Form Coding Instructions

Check all that the resident was normally able to recall

Source: Centers for Medicare & Medicaid Services

54619-2 Current season

Observation ID in Form

C0900A

Fully-Specified Name

Component
Can recall current season in last 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
MDSv3

Long Common Name

Can recall current season in last 7 days [MDSv3]

Basic Attributes

Class
SURVEY.MDS
Type
Surveys
First Released
Version 2.27
Last Updated
Version 2.54 (MAJ)

Normative Answer List LL251-0

AnswerCodeScoreAnswer ID
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value)0LA32-8
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value)1LA33-6

Member of these Panels

LOINCLong Common Name
54580-6Deprecated Minimum Data Set - version 3.0

54620-0 Location of own room

Observation ID in Form

C0900B

Fully-Specified Name

Component
Can recall location of own room in last 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
MDSv3

Long Common Name

Can recall location of own room in last 7 days [MDSv3]

Basic Attributes

Class
SURVEY.MDS
Type
Surveys
First Released
Version 2.27
Last Updated
Version 2.54 (MAJ)

Normative Answer List LL251-0

AnswerCodeScoreAnswer ID
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value)0LA32-8
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value)1LA33-6

Member of these Panels

LOINCLong Common Name
54580-6Deprecated Minimum Data Set - version 3.0

54621-8 Staff names and faces

Observation ID in Form

C0900C

Fully-Specified Name

Component
Can recall staff names and faces in last 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
MDSv3

Long Common Name

Can recall staff names and faces in last 7 days [MDSv3]

Basic Attributes

Class
SURVEY.MDS
Type
Surveys
First Released
Version 2.27
Last Updated
Version 2.54 (MAJ)

Normative Answer List LL251-0

AnswerCodeScoreAnswer ID
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value)0LA32-8
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value)1LA33-6

Member of these Panels

LOINCLong Common Name
54580-6Deprecated Minimum Data Set - version 3.0

54622-6 That he or she is in a nursing home

Observation ID in Form

C0900D

Fully-Specified Name

Component
Can recall that he or she is in a nursing home in last 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
MDSv3

Long Common Name

Can recall that he or she is in a nursing home in last 7 days [MDSv3]

Basic Attributes

Class
SURVEY.MDS
Type
Surveys
First Released
Version 2.27
Last Updated
Version 2.54 (MAJ)

Normative Answer List LL251-0

AnswerCodeScoreAnswer ID
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value)0LA32-8
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value)1LA33-6

Member of these Panels

LOINCLong Common Name
54580-6Deprecated Minimum Data Set - version 3.0

54623-4 None of the above were recalled

Observation ID in Form

C0900Z

Fully-Specified Name

Component
None of the above were recalled in last 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
MDSv3

Long Common Name

None of the above were recalled in last 7 days [MDSv3]

Basic Attributes

Class
SURVEY.MDS
Type
Surveys
First Released
Version 2.27
Last Updated
Version 2.54 (MAJ)

Normative Answer List LL251-0

AnswerCodeScoreAnswer ID
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value)0LA32-8
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value)1LA33-6

Member of these Panels

LOINCLong Common Name
54580-6Deprecated Minimum Data Set - version 3.0