88285-2
Deprecated MDS v3.0 - RAI v1.15.1 - Nursing home OMRA-discharge (NOD) and Swing bed OMRA-discharge (SOD) item set [CMS Assessment]
Deprecated
Status Information
- Status
- DEPRECATED
Term Description
This panel should be used for CMS MDS3.0 v1.15.1 NOD/SOD assessments performed between October 1, 2017 and September 30, 2018.
Source: Regenstrief LOINC
Panel Hierarchy
Details for each LOINC in Panel LHC-Forms
| LOINC | Name | R/O/C | Cardinality | Example UCUM Units |
|---|---|---|---|---|
| 88285-2 | Deprecated MDS v3.0 - RAI v1.15.1 - Nursing home OMRA-discharge (NOD) and Swing bed OMRA-discharge (SOD) item set [CMS Assessment] | |||
| Indent86811-7 | Identification Information | |||
| Indent Indent58198-3 | Type of Record | |||
| Indent Indent54581-4 | Facility Provider Numbers | |||
| Indent Indent Indent76468-8 | National Provider Identifier (NPI) | |||
| Indent Indent Indent69417-4 | CMS Certification Number (CCN) | |||
| Indent Indent Indent45398-5 | State Provider Number | |||
| Indent Indent85632-8 | Type of Provider | |||
| Indent Indent86524-6 | Type of Assessment | |||
| Indent Indent Indent54583-0 | Federal OBRA Reason for Assessment | |||
| Indent Indent Indent54584-8 | PPS Assessment | |||
| Indent Indent Indent54585-5 | PPS Other Medicare Required Assessment - OMRA | |||
| Indent Indent Indent58107-4 | Is this a Swing Bed clinical change assessment? | |||
| Indent Indent Indent54587-1 | Is this assessment the first assessment (OBRA, Scheduled PPS, or Discharge) since the most recent admission/entry or reentry? | |||
| Indent Indent Indent58108-2 | Entry/discharge reporting | |||
| Indent Indent Indent71440-2 | Type of discharge | |||
| Indent Indent Indent86525-3 | Is this a SNF Part A PPS Discharge Assessment? | |||
| Indent Indent86526-1 | Unit Certification or Licensure Designation | |||
| Indent Indent54503-8 | Legal Name of Resident | |||
| Indent Indent Indent45392-8 | First name | |||
| Indent Indent Indent45393-6 | Middle initial | |||
| Indent Indent Indent45394-4 | Last name | |||
| Indent Indent Indent45395-1 | Suffix | |||
| Indent Indent45966-9 | Social Security and Medicare Numbers | |||
| Indent Indent Indent45396-9 | Social Security Number | |||
| Indent Indent Indent45397-7 | Medicare number (or comparable railroad insurance number) | |||
| Indent Indent45400-9 | Medicaid Number | |||
| Indent Indent46098-0 | Gender | |||
| Indent Indent21112-8 | Birth Date | {mm/dd/yyyy} | ||
| Indent Indent59362-4 | Race/Ethnicity | 1..6 | ||
| Indent Indent54505-3 | Language | |||
| Indent Indent Indent54588-9 | Does the resident need or want an interpreter to communicate with a doctor or health care staff? | |||
| Indent Indent Indent54899-0 | Preferred language | |||
| Indent Indent45404-1 | Marital Status | |||
| Indent Indent54506-1 | Optional Resident Items | |||
| Indent Indent Indent46106-1 | Medical record number | |||
| Indent Indent Indent45403-3 | Room number | |||
| Indent Indent Indent52462-9 | Name by which resident prefers to be addressed | |||
| Indent Indent Indent21843-8 | Lifetime occupation(s) | |||
| Indent Indent86528-7 | Most Recent Admission/Entry or Reentry into this Facility | |||
| Indent Indent Indent50786-3 | Entry Date | {mm/dd/yyyy} | ||
| Indent Indent Indent54590-5 | Type of Entry | |||
| Indent Indent Indent85398-6 | Entered From | |||
| Indent Indent52455-3 | Admission Date (Date this episode of care in this facility began) | {mm/dd/yyyy} | ||
| Indent Indent52525-3 | Discharge Date | {mm/dd/yyyy} | ||
| Indent Indent55128-3 | Discharge Status | |||
| Indent Indent54593-9 | Assessment Reference Date. Observation end date | {mm/dd/yyyy} | ||
| Indent Indent54507-9 | Medicare Stay | |||
| Indent Indent Indent54594-7 | Has the resident had a Medicare-covered stay since the most recent entry? | |||
| Indent Indent Indent54595-4 | Start date of most recent Medicare stay | {mm/dd/yyyy} | ||
| Indent Indent Indent54596-2 | End date of most recent Medicare stay | {mm/dd/yyyy} | ||
| Indent86813-3 | Hearing, Speech, and Vision | |||
| Indent Indent54597-0 | Comatose. Persistent vegetative state/no discernible consciousness | |||
| Indent Indent54601-0 | Makes Self Understood. Ability to express ideas and wants, consider both verbal and non-verbal expression | |||
| Indent86882-8 | Cognitive Patterns | |||
| Indent Indent54605-1 | Should Brief Interview for Mental Status (C0200-C0500) be Conducted? | |||
