93223-6Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - version 5.00 [CMS Assessment]Active
Term Description
The effective date of this panel has been delayed due to the COVID-19 PHE. For the latest information, please see announcements on https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/LTCH-Quality-Reporting/LTCH-Quality-Reporting-Spotlight-Announcements.
Source: Regenstrief LOINC
Panel Hierarchy
Details for each LOINC in Panel
LOINC | Name | R/O/C | Cardinality | Example UCUM Units |
---|---|---|---|---|
93223-6 | Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - version 5.00 [CMS Assessment] | |||
Indent93222-8 | Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Admission - version 5.00 [CMS Assessment] | |||
Indent Indent93218-6 | 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 Indent93229-3 | 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 | Last 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 Indent69854-8 | Ethnicity. Are you of Hispanic, Latino/a, or Spanish origin? | 1..4 | ||
Indent Indent Indent Indent69855-5 | Race. What is your race? | 1..14 | ||
Indent Indent Indent Indent93186-5 | Language | |||
Indent Indent Indent Indent Indent54899-0 | What is your preferred language? | |||
Indent Indent Indent Indent Indent54588-9 | Do you need or want an interpreter to communicate with a doctor or health care staff? | |||
Indent Indent Indent Indent45404-1 | Marital Status | |||
Indent Indent Indent Indent93030-5 | Transportation. Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living? | 1..2 | ||
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 Indent93215-2 | Hearing, Speech, and Vision | |||
Indent Indent Indent45482-7 | Comatose. Persistent vegetative state/no discernible consciousness | |||
Indent Indent Indent95744-9 | Hearing. Ability to hear (with hearing aid or hearing appliances if normally used) | |||
Indent Indent Indent95745-6 | Vision. Ability to see in adequate light (with glasses or other visual appliances) | |||
Indent Indent Indent93157-6 | Health Literacy. How often do you need to have someone help you when you read instructions, pamphlets, or other written material from your doctor or pharmacy? | |||
Indent Indent Indent95737-3 | Expression of Ideas and Wants | |||
Indent Indent Indent95740-7 | Understanding Verbal and Non-Verbal Content | |||
Indent Indent93213-7 | Cognitive Patterns | |||
Indent Indent Indent54605-1 | Should Brief Interview for Mental Status (C0200-C0500) be Conducted? | |||
Indent Indent Indent52491-8 | Brief Interview for Mental Status | |||
Indent Indent Indent Indent52731-7 | Repetition of Three Words. Number of words repeated after first attempt | |||
Indent Indent Indent Indent54510-3 | Temporal Orientation (orientation to year, month, and day) | |||
Indent Indent Indent Indent Indent52732-5 | Able to report correct year | |||
Indent Indent Indent Indent Indent52733-3 | Able to report correct month | |||
Indent Indent Indent Indent Indent54609-3 | Able to report correct day of the week | |||
Indent Indent Indent Indent52493-4 | Recall | |||
Indent Indent Indent Indent Indent52735-8 | Able to recall "sock" | |||
Indent Indent Indent Indent Indent52736-6 | Able to recall "blue" | |||
Indent Indent Indent Indent Indent52737-4 | Able to recall "bed" | |||
Indent Indent Indent Indent54614-3 | BIMS Summary Score | {score} | ||
Indent Indent Indent95816-5 | Signs and Symptoms of Delirium (from CAM) | |||
Indent Indent Indent Indent95813-2 | Acute Onset Mental Status Change. Is there evidence of an acute change in mental status from the patient's baseline? | |||
Indent Indent Indent Indent95812-4 | 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 Indent95814-0 | Disorganized thinking - Was the patient'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 Indent95815-7 | Altered level of consciousness - Did the patient have altered level of consciousness, as indicated by any of the following criteria? | |||
Indent Indent93170-9 | Mood | |||
Indent Indent Indent54635-8 | Patient Mood Interview (PHQ-2 to 9) | |||
Indent Indent Indent Indent86843-0 | Symptom Presence | |||
Indent Indent Indent Indent Indent54636-6 | Little interest or pleasure in doing things | |||
Indent Indent Indent Indent Indent54638-2 | Feeling down, depressed or hopeless | |||
Indent Indent Indent Indent Indent54640-8 | Trouble falling or staying asleep, or sleeping too much | |||
