54519-4
Interview for Daily Preferences
Active
Form Coding Instructions
Show resident the response options and say: "While you are in this facility…"
Source: Centers for Medicare & Medicaid Services54698-6 While you are in this facility how important is it to you to choose what clothes to wear?
Observation ID in Form
F0400A
Fully-Specified Name
- Component
- How important it is to choose what clothes to wear while in this facility
- Property
- Find
- Time
- RptPeriod
- System
- ^Patient
- Scale
- Ord
- Method
- CMS Assessment
Long Common Name
How important it is to choose what clothes to wear while in this facility during assessment period [CMS Assessment]
Basic Attributes
- Class
- SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.27
- Last Updated
- Version 2.77 (MAJ)
- Change Reason
- Release 2.77: TIME_ASPCT: Decision by CMS to update the Timing to RptPeriod from Pt for all CMS Assessments; Previous Releases: Updated METHOD to CMS Assessment to use term across CMS instruments as approved by the Clinical LOINC committee; Changed CLASS from SURVEY.MDS to SURVEY.CMS because term is used across CMS assessments. Moved Survey Question text to Display Name for Form for consistent modeling across CMS forms.
- Order vs. Observation
- Observation
Normative Answer List LL659-4
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Very important | 1 | LA11013-2 | |
| Somewhat important | 2 | LA11014-0 | |
| Not very important | 3 | LA11015-7 | |
| Not important at all | 4 | LA11016-5 | |
| Important, but can't do or no choice | 5 | LA11017-3 | |
| No response or non-responsive | 9 | LA11018-1 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 86522-0 | Deprecated MDS v3.0 - RAI v1.14.1 - Nursing home comprehensive (NC) item set [CMS Assessment] |
| 88282-9 | Deprecated MDS v3.0 - RAI v1.15.1 - Nursing home comprehensive (NC) item set [CMS Assessment] |
| 88954-3 | Deprecated MDS v3.0 - RAI v1.16.1 - Nursing home comprehensive (NC) item set [CMS Assessment] |
| 90473-0 | Deprecated MDS v3.0 - RAI v1.17.1, 1.17.2 - Nursing home comprehensive (NC) item set during assessment period [CMS Assessment] |
| 54580-6 | Deprecated Minimum Data Set - version 3.0 |
| 103564-1 | MDS v3.0 - RAI v1.19.1 - Nursing home comprehensive (NC) item set during assessment period [CMS Assessment] |
| 108256-9 | Minimum Data Set (MDS) - version 3.0 - Resident Assessment Instrument (RAI) version 1.20.1 during assessment period [CMS Assessment] |
| 100997-6 | Respiratory Allergen Panel, Area 5 - Serum |
54699-4 While you are in this facility how important is it to you to take care of your personal belongings or things?
Observation ID in Form
F0400B
Fully-Specified Name
- Component
- How important it is to take care of your personal belongings or things while in this facility
- Property
- Find
- Time
- RptPeriod
- System
- ^Patient
- Scale
- Ord
- Method
- CMS Assessment
Long Common Name
How important it is to take care of your personal belongings or things while in this facility during assessment period [CMS Assessment]
Basic Attributes
- Class
- SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.27
- Last Updated
- Version 2.77 (MAJ)
- Change Reason
- Release 2.77: TIME_ASPCT: Decision by CMS to update the Timing to RptPeriod from Pt for all CMS Assessments; Previous Releases: Updated METHOD to CMS Assessment to use term across CMS instruments as approved by the Clinical LOINC committee; Changed CLASS from SURVEY.MDS to SURVEY.CMS because term is used across CMS assessments. Moved Survey Question text to Display Name for Form for consistent modeling across CMS forms.