| Indent Indent52491-8 | Brief Interview for Mental Status (BIMS) | |||
| Indent Indent Indent52731-7 | Repetition of Three Words. Number of words repeated after first attempt | |||
| Indent Indent Indent54510-3 | Temporal Orientation (orientation to year, month, and day) | |||
| Indent Indent Indent Indent52732-5 | Able to report correct year | |||
| Indent Indent Indent Indent52733-3 | Able to report correct month | |||
| Indent Indent Indent Indent54609-3 | Able to report correct day of the week | |||
| Indent Indent Indent52493-4 | Recall | |||
| Indent Indent Indent Indent52735-8 | Able to recall "sock" | |||
| Indent Indent Indent Indent52736-6 | Able to recall "blue" | |||
| Indent Indent Indent Indent52737-4 | Able to recall "bed" | |||
| Indent Indent Indent54614-3 | BIMS Summary Score | {score} | ||
| Indent Indent54615-0 | Should the Staff Assessment for Mental Status (C0700-C1000) be Conducted? | |||
| Indent Indent86814-1 | Staff Assessment for Mental Status | |||
| Indent Indent Indent54616-8 | Short-term Memory OK. Seems or appears to recall after 5 minutes | |||
| Indent Indent Indent54624-2 | Cognitive Skills for Daily Decision Making. Made decisions regarding tasks of daily life | |||
| Indent Indent86584-0 | Delirium | |||
| Indent Indent Indent86585-7 | Signs and Symptoms of Delirium (from CAM) | |||
| Indent Indent Indent Indent54632-5 | Acute Onset Mental Status Change. Is there evidence of an acute change in mental status from the resident's baseline? | |||
| Indent Indent Indent Indent54628-3 | Inattention - Did the resident have difficulty focusing attention, for example being easily distractible, or having difficulty keeping track of what was being said? | |||
| Indent Indent Indent Indent54629-1 | Disorganized thinking - Was the resident's thinking disorganized or incoherent (rambling or irrelevant conversation, unclear or illogical flow of ideas, or unpredictable switching from subject to subject)? | |||
| Indent Indent Indent Indent54630-9 | Altered level of consciousness - Did the resident have altered level of consciousness as indicated by any of the following criteria? | |||
| Indent54633-3 | Mood | |||
| Indent Indent54634-1 | Should Resident Mood Interview be Conducted? | |||
| Indent Indent54635-8 | Resident Mood Interview (PHQ-9) | |||
| Indent Indent Indent86843-0 | Symptom Presence | |||
| Indent Indent Indent Indent54636-6 | Little interest or pleasure in doing things | |||
| Indent Indent Indent Indent54638-2 | Feeling down, depressed or hopeless | |||
| Indent Indent Indent Indent54640-8 | Trouble falling or staying asleep, or sleeping too much | |||
| Indent Indent Indent Indent54642-4 | Feeling tired or having little energy | |||
| Indent Indent Indent Indent54644-0 | Poor appetite or overeating | |||
| Indent Indent Indent Indent54646-5 | Feeling bad about yourself - or that you are a failure or have let yourself or your family down | |||
| Indent Indent Indent Indent54648-1 | Trouble concentrating on things, such as reading the newspaper or watching television | |||
| Indent Indent Indent Indent54650-7 | Moving or speaking so slowly that other people could have noticed. Or the opposite - being so fidgety or restless that you have been moving around a lot more than usual | |||
| Indent Indent Indent Indent54652-3 | Thoughts that you would be better off dead, or of hurting yourself in some way | |||
| Indent Indent Indent86844-8 | Symptom Frequency | |||
| Indent Indent Indent Indent54637-4 | Little interest or pleasure in doing things | |||
| Indent Indent Indent Indent54639-0 | Feeling down, depressed or hopeless | |||
| Indent Indent Indent Indent54641-6 | Trouble falling or staying asleep, or sleeping too much | |||
| Indent Indent Indent Indent54643-2 | Feeling tired or having little energy | |||
| Indent Indent Indent Indent54645-7 | Poor appetite or overeating | |||
| Indent Indent Indent Indent54647-3 | Feeling bad about yourself - or that you are a failure or have let yourself or your family down | |||
| Indent Indent Indent Indent54649-9 | Trouble concentrating on things, such as reading the newspaper or watching television | |||
| Indent Indent Indent Indent54651-5 | Moving or speaking so slowly that other people could have noticed. Or the opposite - being so fidgety or restless that you have been moving around a lot more than usual | |||
