Version 2.79

Status Information

Status
DEPRECATED

Term Description

This panel should be used for CMS LCDS v3.00 Admission assessments performed between April 1, 2016 and June 30, 2018.

Panel Hierarchy

Details for each LOINC in Panel LHC-Forms

LOINC Name R/O/C Cardinality Example UCUM Units
85645-0 Deprecated Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Admission - version 3.00 [CMS Assessment]
Indent85636-9 Administrative Information
IndentIndent58198-3 Type of Record
IndentIndent54581-4 Facility Provider Numbers
IndentIndentIndent76468-8 National Provider Identifier (NPI)
IndentIndentIndent69417-4 CMS Certification Number (CCN)
IndentIndentIndent45398-5 State Medicaid Provider Number
IndentIndent85632-8 Type of Provider
IndentIndent54593-9 Assessment Reference Date. Observation end date {mm/dd/yyyy}
IndentIndent52455-3 Admission Date {mm/dd/yyyy}
IndentIndent52454-6 Reason for Assessment
IndentIndent85816-7 Patient Demographic Information
IndentIndentIndent54503-8 Legal Name of Patient
IndentIndentIndentIndent45392-8 First name
IndentIndentIndentIndent45393-6 Middle initial
IndentIndentIndentIndent45394-4 Patient Last (Family) name
IndentIndentIndentIndent45395-1 Suffix
IndentIndentIndent45966-9 Social Security and Medicare Numbers
IndentIndentIndentIndent45396-9 Social Security Number
IndentIndentIndentIndent45397-7 Medicare number (or comparable railroad insurance number)
IndentIndentIndent45400-9 Medicaid Number
IndentIndentIndent46098-0 Gender
IndentIndentIndent21112-8 Birth Date {mm/dd/yyyy}
IndentIndentIndent59362-4 Race/Ethnicity 1..6
IndentIndentIndent54505-3 Language
IndentIndentIndentIndent54588-9 Does the resident need or want an interpreter to communicate with a doctor or health care staff?
IndentIndentIndentIndent54899-0 Preferred language
IndentIndentIndent45404-1 Marital Status
IndentIndentIndent52556-8 Payer Information 1..13
IndentIndent85815-9 Pre-Admission Service Use
IndentIndentIndent85398-6 Admitted From
Indent85640-1 Hearing, Speech, and Vision
IndentIndent85629-4 Comatose - persistent vegetative state and no discernible consciousness
IndentIndent83250-1 Expression of Ideas and Wants
IndentIndent83249-3 Understanding Verbal Content
Indent85638-5 Cognitive Patterns
IndentIndent85649-2 Signs and Symptoms of Delirium (from CAM)
IndentIndentIndent85812-6 Acute onset and fluctuating course
IndentIndentIndentIndent85634-4 Is there evidence of an acute change in mental status from the patient's baseline?
IndentIndentIndentIndent85630-2 Did the (abnormal) behavior fluctuate during the day, that is, tend to come and go or increase and decrease in severity?
IndentIndentIndent85631-0 Inattention.Did the patient have difficulty focusing attention, for example, being easily distractible or having difficulty keeping track of what was being said?
IndentIndentIndent85651-8 Disorganized thinking.Was the patient's thinking disorganized or incoherent, such as rambling or irrelevant conversation, unclear or illogical flow of ideas, or unpredictable switching from subject to subject?
IndentIndentIndent85811-8 Altered level of consciousness
IndentIndentIndentIndent85646-8 Overall, how would you rate the patient's level of consciousness? Alert (Normal)
IndentIndentIndentIndent85655-9 Overall, how would you rate the patient's level of consciousness? Vigilant (hyperalert) or Lethargic (drowsy, easily aroused) or Stupor (difficult to arouse) or Coma (unarousable)
Indent85639-3 Functional Abilities and Goals
IndentIndent85642-7 Prior Functioning: Everyday Activities
IndentIndentIndent85071-9 Indoor Mobility (Ambulation)
IndentIndent83234-5 Prior Device Use 1..4
IndentIndent85667-4 Self-Care - Admission Performance
IndentIndentIndent83232-9 Eating
IndentIndentIndent83230-3 Oral hygiene
IndentIndentIndent83228-7 Toileting hygiene
IndentIndentIndent85652-6 Wash upper body
IndentIndent85661-7 Self-Care - Discharge Goal
IndentIndentIndent83231-1 Eating
IndentIndentIndent83229-5 Oral hygiene
IndentIndentIndent83227-9 Toileting hygiene
IndentIndentIndent85653-4 Wash upper body
IndentIndent85641-9 Mobility - Admission Performance
IndentIndentIndent83218-8 Roll left and right