- Order vs. Observation
- Observation
Normative Answer List LL659-4
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Very important | 1 | LA11013-2 | |
| Somewhat important | 2 | LA11014-0 | |
| Not very important | 3 | LA11015-7 | |
| Not important at all | 4 | LA11016-5 | |
| Important, but can't do or no choice | 5 | LA11017-3 | |
| No response or non-responsive | 9 | LA11018-1 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 86522-0 | Deprecated MDS v3.0 - RAI v1.14.1 - Nursing home comprehensive (NC) item set [CMS Assessment] |
| 88282-9 | Deprecated MDS v3.0 - RAI v1.15.1 - Nursing home comprehensive (NC) item set [CMS Assessment] |
| 88954-3 | Deprecated MDS v3.0 - RAI v1.16.1 - Nursing home comprehensive (NC) item set [CMS Assessment] |
| 90473-0 | Deprecated MDS v3.0 - RAI v1.17.1, 1.17.2 - Nursing home comprehensive (NC) item set during assessment period [CMS Assessment] |
| 54580-6 | Deprecated Minimum Data Set - version 3.0 |
| 103564-1 | MDS v3.0 - RAI v1.19.1 - Nursing home comprehensive (NC) item set during assessment period [CMS Assessment] |
| 108256-9 | Minimum Data Set (MDS) - version 3.0 - Resident Assessment Instrument (RAI) version 1.20.1 during assessment period [CMS Assessment] |
| 100997-6 | Respiratory Allergen Panel, Area 5 - Serum |
54700-0 While you are in this facility how important is it to you to choose between a tub bath, shower, bed bath, or sponge bath?
Observation ID in Form
F0400C
Fully-Specified Name
- Component
- How important it is to choose between a tub bath, shower, bed bath, or sponge bath while in this facility
- Property
- Find
- Time
- RptPeriod
- System
- ^Patient
- Scale
- Ord
- Method
- CMS Assessment
Long Common Name
How important it is to choose between a tub bath, shower, bed bath, or sponge bath while in this facility during assessment period [CMS Assessment]
Basic Attributes
- Class
- SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.27
- Last Updated
- Version 2.77 (MAJ)
- Change Reason
- Release 2.77: TIME_ASPCT: Decision by CMS to update the Timing to RptPeriod from Pt for all CMS Assessments; Previous Releases: Updated METHOD to CMS Assessment to use term across CMS instruments as approved by the Clinical LOINC committee; Changed CLASS from SURVEY.MDS to SURVEY.CMS because term is used across CMS assessments. Moved Survey Question text to Display Name for Form for consistent modeling across CMS forms.
- Order vs. Observation
- Observation
Normative Answer List LL659-4
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Very important | 1 | LA11013-2 | |
| Somewhat important | 2 | LA11014-0 | |
| Not very important | 3 | LA11015-7 | |
| Not important at all | 4 | LA11016-5 | |
| Important, but can't do or no choice | 5 | LA11017-3 | |
| No response or non-responsive | 9 | LA11018-1 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 86522-0 | Deprecated MDS v3.0 - RAI v1.14.1 - Nursing home comprehensive (NC) item set [CMS Assessment] |
| 88282-9 | Deprecated MDS v3.0 - RAI v1.15.1 - Nursing home comprehensive (NC) item set [CMS Assessment] |
| 88954-3 | Deprecated MDS v3.0 - RAI v1.16.1 - Nursing home comprehensive (NC) item set [CMS Assessment] |
| 90473-0 | Deprecated MDS v3.0 - RAI v1.17.1, 1.17.2 - Nursing home comprehensive (NC) item set during assessment period [CMS Assessment] |
| 54580-6 | Deprecated Minimum Data Set - version 3.0 |
| 103564-1 | MDS v3.0 - RAI v1.19.1 - Nursing home comprehensive (NC) item set during assessment period [CMS Assessment] |
| 108256-9 | Minimum Data Set (MDS) - version 3.0 - Resident Assessment Instrument (RAI) version 1.20.1 during assessment period [CMS Assessment] |
| 100997-6 | Respiratory Allergen Panel, Area 5 - Serum |
54701-8 While you are in this facility how important is it to you to have snacks available between meals?