| Indent Indent Indent Indent54653-1 | Thoughts that you would be better off dead, or of hurting yourself in some way | |||
| Indent Indent54654-9 | Total Severity Score | {score} | ||
| Indent Indent54655-6 | Safety Notification. Was responsible staff or provider informed that there is a potential for resident self harm? | |||
| Indent Indent54657-2 | Staff Assessment of Resident Mood (PHQ-9-OV) | |||
| Indent Indent Indent86833-1 | Symptom Presence | |||
| Indent Indent Indent Indent54658-0 | Little interest or pleasure in doing things | |||
| Indent Indent Indent Indent54660-6 | Feeling or appearing down, depressed, or hopeless | |||
| Indent Indent Indent Indent54662-2 | Trouble falling or staying asleep, or sleeping too much | |||
| Indent Indent Indent Indent54664-8 | Feeling tired or having little energy | |||
| Indent Indent Indent Indent54666-3 | Poor appetite or overeating | |||
| Indent Indent Indent Indent54668-9 | Indicating that s/he feels bad about self, is a failure, or has let self or family down | |||
| Indent Indent Indent Indent54670-5 | Trouble concentrating on things, such as reading the newspaper or watching television | |||
| Indent Indent Indent Indent54672-1 | Moving or speaking so slowly that other people have noticed. Or the opposite-being so fidgety or restless that s/he has been moving around a lot more than usual | |||
| Indent Indent Indent Indent54673-9 | States that life isn't worth living, wishes for death, or attempts to harm self | |||
| Indent Indent Indent Indent54675-4 | Being short-tempered, easily annoyed | |||
| Indent Indent Indent86891-9 | Symptom Frequency | |||
| Indent Indent Indent Indent54659-8 | Little interest or pleasure in doing things | |||
| Indent Indent Indent Indent54661-4 | Feeling or appearing down, depressed, or hopeless | |||
| Indent Indent Indent Indent54663-0 | Trouble falling or staying asleep, or sleeping too much | |||
| Indent Indent Indent Indent54665-5 | Feeling tired or having little energy | |||
| Indent Indent Indent Indent54667-1 | Poor appetite or overeating | |||
| Indent Indent Indent Indent54669-7 | Indicating that s/he feels bad about self, is a failure, or has let self or family down | |||
| Indent Indent Indent Indent54671-3 | Trouble concentrating on things, such as reading the newspaper or watching television | |||
| Indent Indent Indent Indent54904-8 | Moving or speaking so slowly that other people have noticed. Or the opposite-being so fidgety or restless that s/he has been moving around a lot more than usual | |||
| Indent Indent Indent Indent54674-7 | States that life isn't worth living, wishes for death, or attempts to harm self | |||
| Indent Indent Indent Indent54676-2 | Being short-tempered, easily annoyed | |||
| Indent Indent54677-0 | Total Severity Score | {score} | ||
| Indent Indent54655-6 | Safety Notification. Was responsible staff or provider informed that there is a potential for resident self harm? | |||
| Indent86815-8 | Behavior | |||
| Indent Indent86597-2 | Potential Indicators of Psychosis | 1..2 | ||
| Indent Indent54514-5 | Behavioral Symptom - Presence & Frequency | |||
| Indent Indent Indent54682-0 | Physical behavioral symptoms directed toward others | d/(7.d) | ||
| Indent Indent Indent54683-8 | Verbal behavioral symptoms directed toward others | d/(7.d) | ||
| Indent Indent Indent54684-6 | Other behavioral symptoms not directed toward others | d/(7.d) | ||
| Indent Indent54692-9 | Rejection of Care - Presence & Frequency. Did the resident reject evaluation or care (e.g., bloodwork, taking medications, ADL assistance) that is necessary to achieve the resident's goals for health and well-being? | d/(7.d) | ||
| Indent Indent54693-7 | Wandering - Presence & Frequency. Has the resident wandered? | d/(7.d) | ||
| Indent86818-2 | Functional Status | |||
| Indent Indent86880-2 | Activities of Daily Living (ADL) Assistance. Self-Performance | |||
| Indent Indent Indent45588-1 | Bed mobility | |||
| Indent Indent Indent45590-7 | Transfer | |||
| Indent Indent Indent45592-3 | Walk in room | |||
| Indent Indent Indent45594-9 | Walk in corridor | |||
| Indent Indent Indent45596-4 | Locomotion on unit | |||
| Indent Indent Indent45598-0 | Locomotion off unit | |||
| Indent Indent Indent45600-4 | Dressing | |||
| Indent Indent Indent45602-0 | Eating | |||
| Indent Indent Indent45604-6 | Toilet use | |||
| Indent Indent Indent45606-1 | Personal hygiene | |||
