85654-2
Deprecated Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - version 3.00 [CMS Assessment]
Deprecated
Status Information
- Status
- DEPRECATED
Term Description
This panel should be used for CMS LCDS v3.00 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 |
|---|---|---|---|---|
| 85654-2 | Deprecated Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - version 3.00 [CMS Assessment] | |||
| Indent85645-0 | Deprecated Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Admission - version 3.00 [CMS Assessment] | |||
| Indent Indent85636-9 | Administrative Information | |||
| Indent Indent Indent58198-3 | Type of Record | |||
| Indent Indent Indent54581-4 | Facility Provider Numbers | |||
| Indent Indent Indent Indent76468-8 | National Provider Identifier (NPI) | |||
| Indent Indent Indent Indent69417-4 | CMS Certification Number (CCN) | |||
| Indent Indent Indent Indent45398-5 | State Medicaid Provider Number | |||
| Indent Indent Indent85632-8 | Type of Provider | |||
| Indent Indent Indent54593-9 | Assessment Reference Date. Observation end date | {mm/dd/yyyy} | ||
| Indent Indent Indent52455-3 | Admission Date | {mm/dd/yyyy} | ||
| Indent Indent Indent52454-6 | Reason for Assessment | |||
| Indent Indent Indent85816-7 | Patient Demographic Information | |||
| Indent Indent Indent Indent54503-8 | Legal Name of Patient | |||
| Indent Indent Indent Indent Indent45392-8 | First name | |||
| Indent Indent Indent Indent Indent45393-6 | Middle initial | |||
| Indent Indent Indent Indent Indent45394-4 | Patient Last (Family) name | |||
| Indent Indent Indent Indent Indent45395-1 | Suffix | |||
| Indent Indent Indent Indent45966-9 | Social Security and Medicare Numbers | |||
| Indent Indent Indent Indent Indent45396-9 | Social Security Number | |||
| Indent Indent Indent Indent Indent45397-7 | Medicare number (or comparable railroad insurance number) | |||
| Indent Indent Indent Indent45400-9 | Medicaid Number | |||
| Indent Indent Indent Indent46098-0 | Gender | |||
| Indent Indent Indent Indent21112-8 | Birth Date | {mm/dd/yyyy} | ||
| Indent Indent Indent Indent59362-4 | Race/Ethnicity | 1..6 | ||
| Indent Indent Indent Indent54505-3 | Language | |||
| Indent Indent Indent Indent Indent54588-9 | Does the resident need or want an interpreter to communicate with a doctor or health care staff? | |||
| Indent Indent Indent Indent Indent54899-0 | Preferred language | |||
| Indent Indent Indent Indent45404-1 | Marital Status | |||
| Indent Indent Indent Indent52556-8 | Payer Information | 1..13 | ||
| Indent Indent Indent85815-9 | Pre-Admission Service Use | |||
| Indent Indent Indent Indent85398-6 | Admitted From | |||
| Indent Indent85640-1 | Hearing, Speech, and Vision | |||
| Indent Indent Indent85629-4 | Comatose - persistent vegetative state and no discernible consciousness | |||
| Indent Indent Indent83250-1 | Expression of Ideas and Wants | |||
| Indent Indent Indent83249-3 | Understanding Verbal Content | |||
| Indent Indent85638-5 | Cognitive Patterns | |||
| Indent Indent Indent85649-2 | Signs and Symptoms of Delirium (from CAM) | |||
| Indent Indent Indent Indent85812-6 | Acute onset and fluctuating course | |||
| Indent Indent Indent Indent Indent85634-4 | Is there evidence of an acute change in mental status from the patient's baseline? | |||
| Indent Indent Indent Indent Indent85630-2 | Did the (abnormal) behavior fluctuate during the day, that is, tend to come and go or increase and decrease in severity? | |||
| Indent Indent Indent Indent85631-0 | Inattention.Did the patient have difficulty focusing attention, for example, being easily distractible or having difficulty keeping track of what was being said? | |||
| Indent Indent Indent Indent85651-8 | 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? | |||