IndentIndentIndent83216-2 Sit to lying
IndentIndentIndent83214-7 Lying to sitting on side of bed
IndentIndentIndent83212-1 Sit to stand
IndentIndentIndent83210-5 Chair/bed-to-chair transfer
IndentIndentIndent83208-9 Toilet transfer
IndentIndentIndent83270-9 Does the patient walk?
IndentIndentIndent83204-8 Walk 10 feet
IndentIndentIndent83202-2 Walk 50 feet with two turns
IndentIndentIndent83200-6 Walk 150 feet
IndentIndentIndent83271-7 Does the patient use a wheelchair/scooter?
IndentIndentIndent83188-3 Wheel 50 feet with two turns
IndentIndentIndent83272-5 Indicate the type of wheelchair/scooter used
IndentIndentIndent83235-2 Wheel 150 feet
IndentIndentIndent83272-5 Indicate the type of wheelchair/scooter used
IndentIndent85660-9 Mobility - Discharge Goal
IndentIndentIndent83217-0 Roll left and right
IndentIndentIndent83215-4 Sit to lying
IndentIndentIndent83213-9 Lying to sitting on side of bed
IndentIndentIndent83211-3 Sit to stand
IndentIndentIndent83209-7 Chair/Bed-to-chair transfer
IndentIndentIndent83207-1 Toilet transfer
IndentIndentIndent83203-0 Walk 10 feet
IndentIndentIndent83201-4 Walk 50 feet with two turns
IndentIndentIndent83199-0 Walk 150 feet
IndentIndentIndent83187-5 Wheel 50 feet with two turns
IndentIndentIndent83236-0 Wheel 150 feet
Indent83237-8 Bladder and Bowel
IndentIndent83238-6 Bladder Continence
IndentIndent83242-8 Bowel Continence
Indent85635-1 Active Diagnoses
IndentIndent85633-6 Indicate the patient's primary medical condition category
IndentIndent52797-8 Other medical condition
IndentIndent83243-6 Comorbidities and coexisting conditions 0..24
Indent85644-3 Swallowing/Nutritional Status
IndentIndent54567-3 Height and Weight
IndentIndentIndent3137-7 Height (in inches) [in_us];cm;m
IndentIndentIndent3141-9 Weight (in pounds) [lb_av];kg
Indent85055-2 Skin Conditions
IndentIndent58214-8 Unhealed Pressure Ulcer(s). Does this patient have one or more unhealed pressure ulcer(s) at Stage 1 or higher?
IndentIndent83246-9 Current Number of Unhealed Pressure Ulcers at Each Stage - Admission
IndentIndentIndent54884-2 Number of Stage 1 pressure ulcers {#}
IndentIndentIndent55124-2 Number of Stage 2 pressure ulcers {#}
IndentIndentIndent55125-9 Number of Stage 3 pressure ulcers {#}
IndentIndentIndent55126-7 Number of Stage 4 pressure ulcers {#}
IndentIndentIndent54893-3 Number of unstageable pressure ulcers due to non-removable dressing/device {#}
IndentIndentIndent54946-9 Number of unstageable pressure ulcers due to coverage of wound bed by slough and/or eschar {#}
IndentIndentIndent54950-1 Number of unstageable pressure ulcers with suspected deep tissue injury in evolution {#}
Indent85643-5 Special Treatments, Procedures, and Programs
IndentIndent83252-7 Special Treatments, Procedures, and Programs 1..3
IndentIndent69339-0 Influenza Vaccine
IndentIndentIndent55019-4 Did the patient receive the influenza vaccine in this facility for this year's influenza vaccination season?
IndentIndentIndent58131-4 Date influenza vaccine received {mm/dd/yyyy}
IndentIndentIndent55020-2 If influenza vaccine not received, state reason: C
Indent85637-7 Assessment Administration
IndentIndent85648-4 Signature of Persons Completing the Assessment 0..12
IndentIndentIndent85647-6 Signature
IndentIndentIndent85650-0 Title
IndentIndent70157-3 Sections
IndentIndent70158-1 Date sections completed
IndentIndent70127-6 Signature of Person Verifying Assessment Completion
IndentIndent30947-6 LTCH CARE Data Set completion date {mm/dd/yyyy}

Fully-Specified Name

Component
Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Admission - version 3.00
Property
-
Time
Pt
System
^Patient
Scale
-
Method
CMS Assessment

Basic Attributes

Class
PANEL.SURVEY.CMS
Type
Surveys
First Released
Version 2.61
Last Updated
Version 2.73 (DEL)
Change Reason
Release 2.73: Status: LOINC will keep most current version and one prior version of CMS assessments active and discourage all older versions.;
Order vs. Observation
Order
Panel Type
Panel

LOINC Terminology Service (API) using HL7® FHIR® Get Info

CodeSystem lookup
https://fhir.loinc.org/CodeSystem/$lookup?system=http://loinc.org&code=85645-0