| Indent Indent86884-4 | Activities of daily living (ADL) assistance. Support provided | |||
| Indent Indent Indent45589-9 | Bed mobility | |||
| Indent Indent Indent45591-5 | Transfer | |||
| Indent Indent Indent45603-8 | Eating | |||
| Indent Indent Indent45605-3 | Toilet use | |||
| Indent Indent86887-7 | Bathing | |||
| Indent Indent Indent45608-7 | Self-performance | |||
| Indent86615-2 | Functional Abilities and Goals - Discharge (End of SNF PPS Stay) | |||
| Indent Indent86616-0 | Self-Care - Discharge Performance | |||
| Indent Indent Indent83232-9 | Eating | |||
| Indent Indent Indent83230-3 | Oral hygiene | |||
| Indent Indent Indent83228-7 | Toileting hygiene | |||
| Indent Indent86617-8 | Mobility - Discharge Performance | |||
| Indent Indent Indent83216-2 | Sit to lying | |||
| Indent Indent Indent83214-7 | Lying to sitting on side of bed | |||
| Indent Indent Indent83212-1 | Sit to stand | |||
| Indent Indent Indent83210-5 | Chair/bed-to-chair transfer | |||
| Indent Indent Indent83208-9 | Toilet transfer | |||
| Indent Indent Indent83278-2 | Does the resident walk? | |||
| Indent Indent Indent83202-2 | Walk 50 feet with two turns | |||
| Indent Indent Indent83200-6 | Walk 150 feet | |||
| Indent Indent Indent83271-7 | Does the resident use a wheelchair/scooter? | |||
| Indent Indent Indent83188-3 | Wheel 50 feet with two turns | |||
| Indent Indent Indent83272-5 | Indicate the type of wheelchair/scooter used | |||
| Indent Indent Indent83235-2 | Wheel 150 feet | |||
| Indent Indent Indent83272-5 | Indicate the type of wheelchair/scooter used | |||
| Indent89049-1 | Bladder and Bowel | |||
| Indent Indent86624-4 | Appliances | 1..4 | ||
| Indent Indent86866-1 | Urinary Toileting Program | |||
| Indent Indent Indent54767-9 | Has a trial of a toileting program (e.g., scheduled toileting, prompted voiding, or bladder training) been attempted on admission/entry or reentry or since urinary incontinence was noted in this facility? | |||
| Indent Indent Indent54769-5 | Current toileting program or trial - Is a toileting program (e.g., scheduled toileting, prompted voiding, or bladder training) currently being used to manage the resident's urinary continence? | |||
| Indent Indent54770-3 | Urinary Continence | 1..1 | ||
| Indent Indent54771-1 | Bowel Continence | 1..1 | ||
| Indent Indent88695-2 | Bowel Toileting Program. Is a toileting program currently being used to manage the resident's bowel continence? | |||
| Indent86670-7 | Active Diagnoses | |||
| Indent Indent86671-5 | Active Diagnoses in the last 7 days | 1..* | ||
| Indent Indent52797-8 | Additional active diagnoses | 0..10 | ||
| Indent86822-4 | Health Conditions | |||
| Indent Indent54557-4 | Pain Management | |||
| Indent Indent Indent71447-7 | At any time in the last 5 days, has the resident: Received scheduled pain medication regimen? | |||
| Indent Indent Indent71448-5 | At any time in the last 5 days, has the resident: Received PRN pain medications OR was offered and declined? | |||
| Indent Indent Indent71449-3 | At any time in the last 5 days, has the resident: Received non-medication intervention for pain? | |||
| Indent Indent54828-9 | Should Pain Assessment Interview be Conducted? | |||
| Indent Indent54558-2 | Pain Assessment Interview | |||
| Indent Indent Indent54829-7 | Pain Presence. Have you had pain or hurting at any time in the last 5 days? | |||
| Indent Indent Indent54830-5 | Pain Frequency. How much of the time have you experienced pain or hurting over the last 5 days? | |||
| Indent Indent Indent54559-0 | Pain Effect on Function | |||
| Indent Indent Indent Indent54831-3 | Over the past 5 days, has pain made it hard for you to sleep at night? | |||
| Indent Indent Indent Indent54832-1 | Over the past 5 days, have you limited your day-to-day activities because of pain? | |||
| Indent Indent Indent54560-8 | Pain Intensity | |||
| Indent Indent Indent Indent54833-9 | Numeric Rating Scale (00-10) | |||
| Indent Indent Indent Indent54834-7 | Verbal Descriptor Scale | |||
| Indent Indent86890-1 | Other Health Conditions | |||
| Indent Indent Indent86675-6 | Shortness of Breath (dyspnea) | 1..3 | ||
| Indent Indent Indent54846-1 | Prognosis. Does the resident have a condition or chronic disease that may result in a life expectancy of less than 6 months? | |||
| Indent Indent Indent86676-4 | Problem Conditions | 1..4 | ||