| Indent Indent Indent Indent85811-8 | Altered level of consciousness | |||
| Indent Indent Indent Indent Indent85646-8 | Overall, how would you rate the patient's level of consciousness? Alert (Normal) | |||
| Indent Indent Indent Indent Indent85655-9 | 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) | |||
| Indent Indent85639-3 | Functional Abilities and Goals | |||
| Indent Indent Indent85642-7 | Prior Functioning: Everyday Activities | |||
| Indent Indent Indent Indent85071-9 | Indoor Mobility (Ambulation) | |||
| Indent Indent Indent83234-5 | Prior Device Use | 1..4 | ||
| Indent Indent Indent85667-4 | Self-Care - Admission Performance | |||
| Indent Indent Indent Indent83232-9 | Eating | |||
| Indent Indent Indent Indent83230-3 | Oral hygiene | |||
| Indent Indent Indent Indent83228-7 | Toileting hygiene | |||
| Indent Indent Indent Indent85652-6 | Wash upper body | |||
| Indent Indent Indent85661-7 | Self-Care - Discharge Goal | |||
| Indent Indent Indent Indent83231-1 | Eating | |||
| Indent Indent Indent Indent83229-5 | Oral hygiene | |||
| Indent Indent Indent Indent83227-9 | Toileting hygiene | |||
| Indent Indent Indent Indent85653-4 | Wash upper body | |||
| Indent Indent Indent85641-9 | Mobility - Admission Performance | |||
| Indent Indent Indent Indent83218-8 | Roll left and right | |||
| Indent Indent Indent Indent83216-2 | Sit to lying | |||
| Indent Indent Indent Indent83214-7 | Lying to sitting on side of bed | |||
| Indent Indent Indent Indent83212-1 | Sit to stand | |||
| Indent Indent Indent Indent83210-5 | Chair/bed-to-chair transfer | |||
| Indent Indent Indent Indent83208-9 | Toilet transfer | |||
| Indent Indent Indent Indent83270-9 | Does the patient walk? | |||
| Indent Indent Indent Indent83204-8 | Walk 10 feet | |||
| Indent Indent Indent Indent83202-2 | Walk 50 feet with two turns | |||
| Indent Indent Indent Indent83200-6 | Walk 150 feet | |||
| Indent Indent Indent Indent83271-7 | Does the patient use a wheelchair/scooter? | |||
| Indent Indent Indent Indent83188-3 | Wheel 50 feet with two turns | |||
| Indent Indent Indent Indent83272-5 | Indicate the type of wheelchair/scooter used | |||
| Indent Indent Indent Indent83235-2 | Wheel 150 feet | |||
| Indent Indent Indent Indent83272-5 | Indicate the type of wheelchair/scooter used | |||
| Indent Indent Indent85660-9 | Mobility - Discharge Goal | |||
| Indent Indent Indent Indent83217-0 | Roll left and right | |||
| Indent Indent Indent Indent83215-4 | Sit to lying | |||
| Indent Indent Indent Indent83213-9 | Lying to sitting on side of bed | |||
| Indent Indent Indent Indent83211-3 | Sit to stand | |||
| Indent Indent Indent Indent83209-7 | Chair/Bed-to-chair transfer | |||
| Indent Indent Indent Indent83207-1 | Toilet transfer | |||
| Indent Indent Indent Indent83203-0 | Walk 10 feet | |||
| Indent Indent Indent Indent83201-4 | Walk 50 feet with two turns | |||
| Indent Indent Indent Indent83199-0 | Walk 150 feet | |||
| Indent Indent Indent Indent83187-5 | Wheel 50 feet with two turns | |||
| Indent Indent Indent Indent83236-0 | Wheel 150 feet | |||
| Indent Indent83237-8 | Bladder and Bowel | |||
| Indent Indent Indent83238-6 | Bladder Continence | |||
| Indent Indent Indent83242-8 | Bowel Continence | |||
| Indent Indent85635-1 | Active Diagnoses | |||
| Indent Indent Indent85633-6 | Indicate the patient's primary medical condition category | |||
| Indent Indent Indent52797-8 | Other medical condition | |||
| Indent Indent Indent83243-6 | Comorbidities and coexisting conditions | 0..24 | ||
| Indent Indent85644-3 | Swallowing/Nutritional Status | |||
| Indent Indent Indent54567-3 | Height and Weight | |||
| Indent Indent Indent Indent3137-7 | Height (in inches) | [in_us];cm;m | ||
