52536-0
Admission Information
Discouraged
52537-8 Pre-admission Service Use
Observation ID in Form
A
Fully-Specified Name
- Component
- Pre-admission Service Use
- Property
- -
- Time
- Pt
- System
- ^Patient
- Scale
- -
- Method
Basic Attributes
- Class
- SURVEY.CARE
- Type
- Surveys
- First Released
- Version 2.27
- Last Updated
- Version 2.64
- Panel Type
- Panel
Member of these Panels
LOINC | Long Common Name |
---|---|
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 |
52744-0 | Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Admission |
52722-6 Admitted From. Immediately preceding this admission, where was the patient?
Observation ID in Form
A1
Form Coding Instructions
If transferring within units of an acute setting, choose Other and indicate if transferring to ICU, stepdown, med/surg, or other unit
Source: Regenstrief HelpFully-Specified Name
- Component
- Admitted from
- Property
- Type
- Time
- Pt
- System
- Facility
- Scale
- Nom
- Method
- CARE
Basic Attributes
- Class
- SURVEY.CARE
- Type
- Surveys
- First Released
- Version 2.27
- Last Updated
- Version 2.64
Survey Question
- Text
- Admitted From. Immediately preceding this admission, where was the patient?
- Source
- CARE I.a02
Normative Answer List LL730-3
Answer | Code | Score | Answer ID |
---|---|---|---|
Community residential setting (e.g., private home, assisted living, group home, adult foster care) | 1 | LA11501-6 | |
Long-term nursing facility | 2 | LA11502-4 | |
Skilled nursing facility (SNF/TCU) | 3 | LA10080-2 | |
Hospital emergency department | 4 | LA11504-0 | |
Short-stay acute hospital (IPPS) | 5 | LA10078-6 | |
Long-Term Care Hospital (LTCH) | 6 | LA10000-0 | |
Inpatient rehabilitation hospital or unit (IRF) | 7 | LA9986-6 | |
Psychiatric hospital or unit | 8 | LA10065-3 | |
Other (specify) | 9 | LA6310-2 |
Member of these Panels
LOINC | Long Common Name |
---|---|
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 |
69412-5 | Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Long term care hospital (LTCH) - version 1.0 |
52744-0 | Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Admission |
52723-4 Other (specify)
Observation ID in Form
A19
Fully-Specified Name
- Component
- Admitted from.other specified
- Property
- Type
- Time
- Pt
- System
- Facility
- Scale
- Nom
- Method
- CARE
Basic Attributes
- Class
- SURVEY.CARE
- Type
- Surveys
- First Released
- Version 2.27
- Last Updated
- Version 2.64
Member of these Panels
LOINC | Long Common Name |
---|---|
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 |
69412-5 | Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Long term care hospital (LTCH) - version 1.0 |
52744-0 | Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Admission |
52724-2 If admitted from a medical setting, what was the primary diagnosis being treated in the previous setting?
Observation ID in Form
A2a
Fully-Specified Name
- Component
- Primary diagnosis code from previous setting
- Property
- Prid
- Time
- Pt
- System
- ^Patient
- Scale
- Nom
- Method
- CARE
Basic Attributes
- Class
- SURVEY.CARE
- Type
- Surveys
- First Released
- Version 2.27
- Last Updated
- Version 2.64
Survey Question
- Text
- If admitted from a medical setting, what was the primary diagnosis being treated in the previous setting?
- Source
- CARE I.a03
Member of these Panels
LOINC | Long Common Name |
---|---|
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 |
69412-5 | Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Long term care hospital (LTCH) - version 1.0 |
52744-0 | Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Admission |
52725-9 In the last 2 months, what medical services other than those identified in A1. has the patient received?
Observation ID in Form
A3
Form Coding Instructions
Check all that apply
Source: Centers for Medicare & Medicaid ServicesForm Coding Instructions
Check all that apply
Source: Centers for Medicare & Medicaid ServicesFully-Specified Name
- Component
- Medical services received in the last 2Mo
- Property
- Find
- Time
- 2Mo
- System
- ^Patient
- Scale
- Nom
- Method
- CARE
Basic Attributes
- Class
- SURVEY.CARE
- Type
- Surveys
- First Released
- Version 2.27
- Last Updated
- Version 2.64
Survey Question
- Text
- In the last 2 months, what medical services other than those identified in A1. has the patient received?