| Indent Indent54853-7 | Has the resident had any falls since admission/entry or reentry or the prior assessment (OBRA or Scheduled PPS), whichever is more recent? | |||
| Indent Indent54854-5 | Number of Falls Since Admission/Entry or Reentry or Prior Assessment (OBRA or Scheduled PPS), whichever is more recent | |||
| Indent Indent Indent54855-2 | No injury | |||
| Indent Indent Indent54856-0 | Injury (except major) | |||
| Indent Indent Indent54857-8 | Major injury | |||
| Indent86826-5 | Swallowing/Nutritional Status | |||
| Indent Indent54567-3 | Height and Weight | |||
| Indent Indent Indent3137-7 | Height (in inches) | [in_us];cm;m | ||
| Indent Indent Indent3141-9 | Weight (in pounds) | [lb_av];kg | ||
| Indent Indent54863-6 | Weight Loss. Loss of 5% or more in the last month or loss of 10% or more in last 6 months | |||
| Indent Indent86678-0 | Weight Gain. Gain of 5% or more in the last month or gain of 10% or more in last 6 months | |||
| Indent Indent54568-1 | Nutritional Approaches | |||
| Indent Indent Indent71444-4 | Nutritional Approaches. While NOT a Resident | 1..4 | ||
| Indent Indent Indent71445-1 | Nutritional Approaches. While a Resident | 1..4 | ||
| Indent Indent86679-8 | Percent Intake by Artificial Route | |||
| Indent Indent Indent86680-6 | Proportion of total calories the resident received through parenteral or tube feeding. While NOT a Resident | |||
| Indent Indent Indent86681-4 | Proportion of total calories the resident received through parenteral or tube feeding. While a Resident | |||
| Indent Indent Indent86687-1 | Proportion of total calories the resident received through parenteral or tube feeding. During Entire 7 Days | |||
| Indent Indent Indent86682-2 | Average fluid intake per day by IV or tube feeding. While NOT a Resident | mL/d;L/d | ||
| Indent Indent Indent86683-0 | Average fluid intake per day by IV or tube feeding. While a Resident | mL/d;L/d | ||
| Indent Indent Indent86684-8 | Average fluid intake per day by IV or tube feeding. During Entire 7 Days | mL/d;L/d | ||
| Indent89053-3 | Skin Conditions | |||
| Indent Indent86708-5 | Determination of Pressure Ulcer Risk | 0..1 | ||
| Indent Indent58214-8 | Unhealed Pressure Ulcer(s). Does this resident have one or more unhealed pressure ulcer(s) at Stage 1 or higher? | |||
| Indent Indent86270-6 | Current Number of Unhealed Pressure Ulcers at Each Stage | |||
| Indent Indent Indent55124-2 | Number of Stage 2 pressure ulcers | {#} | ||
| Indent Indent Indent54886-7 | Number of these Stage 2 pressure ulcers that were present upon admission/entry or reentry | {#} | ||
| Indent Indent Indent55125-9 | Number of Stage 3 pressure ulcers | {#} | ||
| Indent Indent Indent54887-5 | Number of these Stage 3 pressure ulcers that were present upon admission/entry or reentry | {#} | ||
| Indent Indent Indent55126-7 | Number of Stage 4 pressure ulcers | {#} | ||
| Indent Indent Indent54890-9 | Number of these Stage 4 pressure ulcers that were present upon admission/entry or reentry | {#} | ||
| Indent Indent Indent54893-3 | Number of unstageable pressure ulcers due to non-removable dressing/device | {#} | ||
| Indent Indent Indent54894-1 | Number of these unstageable pressure ulcers that were present upon admission/entry or reentry | {#} | ||
| Indent Indent Indent54946-9 | Number of unstageable pressure ulcers due to coverage of wound bed by slough and/or eschar | {#} | ||
| Indent Indent Indent54947-7 | Number of these unstageable pressure ulcers that were present upon admission/entry or reentry | {#} | ||
| Indent Indent Indent54950-1 | Number of unstageable pressure ulcers with suspected deep tissue injury in evolution | {#} | ||
| Indent Indent Indent54951-9 | Number of these unstageable pressure ulcers that were present upon admission/entry or reentry | {#} | ||
| Indent Indent86746-5 | Dimensions of Unhealed Stage 3 or 4 Pressure Ulcers or Eschar | |||
| Indent Indent Indent86901-6 | Pressure ulcer length: Longest length from head to toe | cm | ||
| Indent Indent Indent86902-4 | Pressure ulcer width: Widest width of the same pressure ulcer, side-to-side perpendicular (90-degree angle) to length | cm | ||
| Indent Indent Indent57228-9 | Pressure ulcer depth: Depth of the same pressure ulcer from the visible surface to the deepest area | cm | ||
| Indent Indent54952-7 | Worsening in Pressure Ulcer Status Since Prior Assessment (OBRA or Scheduled PPS) or Last Admission/Entry or Reentry | |||