Observation ID in Form
F0400D
Fully-Specified Name
- Component
- How important it is to have snacks available between meals while in this facility
- Property
- Find
- Time
- RptPeriod
- System
- ^Patient
- Scale
- Ord
- Method
- CMS Assessment
Long Common Name
How important it is to have snacks available between meals while in this facility during assessment period [CMS Assessment]
Basic Attributes
- Class
- SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.27
- Last Updated
- Version 2.77 (MAJ)
- Change Reason
- Release 2.77: TIME_ASPCT: Decision by CMS to update the Timing to RptPeriod from Pt for all CMS Assessments; Previous Releases: Updated METHOD to CMS Assessment to use term across CMS instruments as approved by the Clinical LOINC committee; Changed CLASS from SURVEY.MDS to SURVEY.CMS because term is used across CMS assessments. Moved Survey Question text to Display Name for Form for consistent modeling across CMS forms.
- Order vs. Observation
- Observation
Normative Answer List LL659-4
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Very important | 1 | LA11013-2 | |
| Somewhat important | 2 | LA11014-0 | |
| Not very important | 3 | LA11015-7 | |
| Not important at all | 4 | LA11016-5 | |
| Important, but can't do or no choice | 5 | LA11017-3 | |
| No response or non-responsive | 9 | LA11018-1 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 86522-0 | Deprecated MDS v3.0 - RAI v1.14.1 - Nursing home comprehensive (NC) item set [CMS Assessment] |
| 88282-9 | Deprecated MDS v3.0 - RAI v1.15.1 - Nursing home comprehensive (NC) item set [CMS Assessment] |
| 88954-3 | Deprecated MDS v3.0 - RAI v1.16.1 - Nursing home comprehensive (NC) item set [CMS Assessment] |
| 90473-0 | Deprecated MDS v3.0 - RAI v1.17.1, 1.17.2 - Nursing home comprehensive (NC) item set during assessment period [CMS Assessment] |
| 54580-6 | Deprecated Minimum Data Set - version 3.0 |
| 103564-1 | MDS v3.0 - RAI v1.19.1 - Nursing home comprehensive (NC) item set during assessment period [CMS Assessment] |
| 108256-9 | Minimum Data Set (MDS) - version 3.0 - Resident Assessment Instrument (RAI) version 1.20.1 during assessment period [CMS Assessment] |
| 100997-6 | Respiratory Allergen Panel, Area 5 - Serum |
54702-6 While you are in this facility how important is it to you to choose your own bedtime?
Observation ID in Form
F0400E
Fully-Specified Name
- Component
- How important it is to choose your own bedtime while in this facility
- Property
- Find
- Time
- RptPeriod
- System
- ^Patient
- Scale
- Ord
- Method
- CMS Assessment
Long Common Name
How important it is to choose your own bedtime while in this facility during assessment period [CMS Assessment]
Basic Attributes
- Class
- SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.27
- Last Updated
- Version 2.77 (MAJ)
- Change Reason
- Release 2.77: TIME_ASPCT: Decision by CMS to update the Timing to RptPeriod from Pt for all CMS Assessments; Previous Releases: Updated METHOD to CMS Assessment to use term across CMS instruments as approved by the Clinical LOINC committee; Changed CLASS from SURVEY.MDS to SURVEY.CMS because term is used across CMS assessments. Moved Survey Question text to Display Name for Form for consistent modeling across CMS forms.
- Order vs. Observation
- Observation
Normative Answer List LL659-4
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Very important | 1 | LA11013-2 | |
| Somewhat important | 2 | LA11014-0 | |
| Not very important | 3 | LA11015-7 | |
| Not important at all | 4 | LA11016-5 | |
| Important, but can't do or no choice | 5 | LA11017-3 | |
| No response or non-responsive | 9 | LA11018-1 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 86522-0 | Deprecated MDS v3.0 - RAI v1.14.1 - Nursing home comprehensive (NC) item set [CMS Assessment] |
| 88282-9 | Deprecated MDS v3.0 - RAI v1.15.1 - Nursing home comprehensive (NC) item set [CMS Assessment] |
| 88954-3 | Deprecated MDS v3.0 - RAI v1.16.1 - Nursing home comprehensive (NC) item set [CMS Assessment] |
| 90473-0 | Deprecated MDS v3.0 - RAI v1.17.1, 1.17.2 - Nursing home comprehensive (NC) item set during assessment period [CMS Assessment] |
| 54580-6 | Deprecated Minimum Data Set - version 3.0 |
| 103564-1 | MDS v3.0 - RAI v1.19.1 - Nursing home comprehensive (NC) item set during assessment period [CMS Assessment] |
| 108256-9 | Minimum Data Set (MDS) - version 3.0 - Resident Assessment Instrument (RAI) version 1.20.1 during assessment period [CMS Assessment] |
| 100997-6 | Respiratory Allergen Panel, Area 5 - Serum |
54703-4 While you are in this facility how important is it to you to have your family or a close friend involved in discussions about your care?