- Source
- CARE I.A4
Normative Answer List LL722-0
Answer | Code | Score | Answer ID |
---|---|---|---|
Skilled nursing facility (SNF/TCU) | a | LA10080-2 | |
Short-stay acute hospital (IPPS) | b | LA10078-6 | |
Long-Term Care Hospital (LTCH) | c | LA10000-0 | |
Inpatient rehabilitation hospital or unit (IRF) | d | LA9986-6 | |
Psychiatric hospital or unit | e | LA10065-3 | |
Home Health Care (HHA) | f | LA9978-3 | |
Hospice | g | LA6216-1 | |
Outpatient Services | h | LA10053-9 | |
None Copyright http://snomed.info/sct ID:260413007 None (qualifier value) | i | LA137-2 |
Member of these Panels
LOINC | Long Common Name |
---|---|
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 |
52744-0 | Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Admission |
Third Party Copyright
This material includes SNOMED Clinical Terms® (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO) under license. All rights reserved. SNOMED CT® was originally created by The College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHTSDO.
This material includes content from the US Edition to SNOMED CT, which is developed and maintained by the U.S. National Library of Medicine and is available to authorized UMLS Metathesaurus Licensees from the UTS Downloads site at https://uts.nlm.nih.gov.
Use of SNOMED CT content is subject to the terms and conditions set forth in the SNOMED CT Affiliate License Agreement. It is the responsibility of those implementing this product to ensure they are appropriately licensed and for more information on the license, including how to register as an Affiliate Licensee, please refer to http://www.snomed.org/snomed-ct/get-snomed-ct or info@snomed.org<mailto:info@snomed.org>. This may incur a fee in SNOMED International non-Member countries.
70129-2 Within this acute care hospital stay, on what other units has the patient been treated prior to coming to this unit?
Form Coding Instructions
Check all that apply
Source: Centers for Medicare & Medicaid ServicesFully-Specified Name
- Component
- Within this acute care hospital stay, on what other units has the patient been treated prior to coming to this unit
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Ord
- Method
- CARE
Basic Attributes
- Class
- SURVEY.CARE
- Type
- Surveys
- First Released
- Version 2.40
- Last Updated
- Version 2.64
Survey Question
- Text
- Within this acute care hospital stay, on what other units has the patient been treated prior to coming to this unit?
- Source
- A4
Normative Answer List LL2016-5
Answer | Code | Score | Answer ID |
---|---|---|---|
Critical care/intensive care unit - 1-2 pts per nurse | a | LA18414-5 | |
Step-down/intermediate unit - 3-6 pts per nurse | b | LA18415-2 | |
General/medical unit or floor - 6 or more pts per nurse | c | LA18416-0 | |
No previous units or not applicable | d | LA18417-8 |
Member of these Panels
LOINC | Long Common Name |
---|---|
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 |
52744-0 | Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Admission |
52538-6 Patient History Prior to this Current Illness, Exacerbation, or Injury
Observation ID in Form
B
Fully-Specified Name
- Component
- Patient History Prior to this Current Illness, Exacerbation, or Injury
- Property
- -
- Time
- Pt
- System
- ^Patient
- Scale
- -
- Method
Basic Attributes
- Class
- SURVEY.CARE
- Type
- Surveys
- First Released
- Version 2.27
- Last Updated
- Version 2.64
- Panel Type
- Panel
Member of these Panels
LOINC | Long Common Name |
---|---|
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 |
52744-0 | Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Admission |
52726-7 Prior to this recent illness, where did the patient live?
Observation ID in Form
B1
Skip Logic
If permanently in long-term care, skip to B5. Prior Functioning. If Other, skip to B5. Prior Functioning. If Unknown, skip to B5. Prior Functioning.
Fully-Specified Name
- Component
- Prior residence
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Nom
- Method
- CARE
Basic Attributes
- Class
- SURVEY.CARE
- Type
- Surveys
- First Released
- Version 2.27
- Last Updated
- Version 2.64
Survey Question
- Text
- Prior to this recent illness, where did the patient live?
- Source
- CARE I.b01
Normative Answer List LL545-5
Answer | Code | Score | Answer ID |
---|---|---|---|
Private residence | 1 | LA10062-0 | |
Community based residence (e.g., assisted living residence, group home, adult foster care) | 2 | LA9951-0 | |
Long-term care facility (e.g., nursing home) | 3 | LA11521-4 | |
Other (e.g., shelter, jail, no known address) | 4 | LA10047-1 | |
Unknown Copyright http://snomed.info/sct ID:261665006 Unknown (qualifier value) | 9 | LA4489-6 |
Member of these Panels
LOINC | Long Common Name |
---|---|
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 |
52744-0 | Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Admission |
Third Party Copyright
This material includes SNOMED Clinical Terms® (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO) under license. All rights reserved. SNOMED CT® was originally created by The College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHTSDO.
This material includes content from the US Edition to SNOMED CT, which is developed and maintained by the U.S. National Library of Medicine and is available to authorized UMLS Metathesaurus Licensees from the UTS Downloads site at https://uts.nlm.nih.gov.