| Indent Indent Indent54953-5 | Stage 2 | {#} | ||
| Indent Indent Indent54954-3 | Stage 3 | {#} | ||
| Indent Indent Indent54955-0 | Stage 4 | {#} | ||
| Indent Indent54956-8 | Healed Pressure Ulcers | |||
| Indent Indent Indent54957-6 | Were pressure ulcers present on the prior assessment (OBRA or scheduled PPS)? | |||
| Indent Indent Indent54958-4 | Stage 2 | {#} | ||
| Indent Indent Indent54959-2 | Stage 3 | {#} | ||
| Indent Indent Indent54960-0 | Stage 4 | {#} | ||
| Indent Indent54970-9 | Number of Venous and Arterial Ulcers | {#} | ||
| Indent Indent88696-0 | Other Ulcers, Wounds and Skin Problems | 1..8 | ||
| Indent Indent86748-1 | Skin and Ulcer Treatments | 1..9 | ||
| Indent88305-8 | Medications | |||
| Indent Indent54982-4 | Injections. Record the number of days that injections of any type were received during the last 7 days or since admission/entry or reentry if less than 7 days. | d/(7.d) | ||
| Indent Indent58217-1 | Insulin | |||
| Indent Indent Indent58127-2 | Insulin injections - Record the number of days that insulin injections were received during the last 7 days or since admission/entry or reentry if less than 7 days | d/(7.d) | ||
| Indent Indent Indent58128-0 | Orders for insulin - Record the number of days the physician (or authorized assistant or practitioner) changed the resident's insulin orders during the last 7 days or since admission/entry or reentry if less than 7 days | d/(7.d) | ||
| Indent Indent88290-2 | Medications Received | |||
| Indent Indent Indent86751-5 | Antipsychotic | d/(7.d) | ||
| Indent Indent Indent86752-3 | Antianxiety | d/(7.d) | ||
| Indent Indent Indent86753-1 | Antidepressant | d/(7.d) | ||
| Indent Indent Indent86754-9 | Hypnotic | d/(7.d) | ||
| Indent Indent Indent86755-6 | Anticoagulant (e.g., warfarin, heparin, or low-molecular weight heparin) | d/(7.d) | ||
| Indent Indent Indent86756-4 | Antibiotic | d/(7.d) | ||
| Indent Indent Indent86757-2 | Diuretic | d/(7.d) | ||
| Indent Indent Indent88291-0 | Opiod | d/(7.d) | ||
| Indent86839-8 | Special Treatments, Procedures, and Programs | |||
| Indent Indent86761-4 | While a Resident | 0..10 | ||
| Indent Indent69339-0 | Influenza Vaccine | |||
| Indent Indent Indent55019-4 | Did the resident receive the influenza vaccine in this facility for this year's influenza vaccination season? | |||
| Indent Indent Indent58131-4 | Date influenza vaccine received | {mm/dd/yyyy} | ||
| Indent Indent Indent55020-2 | If influenza vaccine not received, state reason: | |||
| Indent Indent55021-0 | Pneumococcal Vaccine | |||
| Indent Indent Indent55022-8 | Is the resident's Pneumococcal vaccination up to date? | |||
| Indent Indent Indent45956-0 | If Pneumococcal vaccine not received, state reason: | |||
| Indent Indent86846-3 | Therapies | |||
| Indent Indent Indent86763-0 | Speech-Language Pathology and Audiology Services | |||
| Indent Indent Indent Indent58218-9 | Individual minutes - record the total number of minutes this therapy was administered to the resident individually in the last 7 days | min | ||
| Indent Indent Indent Indent58133-0 | Concurrent minutes - record the total number of minutes this therapy was administered to the resident concurrently with one other resident in the last 7 days | min | ||
| Indent Indent Indent Indent58134-8 | Group minutes - record the total number of minutes this therapy was administered to the resident as part of a group of residents in the last 7 days | min | ||
| Indent Indent Indent Indent86765-5 | Co-treatment minutes - record the total number of minutes this therapy was administered to the resident in co-treatment sessions in the last 7 days | min | ||
| Indent Indent Indent Indent45760-6 | Days - record the number of days this therapy was administered for at least 15 minutes a day in the last 7 days | d/(7.d) | ||
| Indent Indent Indent Indent55025-1 | Therapy start date - record the date the most recent therapy regimen (since the most recent entry) started | {mm/dd/yyyy} | ||
| Indent Indent Indent Indent55026-9 | Therapy end date - record the date the most recent therapy regimen (since the most recent entry) ended | {mm/dd/yyyy} | ||
| Indent Indent Indent86767-1 | Occupational Therapy | |||
| Indent Indent Indent Indent58219-7 | Individual minutes - record the total number of minutes this therapy was administered to the resident individually in the last 7 days | min | ||