Indent Indent Indent Indent Indent54642-4 | Feeling tired or having little energy | |||
Indent Indent Indent Indent Indent54644-0 | Poor appetite or overeating | |||
Indent 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 Indent Indent54648-1 | Trouble concentrating on things, such as reading the newspaper or watching television | |||
Indent 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 Indent Indent54652-3 | Thoughts that you would be better off dead, or of hurting yourself in some way | |||
Indent Indent Indent Indent86844-8 | Symptom Frequency | |||
Indent Indent Indent Indent Indent54637-4 | Little interest or pleasure in doing things | |||
Indent Indent Indent Indent Indent54639-0 | Feeling down, depressed or hopeless | |||
Indent Indent Indent Indent Indent54641-6 | Trouble falling or staying asleep, or sleeping too much | |||
Indent Indent Indent Indent Indent54643-2 | Feeling tired or having little energy | |||
Indent Indent Indent Indent Indent54645-7 | Poor appetite or overeating | |||
Indent 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 Indent Indent54649-9 | Trouble concentrating on things, such as reading the newspaper or watching television | |||
Indent 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 Indent Indent54653-1 | Thoughts that you would be better off dead, or of hurting yourself in some way | |||
Indent Indent Indent54654-9 | Total Severity Score | {score} | ||
Indent Indent Indent93159-2 | Social Isolation. How often do you feel lonely or isolated from those around you? | |||
Indent Indent93210-3 | 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..3 | ||
Indent Indent Indent95859-5 | Self-Care - Admission Performance | |||
Indent Indent Indent Indent95019-6 | Eating | |||
Indent Indent Indent Indent95018-8 | Oral hygiene | |||
Indent Indent Indent Indent95017-0 | Toileting hygiene | |||
Indent Indent Indent Indent95016-2 | Wash upper body | |||
Indent Indent Indent95860-3 | Self-Care - Discharge Goal | |||
Indent Indent Indent Indent89409-7 | Eating | |||
Indent Indent Indent Indent89404-8 | Oral hygiene | |||
Indent Indent Indent Indent89389-1 | Toileting hygiene | |||
Indent Indent Indent Indent96098-9 | Wash upper body | |||
Indent Indent Indent96099-7 | Mobility - Admission Performance | |||
Indent Indent Indent Indent95011-3 | Roll left and right | |||
Indent Indent Indent Indent95010-5 | Sit to lying | |||
Indent Indent Indent Indent95009-7 | Lying to sitting on side of bed | |||
Indent Indent Indent Indent95008-9 | Sit to stand | |||
Indent Indent Indent Indent95007-1 | Chair/bed-to-chair transfer | |||
Indent Indent Indent Indent95006-3 | Toilet transfer | |||
Indent Indent Indent Indent95005-5 | Car transfer | |||
Indent Indent Indent Indent95004-8 | Walk 10 feet | |||
Indent Indent Indent Indent95003-0 | Walk 50 feet with two turns | |||
Indent Indent Indent Indent95002-2 | Walk 150 feet | |||
Indent Indent Indent Indent95001-4 | Walking 10 feet on uneven surfaces | |||
Indent Indent Indent Indent95000-6 | 1 step (curb) | |||
Indent Indent Indent Indent94999-0 | 4 steps | |||
Indent Indent Indent Indent94998-2 | 12 steps | |||
Indent Indent Indent Indent94997-4 | Picking up object | |||
Indent Indent Indent Indent95738-1 | Does the patient use a wheelchair and/or scooter? | |||
Indent Indent Indent Indent94992-5 | Wheel 50 feet with two turns | |||
Indent Indent Indent Indent95739-9 | Indicate the type of wheelchair or scooter used | |||
Indent Indent Indent Indent94991-7 | Wheel 150 feet | |||
Indent Indent Indent Indent95739-9 | Indicate the type of wheelchair or scooter used | |||
Indent Indent Indent89476-6 | Mobility - Discharge Goal | |||
Indent Indent Indent Indent89398-2 | Roll left and right | |||
Indent Indent Indent Indent89394-1 | Sit to lying | |||
Indent Indent Indent Indent85927-2 | Lying to sitting on side of bed | |||
Indent Indent Indent Indent89392-5 | Sit to stand | |||
Indent Indent Indent Indent89414-7 | Chair/bed-to-chair transfer | |||
Indent Indent Indent Indent89390-9 | Toilet transfer | |||
Indent Indent Indent Indent89412-1 | Car transfer | |||
Indent Indent Indent Indent89385-9 | Walk 10 feet | |||
Indent Indent Indent Indent89381-8 | Walk 50 feet with two turns | |||
Indent Indent Indent Indent89383-4 | Walk 150 feet | |||
Indent Indent Indent Indent89379-2 | Walking 10 feet on uneven surfaces | |||
