57306-3 Types and sources of assistance

Observation ID in Form

M2100

Form Coding Instructions

Types and Sources of Assistance: Determine the level of caregiver ability and willingness to provide assistance for the following activities, if assistance is needed. (Check only one box in each row.)

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Types and sources of assistance
Property
-
Time
RptPeriod
System
^Patient
Scale
-
Method
CMS Assessment

Long Common Name

Types and sources of assistance during assessment period [CMS Assessment]

Basic Attributes

Class
PANEL.SURVEY.CMS
Type
Surveys
First Released
Version 2.29
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 from OASIS-C to CMS Assessment to use term across CMS instruments as approved by the Clinical LOINC committee; Changed Scale from Nom to "-" to follow LOINC conventions for panel parent terms
Order vs. Observation
Subset
Panel Type
Organizer

Member of these Panels

LOINCLong Common Name
57039-0Deprecated Outcome and assessment information set (OASIS) form - version C
57194-3Deprecated Outcome and assessment information set (OASIS) form - version C - Discharge from agency
57191-9Deprecated Outcome and assessment information set (OASIS) form - version C - Resumption of Care
57190-1Deprecated Outcome and assessment information set (OASIS) form - version C - Start of care
86264-9Deprecated Outcome and assessment information set (OASIS) form - version C2 - Discharged from agency [CMS Assessment]
86189-8Deprecated Outcome and assessment information set (OASIS) form - version C2 - Resumption of care [CMS Assessment]
85907-4Deprecated Outcome and assessment information set (OASIS) form - version C2 - Start of care [CMS Assessment]
108293-2OASIS E2 - DC during assessment period [CMS Assessment]
108292-4Outcome and assessment information set (OASIS) form - version E2 - Resumption of Care during assessment period [CMS Assessment]
108291-6Outcome and assessment information set (OASIS) form - version E2 - Start of Care during assessment period [CMS Assessment]

57260-2 Non-agency caregiver ability and willingness to assist with ADL

Observation ID in Form

M2100a

Form Coding Instructions

e.g., transfer/ ambulation, bathing, dressing, toileting, eating/feeding

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Non-agency caregiver ability and willingness to assist with ADL
Property
Find
Time
RptPeriod
System
^Patient
Scale
Ord
Method
CMS Assessment

Long Common Name

Non-agency caregiver ability and willingness to assist with ADL during assessment period [CMS Assessment]

Basic Attributes

Class
SURVEY.CMS
Type
Surveys
First Released
Version 2.29
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 from OASIS-C to CMS Assessment to use across CMS instruments as approved by the Clinical LOINC committee; Added to Component to more thoroughly represent the form text;Added "non-agency" to Component to more clearly reflect CMS assessment form text
Order vs. Observation
Observation

Normative Answer List LL821-0

AnswerCodeScoreAnswer ID
No assistance needed in this area0LA12335-8
Caregiver(s) currently provide assistance1LA12336-6
Caregiver(s) need training/ supportive services to provide assistance2LA12337-4
Caregiver(s) not likely to provide assistance3LA12338-2
Unclear if caregiver(s) will provide assistance4LA12339-0
Assistance needed, but no caregiver(s) available5LA12340-8

Member of these Panels

LOINCLong Common Name
57039-0Deprecated Outcome and assessment information set (OASIS) form - version C
57194-3Deprecated Outcome and assessment information set (OASIS) form - version C - Discharge from agency
57191-9Deprecated Outcome and assessment information set (OASIS) form - version C - Resumption of Care
57190-1Deprecated Outcome and assessment information set (OASIS) form - version C - Start of care
86264-9Deprecated Outcome and assessment information set (OASIS) form - version C2 - Discharged from agency [CMS Assessment]
86189-8Deprecated Outcome and assessment information set (OASIS) form - version C2 - Resumption of care [CMS Assessment]
85907-4Deprecated Outcome and assessment information set (OASIS) form - version C2 - Start of care [CMS Assessment]
108293-2OASIS E2 - DC during assessment period [CMS Assessment]
88371-0Outcome and assessment information set (OASIS) form - version D, D1 - Discharged from agency during assessment period [CMS Assessment]
99178-6Outcome and assessment information set (OASIS) form - version E - Discharge from Agency during assessment period [CMS Assessment]
106529-1Outcome and assessment information set (OASIS) form - version E1 - Discharge from Agency during assessment period [CMS Assessment]