| Indent Indent Indent Indent3141-9 | Weight (in pounds) | [lb_av];kg | ||
| Indent Indent85055-2 | Skin Conditions | |||
| Indent Indent Indent58214-8 | Unhealed Pressure Ulcer(s). Does this patient have one or more unhealed pressure ulcer(s) at Stage 1 or higher? | |||
| Indent Indent Indent83246-9 | Current Number of Unhealed Pressure Ulcers at Each Stage - Admission | |||
| Indent Indent Indent Indent54884-2 | Number of Stage 1 pressure ulcers | {#} | ||
| Indent Indent Indent Indent55124-2 | Number of Stage 2 pressure ulcers | {#} | ||
| Indent Indent Indent Indent55125-9 | Number of Stage 3 pressure ulcers | {#} | ||
| Indent Indent Indent Indent55126-7 | Number of Stage 4 pressure ulcers | {#} | ||
| Indent Indent Indent Indent54893-3 | Number of unstageable pressure ulcers due to non-removable dressing/device | {#} | ||
| Indent Indent Indent Indent54946-9 | Number of unstageable pressure ulcers due to coverage of wound bed by slough and/or eschar | {#} | ||
| Indent Indent Indent Indent54950-1 | Number of unstageable pressure ulcers with suspected deep tissue injury in evolution | {#} | ||
| Indent Indent85643-5 | Special Treatments, Procedures, and Programs | |||
| Indent Indent Indent83252-7 | Special Treatments, Procedures, and Programs | 1..3 | ||
| Indent Indent Indent69339-0 | Influenza Vaccine | |||
| Indent Indent Indent Indent55019-4 | Did the patient receive the influenza vaccine in this facility for this year's influenza vaccination season? | |||
| Indent Indent Indent Indent58131-4 | Date influenza vaccine received | {mm/dd/yyyy} | ||
| Indent Indent Indent Indent55020-2 | If influenza vaccine not received, state reason: | C | ||
| Indent Indent85637-7 | Assessment Administration | |||
| Indent Indent Indent85648-4 | Signature of Persons Completing the Assessment | 0..12 | ||
| Indent Indent Indent Indent85647-6 | Signature | |||
| Indent Indent Indent Indent85650-0 | Title | |||
| Indent Indent Indent70157-3 | Sections | |||
| Indent Indent Indent70158-1 | Date sections completed | |||
| Indent Indent Indent70127-6 | Signature of Person Verifying Assessment Completion | |||
| Indent Indent Indent30947-6 | LTCH CARE Data Set completion date | {mm/dd/yyyy} | ||
| Indent85662-5 | Deprecated Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Planned Discharge - version 3.00 [CMS Assessment] | |||
| Indent Indent85663-3 | Administrative Information | |||
| Indent Indent Indent58198-3 | Type of Record | |||
| Indent Indent Indent54581-4 | Facility Provider Numbers | |||
| Indent Indent Indent Indent76468-8 | National Provider Identifier (NPI) | |||
| Indent Indent Indent Indent69417-4 | CMS Certification Number (CCN) | |||
| Indent Indent Indent Indent45398-5 | State Medicaid Provider Number | |||
| Indent Indent Indent85632-8 | Type of Provider | |||
| Indent Indent Indent54593-9 | Assessment Reference Date. Observation end date | {mm/dd/yyyy} | ||
| Indent Indent Indent52455-3 | Admission Date | {mm/dd/yyyy} | ||
| Indent Indent Indent52454-6 | Reason for Assessment | |||
| Indent Indent Indent52525-3 | Discharge Date | {mm/dd/yyyy} | ||
| Indent Indent Indent85817-5 | Patient Demographic Information | |||
| Indent Indent Indent Indent54503-8 | Legal Name of Patient | |||
| Indent Indent Indent Indent Indent45392-8 | Patient First (Given) name | |||
| Indent Indent Indent Indent Indent45393-6 | Middle initial | |||
| Indent Indent Indent Indent Indent45394-4 | Patient Last (Family) name | |||
| Indent Indent Indent Indent Indent45395-1 | Suffix | |||
| Indent Indent Indent Indent45966-9 | Social Security and Medicare numbers | |||
| Indent Indent Indent Indent Indent45396-9 | Social Security Number | |||
| Indent Indent Indent Indent Indent45397-7 | Medicare number (or comparable railroad insurance number) | |||
