due to safety concerns S LA10040-6
Task attempted but not completed A LA10092-7
Not applicable N LA4720-4
Patient refused P LA10058-8

Member of these Panels

LOINC Long Common Name
52745-7 Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Discharge
52743-2 Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Acute Care
52748-1 Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Home Health Admission
52746-5 Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Interim
52744-0 Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Admission

52653-3 Walk 150 ft (45 m)

Term Description

Once standing, can walk at least 150 feet (45 meters) in corridor or similar space.
Source: Regenstrief LOINC

Observation ID in Form

B5a.1

Fully-Specified Name

Component
Walk 150 ft (45 m) during 2D assessment period
Property
Find
Time
2D
System
^Patient
Scale
Ord
Method
CARE

Basic Attributes

Class
SURVEY.CARE
Type
Surveys
First Released
Version 2.26
Last Updated
Version 2.54

Normative Answer List LL586-9

Answer Code Score Answer ID
Independent - Patient completes the activity by themself with no assistance from a helper. 6 LA9983-3
Setup or clean-up assistance - Helper sets up or cleans up; patient completes activity. Helper assists only prior to or following the activity. 5 LA10073-7
Supervision or touching assistance - Helper provides verbal cues or touching/steadying assistance as patient completes activity. Assistance may be provided throughout the activity or intermittently. 4 LA11757-4
Partial/moderate assistance - Helper does less than half the effort. Helper lifts, holds or supports trunk or limbs, but provides less than half the effort. 3 LA10055-4
Substantial/maximal assistance – Helper does MORE THAN HALF the effort. Helper lifts or holds trunk or limbs and provides more than half the effort. 2 LA10090-1
Dependent - Helper does all of the effort. Patient does none of the effort to complete the task. 1 LA9964-3
Not attempted due to medical condition M LA10039-8
Not attempted due to safety concerns S LA10040-6
Task attempted but not completed A LA10092-7
Not applicable N LA4720-4
Patient refused P LA10058-8

Member of these Panels

LOINC Long Common Name
76464-7 American Physical Therapy Association registry panel
52745-7 Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Discharge
52743-2 Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Acute Care
52748-1 Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Home Health Admission
52746-5 Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Interim
52744-0 Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Admission

52654-1 Walk 100 ft (30 m)

Term Description

Once standing, can walk at least 100 feet (30 meters) in corridor or similar space.
Source: Regenstrief LOINC

Observation ID in Form

B5a.2

Fully-Specified Name

Component
Walk 100 ft (30 m) during 2D assessment period
Property
Find
Time
2D
System
^Patient
Scale
Ord
Method
CARE

Basic Attributes

Class
SURVEY.CARE
Type
Surveys
First Released
Version 2.26
Last Updated
Version 2.54

Normative Answer List LL586-9

Answer Code Score Answer ID
Independent - Patient completes the activity by themself with no assistance from a helper. 6 LA9983-3
Setup or clean-up assistance - Helper sets up or cleans up; patient completes activity. Helper assists only prior to or following the activity. 5 LA10073-7
Supervision or touching assistance - Helper provides verbal cues or touching/steadying assistance as patient completes activity. Assistance may be provided throughout the activity or intermittently. 4 LA11757-4
Partial/moderate assistance - Helper does less than half the effort. Helper lifts, holds or supports trunk or limbs, but provides less than half the effort. 3 LA10055-4
Substantial/maximal assistance – Helper does MORE THAN HALF the effort. Helper lifts or holds trunk or limbs and provides more than half the effort. 2 LA10090-1
Dependent - Helper does all of the effort. Patient does none of the effort to complete the task. 1 LA9964-3
Not attempted due to medical condition M LA10039-8
Not attempted due to safety concerns S LA10040-6
Task attempted but not completed A LA10092-7
Not applicable N LA4720-4
Patient refused P LA10058-8

Member of these Panels

LOINC Long Common Name
76464-7 American Physical Therapy Association registry panel
52745-7 Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Discharge
52743-2 Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Acute Care
52748-1 Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Home Health Admission
52746-5 Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Interim
52744-0 Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Admission

52655-8 Walk 50 ft (15m)

Term Description

Once standing, can walk at least 50 feet (15 meters) in corridor or similar space.
Source: Regenstrief LOINC