57261-0 Non-agency caregiver ability and willingness to assist with IADL

Observation ID in Form

M2100b

Form Coding Instructions

e.g., meals, housekeeping, laundry, telephone, shopping, finances

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Non-agency caregiver ability and willingness to assist with IADL
Property
Find
Time
RptPeriod
System
^Patient
Scale
Ord
Method
CMS Assessment

Long Common Name

Non-agency caregiver ability and willingness to assist with IADL during assessment period [CMS Assessment]

Basic Attributes

Class
SURVEY.CMS
Type
Surveys
First Released
Version 2.29
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 from OASIS-C to CMS Assessment to use term across CMS instruments as approved by the Clinical LOINC committee; Added to Component to more thoroughly represent the form text;Added "non-agency" to Component to more clearly reflect CMS assessment form text
Order vs. Observation
Observation

Normative Answer List LL821-0

AnswerCodeScoreAnswer ID
No assistance needed in this area0LA12335-8
Caregiver(s) currently provide assistance1LA12336-6
Caregiver(s) need training/ supportive services to provide assistance2LA12337-4
Caregiver(s) not likely to provide assistance3LA12338-2
Unclear if caregiver(s) will provide assistance4LA12339-0
Assistance needed, but no caregiver(s) available5LA12340-8

Member of these Panels

LOINCLong Common Name
57039-0Deprecated Outcome and assessment information set (OASIS) form - version C
57194-3Deprecated Outcome and assessment information set (OASIS) form - version C - Discharge from agency
57191-9Deprecated Outcome and assessment information set (OASIS) form - version C - Resumption of Care
57190-1Deprecated Outcome and assessment information set (OASIS) form - version C - Start of care
86264-9Deprecated Outcome and assessment information set (OASIS) form - version C2 - Discharged from agency [CMS Assessment]
86189-8Deprecated Outcome and assessment information set (OASIS) form - version C2 - Resumption of care [CMS Assessment]
85907-4Deprecated Outcome and assessment information set (OASIS) form - version C2 - Start of care [CMS Assessment]

57262-8 Non-agency caregiver ability and willingness to assist with medication administration

Observation ID in Form

M2100c

Form Coding Instructions

e.g., oral, inhaled or injectable

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Non-agency caregiver ability and willingness to assist with medication administration
Property
Find
Time
RptPeriod
System
^Patient
Scale
Ord
Method
CMS Assessment

Long Common Name

Non-agency caregiver ability and willingness to assist with medication administration during assessment period [CMS Assessment]

Basic Attributes

Class
SURVEY.CMS
Type
Surveys
First Released
Version 2.29
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 from OASIS-C to CMS Assessment to use term across CMS instruments as approved by the Clinical LOINC committee; Added to Component to more thoroughly represent the form text;Added "non-agency" to Component to more clearly reflect CMS assessment form text
Order vs. Observation
Observation

Normative Answer List LL821-0

AnswerCodeScoreAnswer ID
No assistance needed in this area0LA12335-8
Caregiver(s) currently provide assistance1LA12336-6
Caregiver(s) need training/ supportive services to provide assistance2LA12337-4
Caregiver(s) not likely to provide assistance3LA12338-2
Unclear if caregiver(s) will provide assistance4LA12339-0
Assistance needed, but no caregiver(s) available5LA12340-8

Member of these Panels

LOINCLong Common Name
57039-0Deprecated Outcome and assessment information set (OASIS) form - version C
57194-3Deprecated Outcome and assessment information set (OASIS) form - version C - Discharge from agency
57191-9Deprecated Outcome and assessment information set (OASIS) form - version C - Resumption of Care
57190-1Deprecated Outcome and assessment information set (OASIS) form - version C - Start of care
86264-9Deprecated Outcome and assessment information set (OASIS) form - version C2 - Discharged from agency [CMS Assessment]
86189-8Deprecated Outcome and assessment information set (OASIS) form - version C2 - Resumption of care [CMS Assessment]
85907-4Deprecated Outcome and assessment information set (OASIS) form - version C2 - Start of care [CMS Assessment]
108293-2OASIS E2 - DC during assessment period [CMS Assessment]
88371-0Outcome and assessment information set (OASIS) form - version D, D1 - Discharged from agency during assessment period [CMS Assessment]
99178-6Outcome and assessment information set (OASIS) form - version E - Discharge from Agency during assessment period [CMS Assessment]
106529-1Outcome and assessment information set (OASIS) form - version E1 - Discharge from Agency during assessment period [CMS Assessment]