| Indent Indent Indent Indent45400-9 | Medicaid Number | |||
| Indent Indent Indent Indent46098-0 | Gender | |||
| Indent Indent Indent Indent21112-8 | Birth date | {mm/dd/yyyy} | ||
| Indent Indent Indent Indent59362-4 | Race/Ethnicity | 1..6 | ||
| Indent Indent Indent Indent52556-8 | Payer Information | 1..13 | ||
| Indent Indent Indent55128-3 | Discharge Location | |||
| Indent Indent Indent85412-5 | Program Interruption(s) | |||
| Indent Indent Indent85669-0 | Number of Program Interruptions During This Stay in This Facility | {#} | ||
| Indent Indent Indent85483-6 | Program Interruption Dates | 0..5 | ||
| Indent Indent Indent Indent85413-3 | Interruption Start Date | 1..1 | {mm/dd/yyyy} | |
| Indent Indent Indent Indent85414-1 | Interruption End Date | 1..1 | {mm/dd/yyyy} | |
| Indent Indent85640-1 | Hearing, Speech, and Vision | |||
| Indent Indent Indent85629-4 | Comatose - persistent vegetative state and no discernible consciousness | |||
| Indent Indent Indent83250-1 | Expression of Ideas and Wants | |||
| Indent Indent Indent83249-3 | Understanding Verbal Content | |||
| Indent Indent85638-5 | Cognitive Patterns | |||
| Indent Indent Indent85649-2 | LCDS v3.00 - Signs and Symptoms of Delirium (from CAM) [CMS Assessment] | |||
| Indent Indent Indent Indent85812-6 | Acute onset and fluctuating course | |||
| Indent Indent Indent Indent Indent85634-4 | Is there evidence of an acute change in mental status from the patient's baseline? | |||
| Indent Indent Indent Indent Indent85630-2 | Did the (abnormal) behavior fluctuate during the day, that is, tend to come and go or increase and decrease in severity? | |||
| Indent Indent Indent Indent85631-0 | Inattention.Did the patient have difficulty focusing attention, for example, being easily distractible or having difficulty keeping track of what was being said? | |||
| Indent Indent Indent Indent85651-8 | 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? | |||
| Indent Indent Indent Indent85811-8 | Altered level of consciousness | |||
| Indent Indent Indent Indent Indent85646-8 | Overall, how would you rate the patient's level of consciousness? Alert (Normal) | |||
| Indent Indent Indent Indent Indent85655-9 | 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) | |||
| Indent Indent85664-1 | Functional Abilities and Goals | |||
| Indent Indent Indent85665-8 | Self-Care - Discharge Performance | |||
| Indent Indent Indent Indent83232-9 | Eating | |||
| Indent Indent Indent Indent83230-3 | Oral hygiene | |||
| Indent Indent Indent Indent83228-7 | Toileting hygiene | |||
| Indent Indent Indent Indent85652-6 | Wash upper body | |||
| Indent Indent Indent85672-4 | Mobility - Discharge Performance | |||
| Indent Indent Indent Indent83218-8 | Roll left and right | |||
| Indent Indent Indent Indent83216-2 | Sit to lying | |||
| Indent Indent Indent Indent83214-7 | Lying to sitting on side of bed | |||
| Indent Indent Indent Indent83212-1 | Sit to stand | |||
| Indent Indent Indent Indent83210-5 | Chair/bed-to-chair transfer | |||
| Indent Indent Indent Indent83208-9 | Toilet transfer | |||
| Indent Indent Indent Indent83278-2 | Does the patient walk? | |||
| Indent Indent Indent Indent83204-8 | Walk 10 feet | |||
| Indent Indent Indent Indent83202-2 | Walk 50 feet with two turns | |||
| Indent Indent Indent Indent83200-6 | Walk 150 feet | |||
| Indent Indent Indent Indent83271-7 | Does the patient use a wheelchair/scooter? | |||
| Indent Indent Indent Indent83188-3 | Wheel 50 feet with two turns | |||
| Indent Indent Indent Indent83272-5 | Indicate the type of wheelchair/scooter used | |||
| Indent Indent Indent Indent83235-2 | Wheel 150 feet | |||
| Indent Indent Indent Indent83272-5 | Indicate the type of wheelchair/scooter used | |||