Indent Indent Indent Indent89420-4 | 1 step (curb) | |||
Indent Indent Indent Indent89416-2 | 4 steps | |||
Indent Indent Indent Indent89418-8 | 12 steps | |||
Indent Indent Indent Indent89402-2 | Picking up object | |||
Indent Indent Indent Indent89375-0 | Wheel 50 feet with two turns | |||
Indent Indent Indent Indent89377-6 | Wheel 150 feet | |||
Indent Indent95733-2 | Bladder and Bowel | |||
Indent Indent Indent95735-7 | Bladder Continence | |||
Indent Indent Indent95736-5 | Bowel Continence | |||
Indent Indent95864-5 | Active Diagnoses | |||
Indent Indent Indent89045-9 | Indicate the patient's primary medical condition category | |||
Indent Indent Indent52797-8 | Other medical condition | |||
Indent Indent Indent83243-6 | Comorbidities and Co-existing Conditions | |||
Indent Indent93208-7 | Health Conditions | |||
Indent Indent Indent93156-8 | Pain Effect on Sleep. Over the past 5 days, how much of the time has pain made it hard for you to sleep at night? | |||
Indent Indent Indent93160-0 | Pain Interference with Therapy Activities. Over the past 5 days, how often have you limited your participation in rehabilitation therapy sessions due to pain? | |||
Indent Indent Indent93158-4 | Pain Interference with Day-to-Day Activities. Over the past 5 days, how often have you limited your day-to-day activities (excluding rehabilitation therapy sessions) because of pain? | |||
Indent Indent93207-9 | 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 Indent Indent93178-2 | Nutritional Approaches - On Admission. Check all of the following nutritional approaches that apply on admission. | 1..4 | ||
Indent Indent85055-2 | Skin Conditions | |||
Indent Indent Indent58214-8 | Unhealed Pressure Ulcers/Injuries. Does this patient have one or more unhealed pressure ulcers/injuries? | |||
Indent Indent Indent83246-9 | Current Number of Unhealed Pressure Ulcers/Injuries at Each Stage | |||
Indent Indent Indent Indent54884-2 | Number of Stage 1 pressure injuries | {#} | ||
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/injuries 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 injuries presenting as deep tissue injury | {#} | ||
Indent Indent93168-3 | Medications | |||
Indent Indent Indent93155-0 | High-Risk Drug Classes: Use and Indication | |||
Indent Indent Indent Indent93153-5 | Is taking. Check if the patient is taking any medications by pharmacological classification, not how it is used, in the following classes | 1..6 | ||
Indent Indent Indent Indent93154-3 | Indication noted. If column 1 [Is Taking] is checked, check if there is an indication noted for all medications in the drug class | 0..6 | ||
Indent Indent Indent57255-2 | Drug Regimen Review: Did a complete drug regimen review identify potential clinically significant medication issues? | |||
Indent Indent Indent57281-8 | Medication Follow-up: Did the facility contact a physician (or physician-designee) by midnight of the next calendar day and complete prescribed/recommended actions in response to the identified potential clinically significant medication issues? | |||
Indent Indent93205-3 | Special Treatments, Procedures, and Programs | |||
Indent Indent Indent83252-7 | Special Treatments, Procedures, and Programs - On Admission. Check all of the following treatments, procedures, and programs that apply on admission. | |||
Indent Indent Indent93203-8 | Spontaneous Breathing Trial (SBT) (including Tracheostomy Collar Trial (TCT) or Continuous Positive Airway Pressure (CPAP) Breathing Trial) by Day 2 of the LTCH Stay | |||
Indent Indent Indent Indent87539-3 | Invasive Mechanical Ventilation Support upon Admission to the LTCH | |||
Indent Indent Indent Indent93202-0 | Ventilator Weaning Status | |||
Indent Indent Indent Indent87538-5 | Assessed for readiness for SBT by day 2 of the LTCH stay | |||
Indent Indent Indent Indent87540-1 | Deemed medically ready for SBT by day 2 of the LTCH stay | |||
Indent Indent Indent Indent87541-9 | Is there documentation of reason(s) in the patient's medical record that the patient was deemed medically unready for SBT by day 2 of the LTCH stay? | |||
Indent Indent Indent Indent87542-7 | If the patient was deemed medically ready for SBT, was SBT performed by day 2 of the LTCH stay? | |||
Indent93221-0 | Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Planned Discharge - version 5.00 [CMS Assessment] | |||