57263-6 Medical procedures/treatments

Observation ID in Form

M2100d

Form Coding Instructions

e.g., changing wound dressing

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Non-agency caregiver ability and willingness to assist with medical procedures &or treatments
Property
Find
Time
RptPeriod
System
^Patient
Scale
Ord
Method
CMS Assessment

Long Common Name

Non-agency caregiver ability and willingness to assist with medical procedures/treatments during assessment period [CMS Assessment]

Basic Attributes

Class
SURVEY.CMS
Type
Surveys
First Released
Version 2.29
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 from OASIS-C to CMS Assessment to use term across CMS instruments as approved by the Clinical LOINC committee; Added to Component to more thoroughly represent the form text;Added "non-agency" to Component to more clearly reflect CMS assessment form text; Changed "medication" to "medical" in Component to correct a typo
Order vs. Observation
Observation

Normative Answer List LL821-0

AnswerCodeScoreAnswer ID
No assistance needed in this area0LA12335-8
Caregiver(s) currently provide assistance1LA12336-6
Caregiver(s) need training/ supportive services to provide assistance2LA12337-4
Caregiver(s) not likely to provide assistance3LA12338-2
Unclear if caregiver(s) will provide assistance4LA12339-0
Assistance needed, but no caregiver(s) available5LA12340-8

Member of these Panels

LOINCLong Common Name
57039-0Deprecated Outcome and assessment information set (OASIS) form - version C
57194-3Deprecated Outcome and assessment information set (OASIS) form - version C - Discharge from agency
57191-9Deprecated Outcome and assessment information set (OASIS) form - version C - Resumption of Care
57190-1Deprecated Outcome and assessment information set (OASIS) form - version C - Start of care
86264-9Deprecated Outcome and assessment information set (OASIS) form - version C2 - Discharged from agency [CMS Assessment]
86189-8Deprecated Outcome and assessment information set (OASIS) form - version C2 - Resumption of care [CMS Assessment]
85907-4Deprecated Outcome and assessment information set (OASIS) form - version C2 - Start of care [CMS Assessment]
108293-2OASIS E2 - DC during assessment period [CMS Assessment]
88371-0Outcome and assessment information set (OASIS) form - version D, D1 - Discharged from agency during assessment period [CMS Assessment]
99178-6Outcome and assessment information set (OASIS) form - version E - Discharge from Agency during assessment period [CMS Assessment]
106529-1Outcome and assessment information set (OASIS) form - version E1 - Discharge from Agency during assessment period [CMS Assessment]

57264-4 Non-agency caregiver ability and willingness to assist with management of equipment

Observation ID in Form

M2100e

Form Coding Instructions

includes oxygen, IV/infusion equipment, enteral/ parenteral nutrition, ventilator therapy equipment or supplies

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Non-agency caregiver ability and willingness to assist with management of equipment
Property
Find
Time
RptPeriod
System
^Patient
Scale
Ord
Method
CMS Assessment

Long Common Name

Non-agency caregiver ability and willingness to assist with management of equipment during assessment period [CMS Assessment]

Basic Attributes

Class
SURVEY.CMS
Type
Surveys
First Released
Version 2.29
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 from OASIS-C to CMS Assessment to use term across CMS instruments as approved by the Clinical LOINC committee; Added to Component to more thoroughly represent the form text;Added "non-agency" to Component to more clearly reflect CMS assessment form text
Order vs. Observation
Observation

Normative Answer List LL821-0

AnswerCodeScoreAnswer ID
No assistance needed in this area0LA12335-8
Caregiver(s) currently provide assistance1LA12336-6
Caregiver(s) need training/ supportive services to provide assistance2LA12337-4
Caregiver(s) not likely to provide assistance3LA12338-2
Unclear if caregiver(s) will provide assistance4LA12339-0
Assistance needed, but no caregiver(s) available5LA12340-8