Observation ID in Form
F0400F
Fully-Specified Name
- Component
- How important it is to have your family or a close friend involved in discussions about your care while in this facility
- Property
- Find
- Time
- RptPeriod
- System
- ^Patient
- Scale
- Ord
- Method
- CMS Assessment
Long Common Name
How important it is to have your family or a close friend involved in discussions about your care while in this facility during assessment period [CMS Assessment]
Basic Attributes
- Class
- SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.27
- Last Updated
- Version 2.77 (MAJ)
- Change Reason
- Release 2.77: TIME_ASPCT: Decision by CMS to update the Timing to RptPeriod from Pt for all CMS Assessments; Previous Releases: Updated METHOD to CMS Assessment to use term across CMS instruments as approved by the Clinical LOINC committee; Changed CLASS from SURVEY.MDS to SURVEY.CMS because term is used across CMS assessments. Moved Survey Question text to Display Name for Form for consistent modeling across CMS forms.
- Order vs. Observation
- Observation
Normative Answer List LL659-4
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Very important | 1 | LA11013-2 | |
| Somewhat important | 2 | LA11014-0 | |
| Not very important | 3 | LA11015-7 | |
| Not important at all | 4 | LA11016-5 | |
| Important, but can't do or no choice | 5 | LA11017-3 | |
| No response or non-responsive | 9 | LA11018-1 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 86522-0 | Deprecated MDS v3.0 - RAI v1.14.1 - Nursing home comprehensive (NC) item set [CMS Assessment] |
| 88282-9 | Deprecated MDS v3.0 - RAI v1.15.1 - Nursing home comprehensive (NC) item set [CMS Assessment] |
| 88954-3 | Deprecated MDS v3.0 - RAI v1.16.1 - Nursing home comprehensive (NC) item set [CMS Assessment] |
| 90473-0 | Deprecated MDS v3.0 - RAI v1.17.1, 1.17.2 - Nursing home comprehensive (NC) item set during assessment period [CMS Assessment] |
| 54580-6 | Deprecated Minimum Data Set - version 3.0 |
| 103564-1 | MDS v3.0 - RAI v1.19.1 - Nursing home comprehensive (NC) item set during assessment period [CMS Assessment] |
| 108256-9 | Minimum Data Set (MDS) - version 3.0 - Resident Assessment Instrument (RAI) version 1.20.1 during assessment period [CMS Assessment] |
| 100997-6 | Respiratory Allergen Panel, Area 5 - Serum |
54704-2 While you are in this facility how important is it to you to be able to use the phone in private?
Observation ID in Form
F0400G
Fully-Specified Name
- Component
- How important it is to be able to use the phone in private while in this facility
- Property
- Find
- Time
- RptPeriod
- System
- ^Patient
- Scale
- Ord
- Method
- CMS Assessment
Long Common Name
How important it is to be able to use the phone in private while in this facility during assessment period [CMS Assessment]
Basic Attributes
- Class
- SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.27
- Last Updated
- Version 2.77 (MAJ)
- Change Reason
- Release 2.77: TIME_ASPCT: Decision by CMS to update the Timing to RptPeriod from Pt for all CMS Assessments; Previous Releases: Updated METHOD to CMS Assessment to use term across CMS instruments as approved by the Clinical LOINC committee; Changed CLASS from SURVEY.MDS to SURVEY.CMS because term is used across CMS assessments. Moved Survey Question text to Display Name for Form for consistent modeling across CMS forms.