| Indent Indent85666-6 | Bladder and Bowel | |||
| Indent Indent Indent83238-6 | Bladder Continence | |||
| Indent Indent83279-0 | Health Conditions | |||
| Indent Indent Indent83280-8 | Any Falls Since Admission. Has the patient had any falls since admission? | |||
| Indent Indent Indent54854-5 | Number of Falls Since Admission | |||
| Indent Indent Indent Indent54855-2 | No injury | |||
| Indent Indent Indent Indent54856-0 | Injury (except major) | |||
| Indent Indent Indent Indent54857-8 | Major injury | |||
| Indent Indent85670-8 | Skin conditions | |||
| Indent Indent Indent58214-8 | Unhealed Pressure Ulcer(s). Does this patient have one or more unhealed pressure ulcer(s) at Stage 1 or higher? | |||
| Indent Indent Indent83256-8 | Current Number of Unhealed Pressure Ulcers at Each Stage | |||
| Indent Indent Indent Indent54884-2 | Number of Stage 1 pressure ulcers | {#} | ||
| Indent Indent Indent Indent55124-2 | Number of Stage 2 pressure ulcers | {#} | ||
| Indent Indent Indent Indent54886-7 | Number of these Stage 2 pressure ulcers that were present upon admission | {#} | ||
| Indent Indent Indent Indent55125-9 | Number of Stage 3 pressure ulcers | {#} | ||
| Indent Indent Indent Indent54887-5 | Number of these Stage 3 pressure ulcers that were present upon admission | {#} | ||
| Indent Indent Indent Indent55126-7 | Number of Stage 4 pressure ulcers | {#} | ||
| Indent Indent Indent Indent54890-9 | Number of these Stage 4 pressure ulcers that were present upon admission | {#} | ||
| Indent Indent Indent Indent54893-3 | Number of unstageable pressure ulcers due to non-removable dressing/device | {#} | ||
| Indent Indent Indent Indent54894-1 | Number of these unstageable pressure ulcers that were present upon admission | {#} | ||
| Indent Indent Indent Indent54946-9 | Number of unstageable pressure ulcers due to coverage of wound bed by slough and/or eschar | {#} | ||
| Indent Indent Indent Indent54947-7 | Number of these unstageable pressure ulcers that were present upon admission | {#} | ||
| Indent Indent Indent Indent54950-1 | Number of unstageable pressure ulcers with suspected deep tissue injury in evolution | {#} | ||
| Indent Indent Indent Indent54951-9 | Number of these unstageable pressure ulcers that were present upon admission | {#} | ||
| Indent Indent Indent83282-4 | Worsening in Pressure Ulcer Status Since Admission | |||
| Indent Indent Indent Indent83283-2 | Stage 2 | {#} | ||
| Indent Indent Indent Indent83284-0 | Stage 3 | {#} | ||
| Indent Indent Indent Indent83285-7 | Stage 4 | {#} | ||
| Indent Indent Indent Indent83286-5 | Unstageable - Non-removable dressing | {#} | ||
| Indent Indent Indent Indent83287-3 | Unstageable - Slough and/or eschar | {#} | ||
| Indent Indent Indent Indent83288-1 | Unstageable - Deep tissue injury | {#} | ||
| Indent Indent83247-7 | Special Treatments, Procedures, and Programs | |||
| Indent Indent Indent69339-0 | Influenza Vaccine | |||
| Indent Indent Indent Indent55019-4 | Did the patient receive the influenza vaccine in this facility for this year's influenza vaccination season? | |||
| Indent Indent Indent Indent58131-4 | Date influenza vaccine received | {mm/dd/yyyy} | ||
| Indent Indent Indent Indent55020-2 | If influenza vaccine not received, state reason: | C | ||
| Indent Indent85637-7 | Assessment Administration | |||
| Indent Indent Indent85648-4 | Signature of Persons Completing the Assessment | 0..12 | ||
| Indent Indent Indent Indent85647-6 | Signature | |||
| Indent Indent Indent Indent85650-0 | Title | |||
| Indent Indent Indent70157-3 | Sections | |||
| Indent Indent Indent70158-1 | Date Sections Completed | |||
| Indent Indent Indent70127-6 | Signature of Person Verifying Assessment Completion | |||
| Indent Indent Indent30947-6 | LTCH CARE Data Set Completion Date | {mm/dd/yyyy} | ||