Use of SNOMED CT content is subject to the terms and conditions set forth in the SNOMED CT Affiliate License Agreement. It is the responsibility of those implementing this product to ensure they are appropriately licensed and for more information on the license, including how to register as an Affiliate Licensee, please refer to http://www.snomed.org/snomed-ct/get-snomed-ct or info@snomed.org<mailto:info@snomed.org>. This may incur a fee in SNOMED International non-Member countries.
52539-4 If the patient lived in the community prior to this illness, provide the patient's zip code (if the patient 's residence was in U.S.).
Observation ID in Form
B2
Fully-Specified Name
- Component
- Prior postal code
- Property
- Loc
- Time
- Pt
- System
- ^Patient
- Scale
- Nom
- Method
Additional Names
- Short Name
- Prior postal code
Basic Attributes
- Class
- ADMIN.PATIENT.DEMOG
- Type
- Clinical
- First Released
- Version 2.26
- Last Updated
- Version 2.66
- Change Reason
- Updated Class from SURVEY.CARE to ADMIN; Updated "ZIP code" in Component name to "Postal code", the more universal nomenclature for this concept.
- Order vs. Observation
- Both
Member of these Panels
LOINC | Long Common Name |
---|---|
103991-6 | CMS - Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 4.2 during assessment period [CMS Assessment] |
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 |
52744-0 | Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Admission |
83265-9 | Deprecated Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 1.4 [CMS Assessment] |
87414-9 | Deprecated Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 1.5 [CMS Assessment] |
88329-8 | Deprecated Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 2.0 [CMS Assessment] |
45969-3 | Deprecated MDS background information at admission form - version 2.0 |
89963-3 | Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 3.0 during assessment period [CMS Assessment] |
93128-7 | Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 4.0 during assessment period [CMS Assessment] |
Language Variants Get Info
Tag | Language | Translation |
---|---|---|
es-MX | Spanish (Mexico) | Código postal anterior: |
it-IT | Italian (Italy) | Codice postale precedente: Synonyms: Amministrativo CAP Dati demografici del paziente Paziente Posizione Punto nel tempo (episodio) |
zh-CN | Chinese (China) | 既往邮政编码: Synonyms: 分类型应答; |
52727-5 Lives outside U.S.
Observation ID in Form
B2a
Fully-Specified Name
- Component
- Lives outside U.S.
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Ord
- Method
Basic Attributes
- Class
- SURVEY.CARE
- Type
- Surveys
- First Released
- Version 2.27
- Last Updated
- Version 2.64
- Change Reason
- Method removed and Answer List Type changed to Example because this generic term can be used across contexts
Example 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 |
---|---|
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 |
52744-0 | Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Admission |
Third Party Copyright
This material includes SNOMED Clinical Terms® (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO) under license. All rights reserved. SNOMED CT® was originally created by The College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHTSDO.
This material includes content from the US Edition to SNOMED CT, which is developed and maintained by the U.S. National Library of Medicine and is available to authorized UMLS Metathesaurus Licensees from the UTS Downloads site at https://uts.nlm.nih.gov.
Use of SNOMED CT content is subject to the terms and conditions set forth in the SNOMED CT Affiliate License Agreement. It is the responsibility of those implementing this product to ensure they are appropriately licensed and for more information on the license, including how to register as an Affiliate Licensee, please refer to http://www.snomed.org/snomed-ct/get-snomed-ct or info@snomed.org<mailto:info@snomed.org>. This may incur a fee in SNOMED International non-Member countries.
52540-2 ZIP Code unknown
Observation ID in Form
B2b
Fully-Specified Name
- Component
- ZIP Code unknown
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Ord
- Method
Basic Attributes
- Class
- SURVEY.CARE
- Type
- Surveys
- First Released
- Version 2.27
- Last Updated
- Version 2.64
- Change Reason
- Release 2.73: COMPONENT: Z-I-P and C in code should be capitalized; Previous Releases: Method removed and Answer List Type changed to Example because this generic term can be used across contexts
Example 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 |
---|---|
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 |
52744-0 | Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Admission |
Third Party Copyright
This material includes SNOMED Clinical Terms® (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO) under license. All rights reserved. SNOMED CT® was originally created by The College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHTSDO.
This material includes content from the US Edition to SNOMED CT, which is developed and maintained by the U.S. National Library of Medicine and is available to authorized UMLS Metathesaurus Licensees from the UTS Downloads site at https://uts.nlm.nih.gov.