- Order vs. Observation
- Observation
Normative Answer List LL659-4
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Very important | 1 | LA11013-2 | |
| Somewhat important | 2 | LA11014-0 | |
| Not very important | 3 | LA11015-7 | |
| Not important at all | 4 | LA11016-5 | |
| Important, but can't do or no choice | 5 | LA11017-3 | |
| No response or non-responsive | 9 | LA11018-1 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 86522-0 | Deprecated MDS v3.0 - RAI v1.14.1 - Nursing home comprehensive (NC) item set [CMS Assessment] |
| 88282-9 | Deprecated MDS v3.0 - RAI v1.15.1 - Nursing home comprehensive (NC) item set [CMS Assessment] |
| 88954-3 | Deprecated MDS v3.0 - RAI v1.16.1 - Nursing home comprehensive (NC) item set [CMS Assessment] |
| 90473-0 | Deprecated MDS v3.0 - RAI v1.17.1, 1.17.2 - Nursing home comprehensive (NC) item set during assessment period [CMS Assessment] |
| 54580-6 | Deprecated Minimum Data Set - version 3.0 |
| 103564-1 | MDS v3.0 - RAI v1.19.1 - Nursing home comprehensive (NC) item set during assessment period [CMS Assessment] |
| 108256-9 | Minimum Data Set (MDS) - version 3.0 - Resident Assessment Instrument (RAI) version 1.20.1 during assessment period [CMS Assessment] |
| 100997-6 | Respiratory Allergen Panel, Area 5 - Serum |
54705-9 While you are in this facility how important is it to you to have a place to lock your things to keep them safe?
Observation ID in Form
F0400H
Fully-Specified Name
- Component
- How important it is to have a place to lock your things to keep them safe while in this facility
- Property
- Find
- Time
- RptPeriod
- System
- ^Patient
- Scale
- Ord
- Method
- CMS Assessment
Long Common Name
How important it is to have a place to lock your things to keep them safe while in this facility during assessment period [CMS Assessment]
Basic Attributes
- Class
- SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.27
- Last Updated
- Version 2.77 (MAJ)
- Change Reason
- Release 2.77: TIME_ASPCT: Decision by CMS to update the Timing to RptPeriod from Pt for all CMS Assessments; Previous Releases: Updated METHOD to CMS Assessment to use term across CMS instruments as approved by the Clinical LOINC committee; Changed CLASS from SURVEY.MDS to SURVEY.CMS because term is used across CMS assessments. Moved Survey Question text to Display Name for Form for consistent modeling across CMS forms.
- Order vs. Observation
- Observation
Normative Answer List LL659-4
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Very important | 1 | LA11013-2 | |
| Somewhat important | 2 | LA11014-0 | |
| Not very important | 3 | LA11015-7 | |
| Not important at all | 4 | LA11016-5 | |
| Important, but can't do or no choice | 5 | LA11017-3 | |
| No response or non-responsive | 9 | LA11018-1 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 86522-0 | Deprecated MDS v3.0 - RAI v1.14.1 - Nursing home comprehensive (NC) item set [CMS Assessment] |
| 88282-9 | Deprecated MDS v3.0 - RAI v1.15.1 - Nursing home comprehensive (NC) item set [CMS Assessment] |
| 88954-3 | Deprecated MDS v3.0 - RAI v1.16.1 - Nursing home comprehensive (NC) item set [CMS Assessment] |
| 90473-0 | Deprecated MDS v3.0 - RAI v1.17.1, 1.17.2 - Nursing home comprehensive (NC) item set during assessment period [CMS Assessment] |
| 54580-6 | Deprecated Minimum Data Set - version 3.0 |
| 103564-1 | MDS v3.0 - RAI v1.19.1 - Nursing home comprehensive (NC) item set during assessment period [CMS Assessment] |
| 108256-9 | Minimum Data Set (MDS) - version 3.0 - Resident Assessment Instrument (RAI) version 1.20.1 during assessment period [CMS Assessment] |
| 100997-6 | Respiratory Allergen Panel, Area 5 - Serum |