| Indent85668-2 | Deprecated Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Unplanned Discharge - version 3.00 [CMS Assessment] | |||
| Indent Indent85663-3 | Administrative Information | |||
| Indent Indent Indent58198-3 | Type of Record | |||
| Indent Indent Indent54581-4 | Facility Provider Numbers | |||
| Indent Indent Indent Indent76468-8 | National Provider Identifier (NPI) | |||
| Indent Indent Indent Indent69417-4 | CMS Certification Number (CCN) | |||
| Indent Indent Indent Indent45398-5 | State Medicaid Provider Number | |||
| Indent Indent Indent85632-8 | Type of Provider | |||
| Indent Indent Indent54593-9 | Assessment Reference Date. Observation end date | {mm/dd/yyyy} | ||
| Indent Indent Indent52455-3 | Admission Date | {mm/dd/yyyy} | ||
| Indent Indent Indent52454-6 | Reason for Assessment | |||
| Indent Indent Indent52525-3 | Discharge Date | {mm/dd/yyyy} | ||
| Indent Indent Indent85817-5 | Patient Demographic Information | |||
| Indent Indent Indent Indent54503-8 | Legal Name of Patient | |||
| Indent Indent Indent Indent Indent45392-8 | Patient First (Given) name | |||
| Indent Indent Indent Indent Indent45393-6 | Middle initial | |||
| Indent Indent Indent Indent Indent45394-4 | Patient Last (Family) name | |||
| Indent Indent Indent Indent Indent45395-1 | Suffix | |||
| Indent Indent Indent Indent45966-9 | Social Security and Medicare Numbers | |||
| Indent Indent Indent Indent Indent45396-9 | Social Security Number | |||
| Indent Indent Indent Indent Indent45397-7 | Medicare number (or comparable railroad insurance number) | |||
| Indent Indent Indent Indent45400-9 | Medicaid number | |||
| Indent Indent Indent Indent46098-0 | Gender | |||
| Indent Indent Indent Indent21112-8 | Birth Date | {mm/dd/yyyy} | ||
| Indent Indent Indent Indent59362-4 | Race/Ethnicity | 1..6 | ||
| Indent Indent Indent Indent52556-8 | Payer Information | 1..13 | ||
| Indent Indent Indent55128-3 | Discharge Location | |||
| Indent Indent Indent85412-5 | Program Interruption(s) | |||
| Indent Indent Indent85669-0 | Number of Program Interruptions During This Stay in This Facility | {#} | ||
| Indent Indent Indent85483-6 | Program Interruption Dates | 0..5 | ||
| Indent Indent Indent Indent85413-3 | Interruption Start Date | 1..1 | {mm/dd/yyyy} | |
| Indent Indent Indent Indent85414-1 | Interruption End Date | 1..1 | {mm/dd/yyyy} | |
| Indent Indent85638-5 | Cognitive Patterns | |||
| Indent Indent Indent85649-2 | Signs and Symptoms of Delirium (from CAM) | |||
| Indent Indent Indent Indent85812-6 | Acute onset and fluctuating course | |||
| Indent Indent Indent Indent Indent85634-4 | Is there evidence of an acute change in mental status from the patient's baseline? | |||
| Indent Indent Indent Indent Indent85630-2 | Did the (abnormal) behavior fluctuate during the day, that is, tend to come and go or increase and decrease in severity? | |||
| Indent Indent Indent Indent85631-0 | Inattention. Did the patient have difficulty focusing attention, for example, being easily distractible or having difficulty keeping track of what was being said? | |||
| Indent Indent Indent Indent85651-8 | 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? | |||
| Indent Indent Indent Indent85811-8 | Altered Level of Consciousness | |||
| Indent Indent Indent Indent Indent85646-8 | Overall, how would you rate the patient's level of consciousness? Alert (Normal) | |||
| Indent Indent Indent Indent Indent85655-9 | 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) | |||
| Indent Indent83279-0 | Health Conditions | |||
| Indent Indent Indent83280-8 | Any falls since admission. Has the patient had any falls since admission? | |||
| Indent Indent Indent54854-5 | Number of Falls Since Admission | |||