Member of these Panels

LOINCLong Common Name
57039-0Deprecated Outcome and assessment information set (OASIS) form - version C
57194-3Deprecated Outcome and assessment information set (OASIS) form - version C - Discharge from agency
57191-9Deprecated Outcome and assessment information set (OASIS) form - version C - Resumption of Care
57190-1Deprecated Outcome and assessment information set (OASIS) form - version C - Start of care
86264-9Deprecated Outcome and assessment information set (OASIS) form - version C2 - Discharged from agency [CMS Assessment]
86189-8Deprecated Outcome and assessment information set (OASIS) form - version C2 - Resumption of care [CMS Assessment]
85907-4Deprecated Outcome and assessment information set (OASIS) form - version C2 - Start of care [CMS Assessment]

57265-1 Non-agency caregiver ability and willingness to assist with supervision and safety

Observation ID in Form

M2100f

Form Coding Instructions

e.g., due to cognitive impairment

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Non-agency caregiver ability and willingness to assist with supervision and safety
Property
Find
Time
RptPeriod
System
^Patient
Scale
Ord
Method
CMS Assessment

Long Common Name

Non-agency caregiver ability and willingness to assist with supervision and safety during assessment period [CMS Assessment]

Basic Attributes

Class
SURVEY.CMS
Type
Surveys
First Released
Version 2.29
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 from OASIS-C to CMS Assessment to use term across CMS instruments as approved by the Clinical LOINC committee; Added to Component to more thoroughly represent the form text;Added "non-agency" to Component to more clearly reflect CMS assessment form text
Order vs. Observation
Observation

Normative Answer List LL821-0

AnswerCodeScoreAnswer ID
No assistance needed in this area0LA12335-8
Caregiver(s) currently provide assistance1LA12336-6
Caregiver(s) need training/ supportive services to provide assistance2LA12337-4
Caregiver(s) not likely to provide assistance3LA12338-2
Unclear if caregiver(s) will provide assistance4LA12339-0
Assistance needed, but no caregiver(s) available5LA12340-8

Member of these Panels

LOINCLong Common Name
57039-0Deprecated Outcome and assessment information set (OASIS) form - version C
57194-3Deprecated Outcome and assessment information set (OASIS) form - version C - Discharge from agency
57191-9Deprecated Outcome and assessment information set (OASIS) form - version C - Resumption of Care
57190-1Deprecated Outcome and assessment information set (OASIS) form - version C - Start of care
86264-9Deprecated Outcome and assessment information set (OASIS) form - version C2 - Discharged from agency [CMS Assessment]
86189-8Deprecated Outcome and assessment information set (OASIS) form - version C2 - Resumption of care [CMS Assessment]
85907-4Deprecated Outcome and assessment information set (OASIS) form - version C2 - Start of care [CMS Assessment]
108293-2OASIS E2 - DC during assessment period [CMS Assessment]
88371-0Outcome and assessment information set (OASIS) form - version D, D1 - Discharged from agency during assessment period [CMS Assessment]
88368-6Outcome and assessment information set (OASIS) form - version D, D1 - Resumption of care during assessment period [CMS Assessment]
88373-6Outcome and assessment information set (OASIS) form - version D, D1 - Start of care during assessment period [CMS Assessment]
99178-6Outcome and assessment information set (OASIS) form - version E - Discharge from Agency during assessment period [CMS Assessment]
99160-4Outcome and assessment information set (OASIS) form - version E - Resumption of Care during assessment period [CMS Assessment]
99131-5Outcome and assessment information set (OASIS) form - version E - Start of Care during assessment period [CMS Assessment]
106529-1Outcome and assessment information set (OASIS) form - version E1 - Discharge from Agency during assessment period [CMS Assessment]
106525-9Outcome and assessment information set (OASIS) form - version E1 - Resumption of Care during assessment period [CMS Assessment]
106523-4Outcome and assessment information set (OASIS) form - version E1 - Start of Care during assessment period [CMS Assessment]
108292-4Outcome and assessment information set (OASIS) form - version E2 - Resumption of Care during assessment period [CMS Assessment]
108291-6Outcome and assessment information set (OASIS) form - version E2 - Start of Care during assessment period [CMS Assessment]