Indent Indent93217-8 | 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 Indent93230-1 | 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 | Last 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 Indent93030-5 | Transportation. Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living? | 1..2 | ||
Indent Indent Indent Indent52556-8 | Payer Information | 1..13 | ||
Indent Indent Indent55128-3 | Discharge Location | |||
Indent Indent Indent93182-4 | Provision of Current Reconciled Medication List to Subsequent Provider at Discharge. At the time of discharge to another provider, did your facility provide the patient's current reconciled medication list to the subsequent provider? | |||
Indent Indent Indent93184-0 | Route of Current Reconciled Medication List Transmission to Subsequent Provider. Indicate the route(s) of transmission of the current reconciled medication list to the subsequent provider. | 1..5 | ||
Indent Indent Indent93181-6 | Provision of Current Reconciled Medication List to Patient at Discharge. At the time of discharge, did your facility provide the patient's current reconciled medication list to the patient, family and/or caregiver? | |||
Indent Indent Indent93183-2 | Route of Current Reconciled Medication List Transmission to Patient. Indicate the route(s) of transmission of the current reconciled medication list to the patient/family/caregiver. | 1..5 | ||
Indent Indent93214-5 | Hearing, Speech, and Vision | |||
Indent Indent Indent45482-7 | Comatose. Persistent vegetative state/no discernible consciousness | |||
Indent Indent Indent93157-6 | Health Literacy. How often do you need to have someone help you when you read instructions, pamphlets, or other written material from your doctor or pharmacy? | |||
Indent Indent Indent95737-3 | Expression of Ideas and Wants | |||
Indent Indent Indent95740-7 | Understanding Verbal and Non-Verbal Content | |||
Indent Indent93213-7 | Cognitive Patterns | |||
Indent Indent Indent54605-1 | Should Brief Interview for Mental Status (C0200-C0500) be Conducted? | |||
Indent Indent Indent52491-8 | Brief Interview for Mental Status | |||
Indent Indent Indent Indent52731-7 | Repetition of Three Words. Number of words repeated after first attempt | |||
Indent Indent Indent Indent54510-3 | Temporal Orientation (orientation to year, month, and day) | |||
Indent Indent Indent Indent Indent52732-5 | Able to report correct year | |||
Indent Indent Indent Indent Indent52733-3 | Able to report correct month | |||
Indent Indent Indent Indent Indent54609-3 | Able to report correct day of the week | |||
Indent Indent Indent Indent52493-4 | Recall | |||
Indent Indent Indent Indent Indent52735-8 | Able to recall "sock" | |||
Indent Indent Indent Indent Indent52736-6 | Able to recall "blue" | |||
Indent Indent Indent Indent Indent52737-4 | Able to recall "bed" | |||
Indent Indent Indent Indent54614-3 | BIMS Summary Score | {score} | ||
Indent Indent Indent95816-5 | Signs and Symptoms of Delirium (from CAM) | |||
Indent Indent Indent Indent95813-2 | Acute Onset Mental Status Change. Is there evidence of an acute change in mental status from the patient's baseline? | |||
Indent Indent Indent Indent95812-4 | 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 Indent95814-0 | Disorganized thinking - Was the patient'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 Indent95815-7 | Altered level of consciousness - Did the patient have altered level of consciousness, as indicated by any of the following criteria? | |||
Indent Indent93170-9 | Mood | |||
Indent Indent Indent54635-8 | Patient Mood Interview (PHQ-2 to 9) | |||
Indent Indent Indent Indent86843-0 | Symptom Presence | |||
Indent Indent Indent Indent Indent54636-6 | Little interest or pleasure in doing things | |||
Indent Indent Indent Indent Indent54638-2 | Feeling down, depressed or hopeless | |||
Indent Indent Indent Indent Indent54640-8 | Trouble falling or staying asleep, or sleeping too much | |||
Indent Indent Indent Indent Indent54642-4 | Feeling tired or having little energy | |||
Indent Indent Indent Indent Indent54644-0 | Poor appetite or overeating | |||
Indent 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 Indent Indent54648-1 | Trouble concentrating on things, such as reading the newspaper or watching television | |||
Indent 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 Indent Indent54652-3 | Thoughts that you would be better off dead, or of hurting yourself in some way | |||