Use of SNOMED CT content is subject to the terms and conditions set forth in the SNOMED CT Affiliate License Agreement. It is the responsibility of those implementing this product to ensure they are appropriately licensed and for more information on the license, including how to register as an Affiliate Licensee, please refer to http://www.snomed.org/snomed-ct/get-snomed-ct or info@snomed.org<mailto:info@snomed.org>. This may incur a fee in SNOMED International non-Member countries.
52541-0 If the patient lived in the community prior to this illness, what help was used?
Observation ID in Form
B3
Form Coding Instructions
Check all that apply
Source: Centers for Medicare & Medicaid ServicesFully-Specified Name
- Component
- Prior help
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Nom
- Method
- CARE
Basic Attributes
- Class
- SURVEY.CARE
- Type
- Surveys
- First Released
- Version 2.27
- Last Updated
- Version 2.64
Survey Question
- Text
- If the patient lived in the community prior to this illness, what help was used?
- Source
- CARE I.B3
Normative Answer List LL548-9
Answer | Code | Score | Answer ID |
---|---|---|---|
No help received or no help necessary | a | LA10022-4 | |
Unpaid Assistance | b | LA10111-5 | |
Paid Assistance | c | LA10054-7 | |
Unknown Copyright http://snomed.info/sct ID:261665006 Unknown (qualifier value) | d | LA4489-6 |
Member of these Panels
LOINC | Long Common Name |
---|---|
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 |
52744-0 | Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Admission |
Third Party Copyright
This material includes SNOMED Clinical Terms® (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO) under license. All rights reserved. SNOMED CT® was originally created by The College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHTSDO.
This material includes content from the US Edition to SNOMED CT, which is developed and maintained by the U.S. National Library of Medicine and is available to authorized UMLS Metathesaurus Licensees from the UTS Downloads site at https://uts.nlm.nih.gov.
Use of SNOMED CT content is subject to the terms and conditions set forth in the SNOMED CT Affiliate License Agreement. It is the responsibility of those implementing this product to ensure they are appropriately licensed and for more information on the license, including how to register as an Affiliate Licensee, please refer to http://www.snomed.org/snomed-ct/get-snomed-ct or info@snomed.org<mailto:info@snomed.org>. This may incur a fee in SNOMED International non-Member countries.
52542-8 If the patient lived in the community prior to this illness, who did the patient live with?
Observation ID in Form
B3a
Form Coding Instructions
Check all that apply
Source: Centers for Medicare & Medicaid ServicesFully-Specified Name
- Component
- Patient lived with prior to this illness
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Nom
- Method
- CARE
Basic Attributes
- Class
- SURVEY.CARE
- Type
- Surveys
- First Released
- Version 2.27
- Last Updated
- Version 2.64
Survey Question
- Text
- If the patient lived in the community prior to this illness, who did the patient live with?
- Source
- CARE I.B3a
Normative Answer List LL549-7
Answer | Code | Score | Answer ID |
---|---|---|---|
Lives alone | a | LA6255-9 | |
Lives with paid helper | b | LA9997-3 | |
Lives with other(s) | c | LA9996-5 | |
Unknown Copyright http://snomed.info/sct ID:261665006 Unknown (qualifier value) | d | LA4489-6 |
Member of these Panels
LOINC | Long Common Name |
---|---|
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 |
52744-0 | Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Admission |
Third Party Copyright
This material includes SNOMED Clinical Terms® (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO) under license. All rights reserved. SNOMED CT® was originally created by The College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHTSDO.
This material includes content from the US Edition to SNOMED CT, which is developed and maintained by the U.S. National Library of Medicine and is available to authorized UMLS Metathesaurus Licensees from the UTS Downloads site at https://uts.nlm.nih.gov.
Use of SNOMED CT content is subject to the terms and conditions set forth in the SNOMED CT Affiliate License Agreement. It is the responsibility of those implementing this product to ensure they are appropriately licensed and for more information on the license, including how to register as an Affiliate Licensee, please refer to http://www.snomed.org/snomed-ct/get-snomed-ct or info@snomed.org<mailto:info@snomed.org>. This may incur a fee in SNOMED International non-Member countries.
52543-6 If the patient lived in the community prior to this current illness, exacerbation, or injury, are there any structural barriers in the patient's prior residence that could interfere with the patient's discharge?
Observation ID in Form
B4
Form Coding Instructions
Check all that apply
Source: Centers for Medicare & Medicaid ServicesForm Coding Instructions
Check all that apply
Source: Centers for Medicare & Medicaid ServicesFully-Specified Name
- Component
- Structural barriers in prior residence that could interfere with the patient's discharge
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Nom
- Method
Basic Attributes
- Class
- SURVEY.CARE
- Type
- Surveys
- First Released
- Version 2.27
- Last Updated
- Version 2.64
- Change Reason
- Method removed and Answer List Type changed to Example because this generic term can be used across contexts
Survey Question
- Text
- If the patient lived in the community prior to this current illness, exacerbation, or injury, are there any structural barriers in the patient's prior residence that could interfere with the patient's discharge?