Observation ID in Form

B5a.3

Fully-Specified Name

Component
Walk 50 ft (15 m) during 2D assessment period
Property
Find
Time
2D
System
^Patient
Scale
Ord
Method
CARE

Basic Attributes

Class
SURVEY.CARE
Type
Surveys
First Released
Version 2.26
Last Updated
Version 2.64

Normative Answer List LL586-9

Answer Code Score Answer ID
Independent - Patient completes the activity by themself with no assistance from a helper. 6 LA9983-3
Setup or clean-up assistance - Helper sets up or cleans up; patient completes activity. Helper assists only prior to or following the activity. 5 LA10073-7
Supervision or touching assistance - Helper provides verbal cues or touching/steadying assistance as patient completes activity. Assistance may be provided throughout the activity or intermittently. 4 LA11757-4
Partial/moderate assistance - Helper does less than half the effort. Helper lifts, holds or supports trunk or limbs, but provides less than half the effort. 3 LA10055-4
Substantial/maximal assistance – Helper does MORE THAN HALF the effort. Helper lifts or holds trunk or limbs and provides more than half the effort. 2 LA10090-1
Dependent - Helper does all of the effort. Patient does none of the effort to complete the task. 1 LA9964-3
Not attempted due to medical condition M LA10039-8
Not attempted due to safety concerns S LA10040-6
Task attempted but not completed A LA10092-7
Not applicable N LA4720-4
Patient refused P LA10058-8

Member of these Panels

LOINC Long Common Name
52745-7 Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Discharge
52743-2 Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Acute Care
52748-1 Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Home Health Admission
52746-5 Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Interim
52744-0 Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Admission

52656-6 Walk in Room Once Standing

Term Description

Once standing, can walk at least 10 feet (3 meters) in room, corridor or similar space.
Source: Regenstrief LOINC

Observation ID in Form

B5a.4

Fully-Specified Name

Component
Walk 10 ft (3 m) during 2D assessment period
Property
Find
Time
2D
System
^Patient
Scale
Ord
Method
CARE

Basic Attributes

Class
SURVEY.CARE
Type
Surveys
First Released
Version 2.26
Last Updated
Version 2.54

Normative Answer List LL586-9

Answer Code Score Answer ID
Independent - Patient completes the activity by themself with no assistance from a helper. 6 LA9983-3
Setup or clean-up assistance - Helper sets up or cleans up; patient completes activity. Helper assists only prior to or following the activity. 5 LA10073-7
Supervision or touching assistance - Helper provides verbal cues or touching/steadying assistance as patient completes activity. Assistance may be provided throughout the activity or intermittently. 4 LA11757-4
Partial/moderate assistance - Helper does less than half the effort. Helper lifts, holds or supports trunk or limbs, but provides less than half the effort. 3 LA10055-4
Substantial/maximal assistance – Helper does MORE THAN HALF the effort. Helper lifts or holds trunk or limbs and provides more than half the effort. 2 LA10090-1
Dependent - Helper does all of the effort. Patient does none of the effort to complete the task. 1 LA9964-3
Not attempted due to medical condition M LA10039-8
Not attempted due to safety concerns S LA10040-6
Task attempted but not completed A LA10092-7
Not applicable N LA4720-4
Patient refused P LA10058-8

Member of these Panels

LOINC Long Common Name
76464-7 American Physical Therapy Association registry panel
52745-7 Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Discharge
52743-2 Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Acute Care
52748-1 Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Home Health Admission
52746-5 Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Interim
52744-0 Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Admission

52518-8 Select the longest distance the patient wheels and code his/her level of independence (Level 1-6). Observe performance. (Select only one.)

Observation ID in Form

B5b

Fully-Specified Name

Component
Level of independence on longest distance wheeled
Property
-
Time
Pt
System
^Patient
Scale
-
Method

Basic Attributes

Class
SURVEY.CARE
Type
Surveys
First Released
Version 2.26
Last Updated
Version 2.64
Panel Type
Panel

Survey Question

Text
Select the longest distance the patient wheels and code his/her level of independence (Level 1-6). Observe performance. (Select only one.)
Source
CARE I.b05b