57266-9 Advocacy or facilitation

Observation ID in Form

M2100g

Form Coding Instructions

Advocacy or facilitation of patient's participation in appropriate medical care (includes transportation to or from appointments)

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Non-agency caregiver ability and willingness to assist with advocacy or facilitation of patient participation
Property
Find
Time
RptPeriod
System
^Patient
Scale
Ord
Method
CMS Assessment

Long Common Name

Non-agency caregiver ability and willingness to assist with advocacy or facilitation of patient participation during assessment period [CMS Assessment]

Basic Attributes

Class
SURVEY.CMS
Type
Surveys
First Released
Version 2.29
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 from OASIS-C to CMS Assessment to use term across CMS instruments as approved by the Clinical LOINC committee; Added to Component to more thoroughly represent the form text;Added "non-agency" to Component to more clearly reflect CMS assessment form text
Order vs. Observation
Observation

Normative Answer List LL821-0

AnswerCodeScoreAnswer ID
No assistance needed in this area0LA12335-8
Caregiver(s) currently provide assistance1LA12336-6
Caregiver(s) need training/ supportive services to provide assistance2LA12337-4
Caregiver(s) not likely to provide assistance3LA12338-2
Unclear if caregiver(s) will provide assistance4LA12339-0
Assistance needed, but no caregiver(s) available5LA12340-8

Member of these Panels

LOINCLong Common Name
57039-0Deprecated Outcome and assessment information set (OASIS) form - version C
57194-3Deprecated Outcome and assessment information set (OASIS) form - version C - Discharge from agency
57191-9Deprecated Outcome and assessment information set (OASIS) form - version C - Resumption of Care
57190-1Deprecated Outcome and assessment information set (OASIS) form - version C - Start of care
86264-9Deprecated Outcome and assessment information set (OASIS) form - version C2 - Discharged from agency [CMS Assessment]
86189-8Deprecated Outcome and assessment information set (OASIS) form - version C2 - Resumption of care [CMS Assessment]
85907-4Deprecated Outcome and assessment information set (OASIS) form - version C2 - Start of care [CMS Assessment]

57267-7 How Often does the patient receive ADL or IADL assistance from any caregiver(s) (other than home health agency staff)?

Observation ID in Form

M2110

Skip Logic

Omit "UK" option on DC.

Fully-Specified Name

Component
ADL or IADL assistance frequency from any caregiver
Property
Find
Time
RptPeriod
System
^Patient
Scale
Ord
Method
CMS Assessment

Long Common Name

ADL or IADL assistance frequency from any caregiver during assessment period [CMS Assessment]

Basic Attributes

Class
SURVEY.CMS
Type
Surveys
First Released
Version 2.29
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 from OASIS-C to CMS Assessment to use across CMS instruments as approved by the Clinical LOINC committee; Moved Survey Question text to Override Display Name for consistent modeling across CMS forms; Added "frequency" to Component to clarify concept; Changed Property from NRat to Find because the answer list does not reflect Nrat
Order vs. Observation
Observation

Normative Answer List LL822-8

AnswerCodeScoreAnswer ID
At least daily1LA6157-7
Three or more times per week2LA6396-1
One to two times per week3LA6308-6
Received, but less often than weekly4LA12344-0
No assistance received5LA12345-7
Unknown Copyright http://snomed.info/sct ID:261665006 Unknown (qualifier value)UKLA4489-6

Member of these Panels

LOINCLong Common Name
57039-0Deprecated Outcome and assessment information set (OASIS) form - version C
57194-3Deprecated Outcome and assessment information set (OASIS) form - version C - Discharge from agency
57191-9Deprecated Outcome and assessment information set (OASIS) form - version C - Resumption of Care
57190-1Deprecated Outcome and assessment information set (OASIS) form - version C - Start of care
86264-9Deprecated Outcome and assessment information set (OASIS) form - version C2 - Discharged from agency [CMS Assessment]
86189-8Deprecated Outcome and assessment information set (OASIS) form - version C2 - Resumption of care [CMS Assessment]
85907-4Deprecated Outcome and assessment information set (OASIS) form - version C2 - Start of care [CMS Assessment]