| Indent Indent Indent Indent58136-3 | Concurrent minutes - record the total number of minutes this therapy was administered to the resident concurrently with one other resident in the last 7 days | min | ||
| Indent Indent Indent Indent58137-1 | Group minutes - record the total number of minutes this therapy was administered to the resident as part of a group of residents in the last 7 days | min | ||
| Indent Indent Indent Indent86764-8 | Co-treatment minutes - record the total number of minutes this therapy was administered to the resident in co-treatment sessions in the last 7 days | min | ||
| Indent Indent Indent Indent45762-2 | Days - record the number of days this therapy was administered for at least 15 minutes a day in the last 7 days | d/(7.d) | ||
| Indent Indent Indent Indent55027-7 | Therapy start date - record the date the most recent therapy regimen (since the most recent entry) started | {mm/dd/yyyy} | ||
| Indent Indent Indent Indent55028-5 | Therapy end date - record the date the most recent therapy regimen (since the most recent entry) ended | {mm/dd/yyyy} | ||
| Indent Indent Indent86768-9 | Physical Therapy | |||
| Indent Indent Indent Indent58220-5 | Individual minutes - record the total number of minutes this therapy was administered to the resident individually in the last 7 days | min | ||
| Indent Indent Indent Indent58139-7 | Concurrent minutes - record the total number of minutes this therapy was administered to the resident concurrently with one other resident in the last 7 days | min | ||
| Indent Indent Indent Indent58140-5 | Group minutes - record the total number of minutes this therapy was administered to the resident as part of a group of residents in the last 7 days | min | ||
| Indent Indent Indent Indent86766-3 | Co-treatment minutes - record the total number of minutes this therapy was administered to the resident in co-treatment sessions in the last 7 days | min | ||
| Indent Indent Indent Indent45764-8 | Days - record the number of days this therapy was administered for at least 15 minutes a day in the last 7 days | d/(7.d) | ||
| Indent Indent Indent Indent55029-3 | Therapy start date - record the date the most recent therapy regimen (since the most recent entry) started | {mm/dd/yyyy} | ||
| Indent Indent Indent Indent55030-1 | Therapy end date - record the date the most recent therapy regimen (since the most recent entry) ended | {mm/dd/yyyy} | ||
| Indent Indent Indent86849-7 | Respiratory therapy | |||
| Indent Indent Indent Indent45766-3 | Days - record the number of days this therapy was administered for at least 15 minutes a day in the last 7 days | d/(7.d) | ||
| Indent Indent86769-7 | Distinct Calendar Days of Therapy. Record the number of calendar days that the resident received Speech-Language Pathology and Audiology Services, Occupational Therapy, or Physical Therapy for at least 15 minutes in the past 7 days. | d | ||
| Indent Indent86770-5 | Resumption of Therapy | |||
| Indent Indent Indent86772-1 | Has a previous rehabilitation therapy regimen (speech, occupational, and/or physical therapy) ended, as reported on this End of Therapy OMRA, and has this regimen now resumed at exactly the same level for each discipline? | |||
| Indent Indent Indent86771-3 | Date on which therapy regimen resumed | {mm/dd/yyyy} | ||
| Indent Indent86773-9 | Restorative Nursing Programs | |||
| Indent Indent Indent86774-7 | Technique. Range of motion (passive) | d/(7.d) | ||
| Indent Indent Indent86775-4 | Technique. Range of motion (active) | d/(7.d) | ||
| Indent Indent Indent86776-2 | Technique. Splint or brace assistance | d/(7.d) | ||
| Indent Indent Indent86777-0 | Training and Skill Practice In: Bed mobility | d/(7.d) | ||
| Indent Indent Indent86778-8 | Training and Skill Practice In: Transfer | d/(7.d) | ||
| Indent Indent Indent86779-6 | Training and Skill Practice In: Walking | d/(7.d) | ||
| Indent Indent Indent86780-4 | Training and Skill Practice In: Dressing and/or grooming | d/(7.d) | ||
| Indent Indent Indent86781-2 | Training and Skill Practice In: Eating and/or swallowing | d/(7.d) | ||
| Indent Indent Indent86782-0 | Training and Skill Practice In: Amputation/prostheses care | d/(7.d) | ||
| Indent Indent Indent86783-8 | Training and Skill Practice In: Communication | d/(7.d) | ||
| Indent88328-0 | Restraints and Alarms | |||
| Indent Indent86785-3 | Physical Restraints | |||
