52537-8
Pre-admission Service Use
Discouraged
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
Long Common Name
Admitted from Facility [CARE]
Basic Attributes
- Class
- SURVEY.CARE
- Type
- Surveys
- First Released
- Version 2.27
- Last Updated
- Version 2.64 (MIN)
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
A1_9
Fully-Specified Name
- Component
- Admitted from.other specified
- Property
- Type
- Time
- Pt
- System
- Facility
- Scale
- Nom
- Method
- CARE
Long Common Name
Admitted from.other specified Facility [CARE]
Basic Attributes
- Class
- SURVEY.CARE
- Type
- Surveys
- First Released
- Version 2.27
- Last Updated
- Version 2.64 (MIN)
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
Long Common Name
Primary diagnosis code from previous setting [CARE]
Basic Attributes
- Class
- SURVEY.CARE
- Type
- Surveys
- First Released
- Version 2.27
- Last Updated
- Version 2.64 (MIN)
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
Long Common Name
Medical services received in the last 2 months [CARE]
Basic Attributes
- Class
- SURVEY.CARE
- Type
- Surveys
- First Released
- Version 2.27
- Last Updated
- Version 2.64 (MIN)
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 |
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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
Long Common Name
Within this acute care hospital stay, on what other units has the patient been treated prior to coming to this unit [CARE]
Basic Attributes
- Class
- SURVEY.CARE
- Type
- Surveys
- First Released
- Version 2.40
- Last Updated
- Version 2.64 (MIN)
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 |