Version 2.77

Term Description

This panel should be used for CMS LCDS v4.00 assessments performed since July 1, 2018. The effective date of new versions of this form (e.g. v5.00) have been delayed due to the COVID-19 PHE. For the latest information, please see announcements on
Source: Regenstrief LOINC

Panel Hierarchy

Details for each LOINC in Panel LHC-Forms

LOINC Name R/O/C Cardinality Example UCUM Units
87507-0 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Planned Discharge - version 4.00 during assessment period [CMS Assessment]
Indent87504-7 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
IndentIndent52525-3 Discharge Date {mm/dd/yyyy}
IndentIndent85817-5 Patient Demographic Information
IndentIndentIndent54503-8 Legal Name of Patient
IndentIndentIndentIndent45392-8 Patient First (Given) 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
IndentIndentIndent52556-8 Payer Information 1..13
IndentIndent55128-3 Discharge Location
Indent87215-0 Hearing, Speech, and Vision
IndentIndent54597-0 Comatose. Persistent vegetative state/no discernible consciousness
IndentIndent95737-3 Expression of Ideas and Wants
IndentIndent95740-7 Understanding Verbal and Non-Verbal Content
Indent95854-6 Cognitive Patterns
IndentIndent95852-0 Signs and Symptoms of Delirium (from CAM)
IndentIndentIndent95853-8 Acute Onset and Fluctuating Course
IndentIndentIndentIndent95813-2 Is there evidence of an acute change in mental status from the patient's baseline?
IndentIndentIndentIndent95855-3 Did the (abnormal) behavior fluctuate during the day, that is, tend to come and go or increase and decrease in severity?
IndentIndentIndent95812-4 Inattention.Did the patient have difficulty focusing attention, for example, being easily distractible or having difficulty keeping track of what was being said?
IndentIndentIndent95814-0 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?
IndentIndentIndent95856-1 Altered Level of Consciousness
IndentIndentIndentIndent95857-9 Overall, how would you rate the patient's level of consciousness? Alert (Normal)
IndentIndentIndentIndent95858-7 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)
Indent88237-3 Functional Abilities and Goals
IndentIndent95861-1 Self-Care - Discharge Performance
IndentIndentIndent95019-6 Eating
IndentIndentIndent95018-8 Oral hygiene
IndentIndentIndent95017-0 Toileting hygiene
IndentIndentIndent95016-2 Wash upper body
IndentIndent87501-3 Mobility - Discharge Performance
IndentIndentIndent95011-3 Roll left and right
IndentIndentIndent95010-5 Sit to lying
IndentIndentIndent95009-7 Lying to sitting on side of bed
IndentIndentIndent95008-9 Sit to stand
IndentIndentIndent95007-1 Chair/bed-to-chair transfer
IndentIndentIndent95006-3 Toilet transfer
IndentIndentIndent95004-8 Walk 10 feet
IndentIndentIndent95003-0 Walk 50 feet with two turns
IndentIndentIndent95002-2 Walk 150 feet
IndentIndentIndent95738-1 Does the patient use a wheelchair and/or scooter?
IndentIndentIndent94992-5 Wheel 50 feet with two turns
IndentIndentIndent95739-9 Indicate the type of wheelchair or scooter used
IndentIndentIndent94991-7 Wheel 150 feet
IndentIndentIndent95739-9 Indicate the type of wheelchair or scooter used
Indent95863-7 Bladder and Bowel
IndentIndent95735-7 Bladder Continence
Indent83279-0 Health Conditions
IndentIndent83280-8 Any Falls Since Admission. Has the patient had any falls since admission?
IndentIndent54854-5 Number of Falls Since Admission
IndentIndentIndent54855-2 No injury
IndentIndentIndent54856-0 Injury (except major)
IndentIndentIndent54857-8 Major injury
Indent87500-5 Skin Conditions
IndentIndent58214-8 Unhealed Pressure Ulcers/Injuries. Does this patient have one or more unhealed pressure ulcers/injuries?
IndentIndent83256-8 Current Number of Unhealed Pressure Ulcers/Injuries at Each Stage
IndentIndentIndent54884-2 Number of Stage 1 pressure injuries {#}
IndentIndentIndent55124-2 Number of Stage 2 pressure ulcers {#}
IndentIndentIndent54886-7 Number of these Stage 2 pressure ulcers that were present upon admission {#}
IndentIndentIndent55125-9 Number of Stage 3 pressure ulcers {#}
IndentIndentIndent54887-5 Number of these Stage 3 pressure ulcers that were present upon admission {#}
IndentIndentIndent55126-7 Number of Stage 4 pressure ulcers {#}
IndentIndentIndent54890-9 Number of these Stage 4 pressure ulcers that were present upon admission {#}
IndentIndentIndent54893-3 Number of unstageable pressure ulcers/injuries due to non-removable dressing/device {#}
IndentIndentIndent54894-1 Number of these unstageable pressure ulcers/injuries that were present upon admission {#}
IndentIndentIndent54946-9 Number of unstageable pressure ulcers due to coverage of wound bed by slough and/or eschar {#}
IndentIndentIndent54947-7 Number of these unstageable pressure ulcers that were present upon admission {#}
IndentIndentIndent54950-1 Number of unstageable pressure injuries presenting as deep tissue injury {#}
IndentIndentIndent54951-9 Number of these unstageable pressure injuries that were present upon admission {#}
Indent87522-9 Medications
IndentIndent57256-0 Did the facility contact and complete physician (or physician-designee) prescribed/recommended actions by midnight of the next calendar day each time potential clinically significant medication issues were identified since the admission?
Indent87214-3 Special Treatments, Procedures, and Programs
IndentIndent86851-3 Ventilator Liberation Rate. Invasive Mechanical Ventilator: Liberation Status at Discharge
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

Fully-Specified Name

Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Planned Discharge - version 4.00
CMS Assessment

Basic Attributes

First Released
Version 2.63
Last Updated
Version 2.77
Change Reason
Release 2.77: TIME_ASPCT: Decision by CMS to update the Timing to RptPeriod from Pt for all CMS Assessments;
Order vs. Observation
Panel Type

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

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