Indent Indent Indent Indent86844-8 | Symptom Frequency | |||
Indent Indent Indent Indent Indent54637-4 | Little interest or pleasure in doing things | |||
Indent Indent Indent Indent Indent54639-0 | Feeling down, depressed or hopeless | |||
Indent Indent Indent Indent Indent54641-6 | Trouble falling or staying asleep, or sleeping too much | |||
Indent Indent Indent Indent Indent54643-2 | Feeling tired or having little energy | |||
Indent Indent Indent Indent Indent54645-7 | Poor appetite or overeating | |||
Indent 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 Indent Indent54649-9 | Trouble concentrating on things, such as reading the newspaper or watching television | |||
Indent 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 Indent Indent54653-1 | Thoughts that you would be better off dead, or of hurting yourself in some way | |||
Indent Indent Indent54654-9 | Total Severity Score | {score} | ||
Indent Indent Indent93159-2 | Social Isolation. How often do you feel lonely or isolated from those around you? | |||
Indent Indent93209-5 | Functional Abilities and Goals | |||
Indent Indent Indent95861-1 | Self-Care - Discharge Performance | |||
Indent Indent Indent Indent95019-6 | Eating | |||
Indent Indent Indent Indent95018-8 | Oral hygiene | |||
Indent Indent Indent Indent95017-0 | Toileting hygiene | |||
Indent Indent Indent Indent95016-2 | Wash upper body | |||
Indent Indent Indent96100-3 | Mobility - Discharge Performance | |||
Indent Indent Indent Indent95011-3 | Roll left and right | |||
Indent Indent Indent Indent95010-5 | Sit to lying | |||
Indent Indent Indent Indent95009-7 | Lying to sitting on side of bed | |||
Indent Indent Indent Indent95008-9 | Sit to stand | |||
Indent Indent Indent Indent95007-1 | Chair/bed-to-chair transfer | |||
Indent Indent Indent Indent95006-3 | Toilet transfer | |||
Indent Indent Indent Indent95005-5 | Car transfer | |||
Indent Indent Indent Indent95004-8 | Walk 10 feet | |||
Indent Indent Indent Indent95003-0 | Walk 50 feet with two turns | |||
Indent Indent Indent Indent95002-2 | Walk 150 feet | |||
Indent Indent Indent Indent95001-4 | Walking 10 feet on uneven surfaces | |||
Indent Indent Indent Indent95000-6 | 1 step (curb) | |||
Indent Indent Indent Indent94999-0 | 4 steps | |||
Indent Indent Indent Indent94998-2 | 12 steps | |||
Indent Indent Indent Indent94997-4 | Picking up object | |||
Indent Indent Indent Indent95738-1 | Does the resident use a wheelchair and/or scooter? | |||
Indent Indent Indent Indent94992-5 | Wheel 50 feet with two turns | |||
Indent Indent Indent Indent95739-9 | Indicate the type of wheelchair or scooter used | |||
Indent Indent Indent Indent94991-7 | Wheel 150 feet | |||
Indent Indent Indent Indent95739-9 | Indicate the type of wheelchair or scooter used | |||
Indent Indent95863-7 | Bladder and Bowel | |||
Indent Indent Indent95735-7 | Bladder Continence | |||
Indent Indent93177-4 | Health Conditions | |||
Indent Indent Indent93156-8 | Pain Effect on Sleep. Over the past 5 days, how much of the time has pain made it hard for you to sleep at night? | |||
Indent Indent Indent93160-0 | Pain Interference with Therapy Activities. Over the past 5 days, how often have you limited your participation in rehabilitation therapy sessions due to pain? | |||
Indent Indent Indent93158-4 | Pain Interference with Day-to-Day Activities. Over the past 5 days, how often have you limited your day-to-day activities (excluding rehabilitation therapy sessions) because of pain? | |||
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 Indent93176-6 | Swallowing/Nutritional Status | |||
Indent Indent Indent93180-8 | Nutritional Approaches | |||
Indent Indent Indent Indent71445-1 | Nutritional Approaches - Last 7 Days. Check all of the nutritional approaches that were received in the last 7 days. | 1..4 | ||
Indent Indent Indent Indent93178-2 | Nutritional Approaches - At Discharge. Check all of the following nutritional approaches that apply at discharge. | 1..4 | ||
Indent Indent87500-5 | Skin Conditions | |||
Indent Indent Indent58214-8 | Unhealed Pressure Ulcers/Injuries. Does this patient have one or more unhealed pressure ulcers/injuries? | |||
Indent Indent Indent83256-8 | Current Number of Unhealed Pressure Ulcers/Injuries at Each Stage | |||
Indent Indent Indent Indent54884-2 | Number of Stage 1 pressure injuries | {#} | ||