| Indent Indent Indent Indent54855-2 | No injury | |||
| Indent Indent Indent Indent54856-0 | Injury (except major) | |||
| Indent Indent Indent Indent54857-8 | Major injury | |||
| Indent Indent85670-8 | Skin Conditions | |||
| Indent Indent Indent58214-8 | Unhealed Pressure Ulcer(s). Does this patient have one or more unhealed pressure ulcer(s) at Stage 1 or higher? | |||
| Indent Indent Indent83256-8 | Current Number of Unhealed Pressure Ulcers at Each Stage | |||
| Indent Indent Indent Indent54884-2 | Number of Stage 1 pressure ulcers | {#} | ||
| Indent Indent Indent Indent55124-2 | Number of Stage 2 pressure ulcers | {#} | ||
| Indent Indent Indent Indent54886-7 | Number of these Stage 2 pressure ulcers that were present upon admission | {#} | ||
| Indent Indent Indent Indent55125-9 | Number of Stage 3 pressure ulcers | {#} | ||
| Indent Indent Indent Indent54887-5 | Number of these Stage 3 pressure ulcers that were present upon admission | {#} | ||
| Indent Indent Indent Indent55126-7 | Number of Stage 4 pressure ulcers | {#} | ||
| Indent Indent Indent Indent54890-9 | Number of these Stage 4 pressure ulcers that were present upon admission | {#} | ||
| Indent Indent Indent Indent54893-3 | Number of unstageable pressure ulcers due to non-removable dressing/device | {#} | ||
| Indent Indent Indent Indent54894-1 | Number of these unstageable pressure ulcers that were present upon admission | {#} | ||
| Indent Indent Indent Indent54946-9 | Number of unstageable pressure ulcers due to coverage of wound bed by slough and/or eschar | {#} | ||
| Indent Indent Indent Indent54947-7 | Number of these unstageable pressure ulcers that were present upon admission | {#} | ||
| Indent Indent Indent Indent54950-1 | Number of unstageable pressure ulcers with suspected deep tissue injury in evolution | {#} | ||
| Indent Indent Indent Indent54951-9 | Number of these unstageable pressure ulcers that were present upon admission | {#} | ||
| Indent Indent Indent83282-4 | Worsening in Pressure Ulcer Status Since Admission | |||
| Indent Indent Indent Indent83283-2 | Stage 2 | {#} | ||
| Indent Indent Indent Indent83284-0 | Stage 3 | {#} | ||
| Indent Indent Indent Indent83285-7 | Stage 4 | {#} | ||
| Indent Indent Indent Indent83286-5 | Unstageable - Non-removable dressing | {#} | ||
| Indent Indent Indent Indent83287-3 | Unstageable - Slough and/or eschar | {#} | ||
| Indent Indent Indent Indent83288-1 | Unstageable - Deep tissue injury | {#} | ||
| Indent Indent83247-7 | Special Treatments, Procedures, and Programs | |||
| Indent Indent Indent69339-0 | Influenza Vaccine | |||
| Indent Indent Indent Indent55019-4 | Did the patient receive the influenza vaccine in this facility for this year's influenza vaccination season? | |||
| Indent Indent Indent Indent58131-4 | Date influenza vaccine received | {mm/dd/yyyy} | ||
| Indent Indent Indent Indent55020-2 | If influenza vaccine not received, state reason: | C | ||
| Indent Indent85637-7 | Assessment Administration | |||
| Indent Indent Indent85648-4 | Signature of Persons Completing the Assessment | 0..12 | ||
| Indent Indent Indent Indent85647-6 | Signature | |||
| Indent Indent Indent Indent85650-0 | Title | |||
| Indent Indent Indent70157-3 | Sections | |||
| Indent Indent Indent70158-1 | Date Section Completed | |||
| Indent Indent Indent70127-6 | Signature of Person Verifying Assessment Completion | |||
| Indent Indent Indent30947-6 | LTCH CARE Data Set Completion Date | {mm/dd/yyyy} | ||
| Indent85671-6 | Deprecated Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Expired - version 3.00 [CMS Assessment] | |||
| Indent Indent85673-2 | Administrative Information | |||
| Indent Indent Indent58198-3 | Type of Record | |||
| Indent Indent Indent54581-4 | Facility Provider Numbers | |||