- Source
- CARE I.B4
Example Answer List LL550-5
Answer | Code | Score | Answer ID |
---|---|---|---|
Structural barriers are not an issue. | a | LA10089-3 | |
Stairs inside the living setting that must be used by patient (e.g., to get to toileting, sleeping, eating areas). | b | LA10086-9 | |
Stairs leading from inside to outside of living setting. | c | LA10087-7 | |
Narrow or obstructed doorways for patients using wheelchairs or walkers. | d | LA10016-6 | |
Insufficient space to accommodate extra equipment (e.g., hospital bed, vent equipment). | e | LA9987-4 | |
Other (specify) | f | LA6310-2 | |
Unknown Copyright http://snomed.info/sct ID:261665006 Unknown (qualifier value) | g | LA4489-6 |
Member of these Panels
LOINC | Long Common Name |
---|---|
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 |
52744-0 | Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Admission |
Third Party Copyright
This material includes SNOMED Clinical Terms® (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO) under license. All rights reserved. SNOMED CT® was originally created by The College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHTSDO.
This material includes content from the US Edition to SNOMED CT, which is developed and maintained by the U.S. National Library of Medicine and is available to authorized UMLS Metathesaurus Licensees from the UTS Downloads site at https://uts.nlm.nih.gov.
Use of SNOMED CT content is subject to the terms and conditions set forth in the SNOMED CT Affiliate License Agreement. It is the responsibility of those implementing this product to ensure they are appropriately licensed and for more information on the license, including how to register as an Affiliate Licensee, please refer to http://www.snomed.org/snomed-ct/get-snomed-ct or info@snomed.org<mailto:info@snomed.org>. This may incur a fee in SNOMED International non-Member countries.
52544-4 Other (specify)
Observation ID in Form
B4f
Fully-Specified Name
- Component
- Structural barrier.other specified
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Nom
- Method
- CARE
Basic Attributes
- Class
- SURVEY.CARE
- Type
- Surveys
- First Released
- Version 2.27
- Last Updated
- Version 2.64
Member of these Panels
LOINC | Long Common Name |
---|---|
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 |
52744-0 | Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Admission |
52449-6 Prior Functioning. Indicate the patient's usual ability with everyday activities prior to this current illness, exacerbation, or injury.
Observation ID in Form
B5
Form Coding Instructions
Indicate the patient's usual ability with everyday activities prior to this current illness, exacerbation, or injury. Check only one box in each row
Source: Centers for Medicare & Medicaid ServicesFully-Specified Name
- Component
- Prior Functioning
- Property
- -
- Time
- Pt
- System
- ^Patient
- Scale
- -
- Method
Basic Attributes
- Class
- SURVEY.CARE
- Type
- Surveys
- First Released
- Version 2.27
- Last Updated
- Version 2.64
- Panel Type
- Panel
Survey Question
- Text
- Prior Functioning. Indicate the patient's usual ability with everyday activities prior to this current illness, exacerbation, or injury.
- Source
- CARE I.B5
Member of these Panels
LOINC | Long Common Name |
---|---|
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 |
52744-0 | Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Admission |
52545-1 Self Care: Did the patient need help bathing, dressing, using the toilet, or eating?
Observation ID in Form
B5a
Fully-Specified Name
- Component
- Prior functioning.self care
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Ord
- Method
- CARE
Basic Attributes
- Class
- SURVEY.CARE
- Type
- Surveys
- First Released
- Version 2.27
- Last Updated
- Version 2.64
- Change Reason
- Edits made and then reverted
Survey Question
- Text
- Self Care: Did the patient need help bathing, dressing, using the toilet, or eating?
- Source
- CARE I.b05a
Normative Answer List LL546-3
Answer | Code | Score | Answer ID |
---|---|---|---|
Independent – Patient completed the activities by him/herself, with or without an assistive device, with no assistance from a helper. | 3 | LA9982-5 | |
Needed partial assistance – Patient needed partial assistance from another person to complete activities. | 2 | LA10018-2 | |
Dependent – A helper completed the activity for the patient. | 1 | LA9963-5 | |
Not applicable | 8 | LA4720-4 | |
Unknown Copyright http://snomed.info/sct ID:261665006 Unknown (qualifier value) | 9 | LA4489-6 |
Member of these Panels
LOINC | Long Common Name |
---|---|
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 |
52744-0 | Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Admission |
Third Party Copyright
This material includes SNOMED Clinical Terms® (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO) under license. All rights reserved. SNOMED CT® was originally created by The College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHTSDO.