Normative Answer List LL586-9

Answer Code Score Answer ID
Independent - Patient completes the activity by themself with no assistance from a helper. 6 LA9983-3
Setup or clean-up assistance - Helper sets up or cleans up; patient completes activity. Helper assists only prior to or following the activity. 5 LA10073-7
Supervision or touching assistance - Helper provides verbal cues or touching/steadying assistance as patient completes activity. Assistance may be provided throughout the activity or intermittently. 4 LA11757-4
Partial/moderate assistance - Helper does less than half the effort. Helper lifts, holds or supports trunk or limbs, but provides less than half the effort. 3 LA10055-4
Substantial/maximal assistance – Helper does MORE THAN HALF the effort. Helper lifts or holds trunk or limbs and provides more than half the effort. 2 LA10090-1
Dependent - Helper does all of the effort. Patient does none of the effort to complete the task. 1 LA9964-3
Not attempted due to medical condition M LA10039-8
Not attempted due to safety concerns S LA10040-6
Task attempted but not completed A LA10092-7
Not applicable N LA4720-4
Patient refused P LA10058-8

Member of these Panels

LOINC Long Common Name
52745-7 Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Discharge
52743-2 Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Acute Care
52748-1 Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Home Health Admission
52746-5 Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Interim
52744-0 Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Admission

52657-4 Wheel 150 ft (45 m)

Term Description

Once sitting, can wheel at least 150 feet (45 meters) in corridor or similar space.
Source: Regenstrief LOINC

Observation ID in Form

B5b.1

Fully-Specified Name

Component
Wheel 150 ft (45 m) during 2D assessment period
Property
Find
Time
2D
System
^Patient
Scale
Ord
Method
CARE

Basic Attributes

Class
SURVEY.CARE
Type
Surveys
First Released
Version 2.26
Last Updated
Version 2.54

Normative Answer List LL586-9

Answer Code Score Answer ID
Independent - Patient completes the activity by themself with no assistance from a helper. 6 LA9983-3
Setup or clean-up assistance - Helper sets up or cleans up; patient completes activity. Helper assists only prior to or following the activity. 5 LA10073-7
Supervision or touching assistance - Helper provides verbal cues or touching/steadying assistance as patient completes activity. Assistance may be provided throughout the activity or intermittently. 4 LA11757-4
Partial/moderate assistance - Helper does less than half the effort. Helper lifts, holds or supports trunk or limbs, but provides less than half the effort. 3 LA10055-4
Substantial/maximal assistance – Helper does MORE THAN HALF the effort. Helper lifts or holds trunk or limbs and provides more than half the effort. 2 LA10090-1
Dependent - Helper does all of the effort. Patient does none of the effort to complete the task. 1 LA9964-3
Not attempted due to medical condition M LA10039-8
Not attempted due to safety concerns S LA10040-6
Task attempted but not completed A LA10092-7
Not applicable N LA4720-4
Patient refused P LA10058-8

Member of these Panels

LOINC Long Common Name
76464-7 American Physical Therapy Association registry panel
52745-7 Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Discharge
52743-2 Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Acute Care
52748-1 Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Home Health Admission
52746-5 Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Interim
52744-0 Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Admission

52658-2 Wheel 100 ft (30 m)

Term Description

Once sitting, can wheel at least 100 feet (30 meters) in corridor or similar space.
Source: Regenstrief LOINC

Observation ID in Form

B5b.2

Fully-Specified Name

Component
Wheel 100 ft (30 m) during 2D assessment period
Property
Find
Time
2D
System
^Patient
Scale
Ord
Method
CARE

Basic Attributes

Class
SURVEY.CARE
Type
Surveys
First Released
Version 2.26
Last Updated
Version 2.54

Normative Answer List LL586-9

Answer Code Score Answer ID
Independent - Patient completes the activity by themself with no assistance from a helper. 6 LA9983-3
Setup or clean-up assistance - Helper sets up or cleans up; patient completes activity. Helper assists only prior to or following the activity. 5 LA10073-7
Supervision or touching assistance - Helper provides verbal cues or touching/steadying assistance as patient completes activity. Assistance may be provided throughout the activity or intermittently. 4 LA11757-4
Partial/moderate assistance - Helper does less than half the effort. Helper lifts, holds or supports trunk or limbs, but provides less than half the effort. 3 LA10055-4
Substantial/maximal assistance – Helper does MORE THAN HALF the effort. Helper lifts or holds trunk or limbs and provides more than half the effort. 2 LA10090-1
Dependent - Helper does all of the effort. Patient does none of the effort to complete the task. 1 LA9964-3
Not attempted due to medical condition M LA10039-8
Not attempted due to safety concerns S LA10040-6
Task attempted but not completed A LA10092-7
Not applicable N LA4720-4
Patient refused P LA10058-8