| Indent Indent Indent Indent76468-8 | National Provider Identifier (NPI) | |||
| Indent Indent Indent Indent69417-4 | CMS Certification Number (CCN) | |||
| Indent Indent Indent Indent45398-5 | State Medicaid Provider Number | |||
| Indent Indent Indent85632-8 | Type of Provider | |||
| Indent Indent Indent54593-9 | Assessment Reference Date. Observation end date | {mm/dd/yyyy} | ||
| Indent Indent Indent52455-3 | Admission Date | {mm/dd/yyyy} | ||
| Indent Indent Indent52454-6 | Reason for Assessment | |||
| Indent Indent Indent52525-3 | Discharge Date | {mm/dd/yyyy} | ||
| Indent Indent Indent85817-5 | Patient Demographic Information | |||
| Indent Indent Indent Indent54503-8 | Legal Name of Patient | |||
| Indent Indent Indent Indent Indent45392-8 | Patient First (Given) name | |||
| Indent Indent Indent Indent Indent45393-6 | Middle initial | |||
| Indent Indent Indent Indent Indent45394-4 | Patient Last (Family) name | |||
| Indent Indent Indent Indent Indent45395-1 | Suffix | |||
| Indent Indent Indent Indent45966-9 | Social Security and Medicare numbers | |||
| Indent Indent Indent Indent Indent45396-9 | Social Security Number | |||
| Indent Indent Indent Indent Indent45397-7 | Medicare number (or comparable railroad insurance number) | |||
| Indent Indent Indent Indent45400-9 | Medicaid Number | |||
| Indent Indent Indent Indent46098-0 | Gender | |||
| Indent Indent Indent Indent21112-8 | Birth Date | {mm/dd/yyyy} | ||
| Indent Indent Indent Indent59362-4 | Race/Ethnicity | 1..6 | ||
| Indent Indent Indent Indent52556-8 | Payer Information | 1..13 | ||
| Indent Indent83279-0 | Health Conditions | |||
| Indent Indent Indent83280-8 | Any Falls Since Admission. Has the patient had any falls since admission? | |||
| Indent Indent Indent54854-5 | Number of Falls Since Admission | |||
| Indent Indent Indent Indent54855-2 | No injury | |||
| Indent Indent Indent Indent54856-0 | Injury (except major) | |||
| Indent Indent Indent Indent54857-8 | Major injury | |||
| Indent Indent83247-7 | Special Treatments, Procedures, and Programs | |||
| Indent Indent Indent69339-0 | Influenza Vaccine | |||
| Indent Indent Indent Indent55019-4 | Did the patient receive the influenza vaccine in this facility for this year's influenza vaccination season? | |||
| Indent Indent Indent Indent58131-4 | Date influenza vaccine received | {mm/dd/yyyy} | ||
| Indent Indent Indent Indent55020-2 | If influenza vaccine not received, state reason: | C | ||
| Indent Indent85637-7 | Assessment Administration | |||
| Indent Indent Indent85648-4 | Signature of Persons Completing the Assessment | 0..12 | ||
| Indent Indent Indent Indent85647-6 | Signature | |||
| Indent Indent Indent Indent85650-0 | Title | |||
| Indent Indent Indent70157-3 | Sections | |||
| Indent Indent Indent70158-1 | Date Sections Completed | |||
| Indent Indent Indent70127-6 | Signature of Person Verifying Assessment Completion | |||
| Indent Indent Indent30947-6 | 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) - 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
- Convenience group
LOINC Terminology Service (API) using HL7® FHIR® Get Info
Requests to this service require a free LOINC username and password. Below is a sample of the possible capabilities. See the LOINC Terminology Service documentation for more information.
- CodeSystem lookup
- https:
//fhir.loinc.org/CodeSystem/$lookup?system=http: //loinc.org&code=85654-2 - Questionnaire definition
- https:
//fhir.loinc.org/Questionnaire/?url=http: //loinc.org/q/85654-2
LOINC Copyright
Copyright © 2025 Regenstrief Institute, Inc. All Rights Reserved. To the extent included herein, the LOINC table and LOINC codes are copyright © Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee. See https://