This material includes content from the US Edition to SNOMED CT, which is developed and maintained by the U.S. National Library of Medicine and is available to authorized UMLS Metathesaurus Licensees from the UTS Downloads site at https://uts.nlm.nih.gov.
Use of SNOMED CT content is subject to the terms and conditions set forth in the SNOMED CT Affiliate License Agreement. It is the responsibility of those implementing this product to ensure they are appropriately licensed and for more information on the license, including how to register as an Affiliate Licensee, please refer to http://www.snomed.org/snomed-ct/get-snomed-ct or info@snomed.org<mailto:info@snomed.org>. This may incur a fee in SNOMED International non-Member countries.
52546-9 Indoor Mobility (Ambulation): Did the patient need assistance with walking from room to room (with or without devices such as cane, crutch, or walker)?
Observation ID in Form
B5b
Fully-Specified Name
- Component
- Prior functioning.mobility - ambulation
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Ord
- Method
- CARE
Basic Attributes
- Class
- SURVEY.CARE
- Type
- Surveys
- First Released
- Version 2.27
- Last Updated
- Version 2.64
- Change Reason
- Made edits and then reverted back
Survey Question
- Text
- Indoor Mobility (Ambulation): Did the patient need assistance with walking from room to room (with or without devices such as cane, crutch, or walker)?
- Source
- CARE I.b05b
Normative Answer List LL546-3
Answer | Code | Score | Answer ID |
---|---|---|---|
Independent – Patient completed the activities by him/herself, with or without an assistive device, with no assistance from a helper. | 3 | LA9982-5 | |
Needed partial assistance – Patient needed partial assistance from another person to complete activities. | 2 | LA10018-2 | |
Dependent – A helper completed the activity for the patient. | 1 | LA9963-5 | |
Not applicable | 8 | LA4720-4 | |
Unknown Copyright http://snomed.info/sct ID:261665006 Unknown (qualifier value) | 9 | LA4489-6 |
Member of these Panels
LOINC | Long Common Name |
---|---|
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 |
52744-0 | Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Admission |
Third Party Copyright
This material includes SNOMED Clinical Terms® (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO) under license. All rights reserved. SNOMED CT® was originally created by The College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHTSDO.
This material includes content from the US Edition to SNOMED CT, which is developed and maintained by the U.S. National Library of Medicine and is available to authorized UMLS Metathesaurus Licensees from the UTS Downloads site at https://uts.nlm.nih.gov.
Use of SNOMED CT content is subject to the terms and conditions set forth in the SNOMED CT Affiliate License Agreement. It is the responsibility of those implementing this product to ensure they are appropriately licensed and for more information on the license, including how to register as an Affiliate Licensee, please refer to http://www.snomed.org/snomed-ct/get-snomed-ct or info@snomed.org<mailto:info@snomed.org>. This may incur a fee in SNOMED International non-Member countries.
52547-7 Stairs (Ambulation): Did the patient need assistance with internal or external stairs (with or without devices such as cane, crutch, or walker)?
Observation ID in Form
B5c
Fully-Specified Name
- Component
- Prior functioning.stairs - ambulation
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Ord
- Method
- CARE
Basic Attributes
- Class
- SURVEY.CARE
- Type
- Surveys
- First Released
- Version 2.27
- Last Updated
- Version 2.64
- Change Reason
- Made edits and then reverted back
Survey Question
- Text
- Stairs (Ambulation): Did the patient need assistance with internal or external stairs (with or without devices such as cane, crutch, or walker)?
- Source
- CARE I.b05c
Normative Answer List LL546-3
Answer | Code | Score | Answer ID |
---|---|---|---|
Independent – Patient completed the activities by him/herself, with or without an assistive device, with no assistance from a helper. | 3 | LA9982-5 | |
Needed partial assistance – Patient needed partial assistance from another person to complete activities. | 2 | LA10018-2 | |
Dependent – A helper completed the activity for the patient. | 1 | LA9963-5 | |
Not applicable | 8 | LA4720-4 | |
Unknown Copyright http://snomed.info/sct ID:261665006 Unknown (qualifier value) | 9 | LA4489-6 |
Member of these Panels
LOINC | Long Common Name |
---|---|
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 |
52744-0 | Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Admission |
Third Party Copyright
This material includes SNOMED Clinical Terms® (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO) under license. All rights reserved. SNOMED CT® was originally created by The College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHTSDO.
This material includes content from the US Edition to SNOMED CT, which is developed and maintained by the U.S. National Library of Medicine and is available to authorized UMLS Metathesaurus Licensees from the UTS Downloads site at https://uts.nlm.nih.gov.