Member of these Panels

LOINC Long Common Name
76464-7 American Physical Therapy Association registry panel
52745-7 Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Discharge
52743-2 Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Acute Care
52748-1 Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Home Health Admission
52746-5 Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Interim
52744-0 Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Admission

52659-0 Wheel 50 ft (15 m)

Term Description

Once sitting, can wheel at least 50 feet (15 meters) in corridor or similar space.
Source: Regenstrief LOINC

Observation ID in Form

B5b.3

Fully-Specified Name

Component
Wheel 50 ft (15 m) during 2D assessment period
Property
Find
Time
2D
System
^Patient
Scale
Ord
Method
CARE

Basic Attributes

Class
SURVEY.CARE
Type
Surveys
First Released
Version 2.26
Last Updated
Version 2.54

Normative Answer List LL586-9

Answer Code Score Answer ID
Independent - Patient completes the activity by themself with no assistance from a helper. 6 LA9983-3
Setup or clean-up assistance - Helper sets up or cleans up; patient completes activity. Helper assists only prior to or following the activity. 5 LA10073-7
Supervision or touching assistance - Helper provides verbal cues or touching/steadying assistance as patient completes activity. Assistance may be provided throughout the activity or intermittently. 4 LA11757-4
Partial/moderate assistance - Helper does less than half the effort. Helper lifts, holds or supports trunk or limbs, but provides less than half the effort. 3 LA10055-4
Substantial/maximal assistance – Helper does MORE THAN HALF the effort. Helper lifts or holds trunk or limbs and provides more than half the effort. 2 LA10090-1
Dependent - Helper does all of the effort. Patient does none of the effort to complete the task. 1 LA9964-3
Not attempted due to medical condition M LA10039-8
Not attempted due to safety concerns S LA10040-6
Task attempted but not completed A LA10092-7
Not applicable N LA4720-4
Patient refused P LA10058-8

Member of these Panels

LOINC Long Common Name
76464-7 American Physical Therapy Association registry panel
52745-7 Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Discharge
52743-2 Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Acute Care
52748-1 Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Home Health Admission
52746-5 Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Interim
52744-0 Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Admission

52660-8 Wheel in Room Once Seated

Term Description

Once seated, can wheel at least 10 feet (3 meters) in room, corridor, or similar space.
Source: Regenstrief LOINC

Observation ID in Form

B5b.4

Fully-Specified Name

Component
Wheel 10 ft (3 m) during 2D assessment period
Property
Find
Time
2D
System
^Patient
Scale
Ord
Method
CARE

Basic Attributes

Class
SURVEY.CARE
Type
Surveys
First Released
Version 2.26
Last Updated
Version 2.54

Normative Answer List LL586-9

Answer Code Score Answer ID
Independent - Patient completes the activity by themself with no assistance from a helper. 6 LA9983-3
Setup or clean-up assistance - Helper sets up or cleans up; patient completes activity. Helper assists only prior to or following the activity. 5 LA10073-7
Supervision or touching assistance - Helper provides verbal cues or touching/steadying assistance as patient completes activity. Assistance may be provided throughout the activity or intermittently. 4 LA11757-4
Partial/moderate assistance - Helper does less than half the effort. Helper lifts, holds or supports trunk or limbs, but provides less than half the effort. 3 LA10055-4
Substantial/maximal assistance – Helper does MORE THAN HALF the effort. Helper lifts or holds trunk or limbs and provides more than half the effort. 2 LA10090-1
Dependent - Helper does all of the effort. Patient does none of the effort to complete the task. 1 LA9964-3
Not attempted due to medical condition M LA10039-8
Not attempted due to safety concerns S LA10040-6
Task attempted but not completed A LA10092-7
Not applicable N LA4720-4
Patient refused P LA10058-8

Member of these Panels

LOINC Long Common Name
76464-7 American Physical Therapy Association registry panel
52745-7 Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Discharge
52743-2 Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Acute Care
52748-1 Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Home Health Admission
52746-5 Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Interim
52744-0 Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Admission