| Indent Indent Indent86786-1 | Used in Bed. Bed rail | d/(7.d) | ||
| Indent Indent Indent86787-9 | Used in Bed. Trunk restraint | d/(7.d) | ||
| Indent Indent Indent86788-7 | Used in Bed. Limb restraint | d/(7.d) | ||
| Indent Indent Indent86789-5 | Used in Bed. Other | d/(7.d) | ||
| Indent Indent Indent86790-3 | Used in Chair or Out of Bed. Trunk restraint | d/(7.d) | ||
| Indent Indent Indent86791-1 | Used in Chair or Out of Bed. Limb restraint | d/(7.d) | ||
| Indent Indent Indent86792-9 | Used in Chair or Out of Bed. Chair prevents rising | d/(7.d) | ||
| Indent Indent Indent86793-7 | Used in Chair or Out of Bed. Other | d/(7.d) | ||
| Indent86853-9 | Participation in Assessment and Goal Setting | |||
| Indent Indent55053-3 | Participation in Assessment | |||
| Indent Indent Indent55054-1 | Resident participated in assessment | |||
| Indent Indent Indent55074-9 | Family or significant other participated in assessment | |||
| Indent Indent Indent58221-3 | Guardian or legally authorized representative participated in assessment | |||
| Indent Indent58146-2 | Discharge Plan. Is active discharge planning already occurring for the resident to return to the community? | |||
| Indent Indent58150-4 | Referral. Has a referral been made to the Local Contact Agency? | |||
| Indent87224-2 | Correction Request | |||
| Indent Indent85632-8 | Type of Provider | |||
| Indent Indent87226-7 | Name of Resident | |||
| Indent Indent Indent45392-8 | Patient First (Given) name | |||
| Indent Indent Indent45394-4 | Patient Last (Family) name | |||
| Indent Indent46098-0 | Gender | |||
| Indent Indent21112-8 | Birth Date | {mm/dd/yyyy} | ||
| Indent Indent45396-9 | Social Security Number | |||
| Indent Indent87227-5 | Type of Assessment | |||
| Indent Indent Indent54583-0 | Federal OBRA Reason for Assessment | |||
| Indent Indent Indent54584-8 | PPS Assessment | |||
| Indent Indent Indent54585-5 | PPS Other Medicare Required Assessment - OMRA | |||
| Indent Indent Indent58107-4 | Is this a Swing Bed clinical change assessment? | |||
| Indent Indent Indent58108-2 | Entry/discharge reporting | |||
| Indent Indent Indent86525-3 | Is this a SNF Part A PPS Discharge Assessment? | |||
| Indent Indent87216-8 | Date on existing record to be modified/inactivated | |||
| Indent Indent Indent54593-9 | Assessment Reference Date | {mm/dd/yyyy} | ||
| Indent Indent Indent52525-3 | Discharge Date | {mm/dd/yyyy} | ||
| Indent Indent Indent50786-3 | Entry Date | {mm/dd/yyyy} | ||
| Indent Indent87209-3 | Correction Attestation Section | |||
| Indent Indent Indent58200-7 | Correction Number | {#} | ||
| Indent Indent Indent87217-6 | Reasons for Modification | 1..6 | ||
| Indent Indent Indent87225-9 | Reasons for Inactivation | 1..2 | ||
| Indent Indent Indent87218-4 | RN Assessment Coordinator Attestation of Completion | |||
| Indent Indent Indent Indent87219-2 | Attesting individual's first name | |||
| Indent Indent Indent Indent87220-0 | Attesting individual's last name | |||
| Indent Indent Indent Indent87221-8 | Attesting individual's title | |||
| Indent Indent Indent Indent87222-6 | Attestation date | {mm/dd/yyyy} | ||
| Indent87228-3 | Assessment Administration | |||
| Indent Indent55064-0 | Medicare Part A Billing | |||
| Indent Indent Indent55065-7 | Medicare Part A HIPPS code | |||
| Indent Indent Indent55066-5 | RUG version code | |||
| Indent Indent Indent58421-9 | Is this a Medicare Short Stay assessment? | |||
| Indent Indent59375-6 | Medicare Part A Non-Therapy Billing | |||
| Indent Indent Indent58210-6 | Medicare Part A non-therapy HIPPS code | |||
| Indent Indent Indent58211-4 | RUG version code | |||
| Indent Indent55070-7 | Insurance Billing | |||
| Indent Indent Indent55071-5 | RUG billing code | |||
| Indent Indent Indent55072-3 | RUG billing version |
Fully-Specified Name
- Component
- MDS v3.0 - RAI v1.15.1 - Nursing home OMRA-discharge (NOD) & Swing bed OMRA-discharge (SOD) item set
- Property
- -
- Time
- Pt
- System
- ^Patient
- Scale
- -
- Method
- CMS Assessment
Basic Attributes
- Class
- PANEL.SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.64
- Last Updated
- Version 2.73
- 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
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=88285-2
LOINC Copyright
Copyright © 2024 Regenstrief Institute, Inc. All Rights Reserved. To the extent included herein, the LOINC table and LOINC codes are copyright