Use of SNOMED CT content is subject to the terms and conditions set forth in the SNOMED CT Affiliate License Agreement. It is the responsibility of those implementing this product to ensure they are appropriately licensed and for more information on the license, including how to register as an Affiliate Licensee, please refer to http://www.snomed.org/snomed-ct/get-snomed-ct or info@snomed.org<mailto:info@snomed.org>. This may incur a fee in SNOMED International non-Member countries.
52548-5 Indoor Mobility (Wheelchair): Did the patient need assistance with moving from room to room using a wheelchair, scooter, or other wheeled mobility device?
Observation ID in Form
B5d
Fully-Specified Name
- Component
- Prior functioning.mobility - wheelchair
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Ord
- Method
- CARE
Basic Attributes
- Class
- SURVEY.CARE
- Type
- Surveys
- First Released
- Version 2.27
- Last Updated
- Version 2.64
Survey Question
- Text
- Indoor Mobility (Wheelchair): Did the patient need assistance with moving from room to room using a wheelchair, scooter, or other wheeled mobility device?
- Source
- CARE I.b05d
Normative Answer List LL546-3
Answer | Code | Score | Answer ID |
---|---|---|---|
Independent – Patient completed the activities by him/herself, with or without an assistive device, with no assistance from a helper. | 3 | LA9982-5 | |
Needed partial assistance – Patient needed partial assistance from another person to complete activities. | 2 | LA10018-2 | |
Dependent – A helper completed the activity for the patient. | 1 | LA9963-5 | |
Not applicable | 8 | LA4720-4 | |
Unknown Copyright http://snomed.info/sct ID:261665006 Unknown (qualifier value) | 9 | LA4489-6 |
Member of these Panels
LOINC | Long Common Name |
---|---|
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 |
52744-0 | Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Admission |
Third Party Copyright
This material includes SNOMED Clinical Terms® (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO) under license. All rights reserved. SNOMED CT® was originally created by The College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHTSDO.
This material includes content from the US Edition to SNOMED CT, which is developed and maintained by the U.S. National Library of Medicine and is available to authorized UMLS Metathesaurus Licensees from the UTS Downloads site at https://uts.nlm.nih.gov.
Use of SNOMED CT content is subject to the terms and conditions set forth in the SNOMED CT Affiliate License Agreement. It is the responsibility of those implementing this product to ensure they are appropriately licensed and for more information on the license, including how to register as an Affiliate Licensee, please refer to http://www.snomed.org/snomed-ct/get-snomed-ct or info@snomed.org<mailto:info@snomed.org>. This may incur a fee in SNOMED International non-Member countries.
52549-3 Functional Cognition: Did the patient need help planning regular tasks, such as shopping or remembering to take medication?
Observation ID in Form
B5e
Fully-Specified Name
- Component
- Prior functioning.functional cognition
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Ord
- Method
- CARE
Basic Attributes
- Class
- SURVEY.CARE
- Type
- Surveys
- First Released
- Version 2.27
- Last Updated
- Version 2.64
- Change Reason
- Made edits and then reverted back
Survey Question
- Text
- Functional Cognition: Did the patient need help planning regular tasks, such as shopping or remembering to take medication?
- Source
- CARE I.b05e
Normative Answer List LL546-3
Answer | Code | Score | Answer ID |
---|---|---|---|
Independent – Patient completed the activities by him/herself, with or without an assistive device, with no assistance from a helper. | 3 | LA9982-5 | |
Needed partial assistance – Patient needed partial assistance from another person to complete activities. | 2 | LA10018-2 | |
Dependent – A helper completed the activity for the patient. | 1 | LA9963-5 | |
Not applicable | 8 | LA4720-4 | |
Unknown Copyright http://snomed.info/sct ID:261665006 Unknown (qualifier value) | 9 | LA4489-6 |
Member of these Panels
LOINC | Long Common Name |
---|---|
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 |
52744-0 | Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Admission |
Third Party Copyright
This material includes SNOMED Clinical Terms® (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO) under license. All rights reserved. SNOMED CT® was originally created by The College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHTSDO.
This material includes content from the US Edition to SNOMED CT, which is developed and maintained by the U.S. National Library of Medicine and is available to authorized UMLS Metathesaurus Licensees from the UTS Downloads site at https://uts.nlm.nih.gov.
Use of SNOMED CT content is subject to the terms and conditions set forth in the SNOMED CT Affiliate License Agreement. It is the responsibility of those implementing this product to ensure they are appropriately licensed and for more information on the license, including how to register as an Affiliate Licensee, please refer to http://www.snomed.org/snomed-ct/get-snomed-ct or info@snomed.org<mailto:info@snomed.org>. This may incur a fee in SNOMED International non-Member countries.
52550-1 Mobility devices and aids used prior to current illness, exacerbation, or injury [CARE]
Observation ID in Form
B6
Form Coding Instructions
Check all that apply
Source: Centers for Medicare & Medicaid ServicesFully-Specified Name
- Component
- Mobility devices and aids used prior to current illness, exacerbation, or injury
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Nom
- Method
- CARE
Basic Attributes
- Class
- SURVEY.CARE
- Type
- Surveys
- First Released
- Version 2.27
- Last Updated
- Version 2.64
Normative Answer List LL551-3
Answer | Code | Score | Answer ID |
---|---|---|---|
Cane/crutch | a | LA9941-1 | |
Walker | b | LA10117-2 | |
Orthotics/Prosthetics | c | LA10046-3 | |
Wheelchair/scooter full time | d | LA10119-8 | |
Wheelchair/scooter part time | e | LA10120-6 | |
Mechanical lift required | f | LA10003-4 | |
Other (specify) | g | LA6310-2 | |
None apply | h | LA10029-9 | |
Unknown Copyright http://snomed.info/sct ID:261665006 Unknown (qualifier value) | i | LA4489-6 |
Member of these Panels
LOINC | Long Common Name |
---|---|
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 |
52744-0 | Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Admission |
Third Party Copyright
This material includes SNOMED Clinical Terms® (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO) under license. All rights reserved. SNOMED CT® was originally created by The College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHTSDO.
This material includes content from the US Edition to SNOMED CT, which is developed and maintained by the U.S. National Library of Medicine and is available to authorized UMLS Metathesaurus Licensees from the UTS Downloads site at https://uts.nlm.nih.gov.
Use of SNOMED CT content is subject to the terms and conditions set forth in the SNOMED CT Affiliate License Agreement. It is the responsibility of those implementing this product to ensure they are appropriately licensed and for more information on the license, including how to register as an Affiliate Licensee, please refer to http://www.snomed.org/snomed-ct/get-snomed-ct or info@snomed.org<mailto:info@snomed.org>. This may incur a fee in SNOMED International non-Member countries.
52551-9 Other (specify)
Observation ID in Form
B6g
Fully-Specified Name
- Component
- Prior mobility device.other specified
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Nom
- Method
- CARE
Basic Attributes
- Class
- SURVEY.CARE
- Type
- Surveys
- First Released
- Version 2.27
- Last Updated
- Version 2.64
Member of these Panels
LOINC | Long Common Name |
---|---|
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 |
52744-0 | Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Admission |
52552-7 Falls in the past year
Observation ID in Form
B7
Fully-Specified Name
- Component
- Falls in the past Y
- Property
- Hx
- Time
- 1Y
- System
- ^Patient
- Scale
- Ord
- Method
Basic Attributes
- Class
- SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.27
- Last Updated
- Version 2.70
- Change Reason
- Release 2.70: METHOD_TYP: General concept not specific to CMS; Previous Releases: Changed Component from "History of falls in the past year" to "Falls in the past Y" and Property from "Find" to "Hx" based on current LOINC model.
- Order vs. Observation
- Observation
Normative Answer List LL208-0
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 | |
Unknown Copyright http://snomed.info/sct ID:261665006 Unknown (qualifier value) | 9 | LA4489-6 |
Member of these Panels
LOINC | Long Common Name |
---|---|
103991-6 | CMS - Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 4.2 during assessment period [CMS Assessment] |
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 |
52744-0 | Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Post Acute Care (PAC) - Admission |
83265-9 | Deprecated Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 1.4 [CMS Assessment] |
87414-9 | Deprecated Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 1.5 [CMS Assessment] |
88329-8 | Deprecated Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 2.0 [CMS Assessment] |
89963-3 | Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 3.0 during assessment period [CMS Assessment] |
93128-7 | Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 4.0 during assessment period [CMS Assessment] |
97874-2 | Stay Independent panel [Stay Independent] |
Third Party Copyright
This material includes SNOMED Clinical Terms® (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO) under license. All rights reserved. SNOMED CT® was originally created by The College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHTSDO.
This material includes content from the US Edition to SNOMED CT, which is developed and maintained by the U.S. National Library of Medicine and is available to authorized UMLS Metathesaurus Licensees from the UTS Downloads site at https://uts.nlm.nih.gov.
Use of SNOMED CT content is subject to the terms and conditions set forth in the SNOMED CT Affiliate License Agreement. It is the responsibility of those implementing this product to ensure they are appropriately licensed and for more information on the license, including how to register as an Affiliate Licensee, please refer to http://www.snomed.org/snomed-ct/get-snomed-ct or info@snomed.org<mailto:info@snomed.org>. This may incur a fee in SNOMED International non-Member countries.