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/injuries due to non-removable dressing/device | {#} | ||
Indent Indent Indent Indent54894-1 | Number of these unstageable pressure ulcers/injuries 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 injuries presenting as deep tissue injury | {#} | ||
Indent Indent Indent Indent54951-9 | Number of these unstageable pressure injuries that were present upon admission | {#} | ||
Indent Indent93169-1 | Medications | |||
Indent Indent Indent93155-0 | High-Risk Drug Classes: Use and Indication | |||
Indent Indent Indent Indent93153-5 | Is taking. Check if the patient is taking any medications by pharmacological classification, not how it is used, in the following classes | 1..6 | ||
Indent Indent Indent Indent93154-3 | Indication noted. If column 1 [Is Taking] is checked, check if there is an indication noted for all medications in the drug class | 0..6 | ||
Indent Indent Indent57256-0 | 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? | |||
Indent Indent93204-6 | Special Treatments, Procedures, and Programs | |||
Indent Indent Indent93185-7 | Special Treatments, Procedures, and Programs - At Discharge. Check all of the following treatments, procedures, and programs that apply at discharge. | |||
Indent Indent Indent86851-3 | Ventilator Liberation Rate. Invasive Mechanical Ventilator: Liberation Status at Discharge | |||
Indent93220-2 | Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Unplanned Discharge - version 5.00 [CMS Assessment] | |||
Indent Indent93231-9 | 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 Indent52525-3 | Discharge Date | {mm/dd/yyyy} | ||
Indent Indent Indent93228-5 | 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 | Last 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 Indent52556-8 | Payer Information | 1..13 | ||
Indent Indent Indent85411-7 | Patient Discharged Against Medical Advice? | |||
Indent Indent Indent55128-3 | Discharge Location | |||
Indent Indent Indent93182-4 | Provision of Current Reconciled Medication List to Subsequent Provider at Discharge. At the time of discharge to another provider, did your facility provide the patient's current reconciled medication list to the subsequent provider? | |||
Indent Indent Indent93184-0 | Route of Current Reconciled Medication List Transmission to Subsequent Provider. Indicate the route(s) of transmission of the current reconciled medication list to the subsequent provider. | 1..5 | ||
Indent Indent Indent93181-6 | Provision of Current Reconciled Medication List to Patient at Discharge. At the time of discharge, did your facility provide the patient's current reconciled medication list to the patient, family and/or caregiver? | |||
Indent Indent Indent93183-2 | Route of Current Reconciled Medication List Transmission to Patient. Indicate the route(s) of transmission of the current reconciled medication list to the patient/family/caregiver. | 1..5 | ||
Indent Indent93211-1 | Cognitive patterns | |||
Indent Indent Indent95816-5 | Signs and Symptoms of Delirium (from CAM) | |||
Indent Indent Indent Indent95813-2 | Acute Onset Mental Status Change. Is there evidence of an acute change in mental status from the patient's baseline? | |||
Indent Indent Indent Indent95812-4 | 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 Indent95814-0 | Disorganized thinking - Was the patient'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 Indent95815-7 | Altered level of consciousness - Did the patient have altered level of consciousness, as indicated by any of the following criteria? | |||
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 Indent93176-6 | Swallowing/Nutritional Status | |||
Indent Indent Indent93180-8 | Nutritional Approaches | |||
Indent Indent Indent Indent71445-1 | Nutritional Approaches - Last 7 Days. Check all of the nutritional approaches that were received in the last 7 days. | 1..4 | ||
Indent Indent Indent Indent93178-2 | Nutritional Approaches - At Discharge. Check all of the following nutritional approaches that apply at discharge. | 1..4 | ||
Indent Indent87500-5 | Skin Conditions | |||
Indent Indent Indent58214-8 | Unhealed Pressure Ulcers/Injuries. Does this patient have one or more unhealed pressure ulcers/injuries? | |||
Indent Indent Indent83256-8 | Current Number of Unhealed Pressure Ulcers/Injuries at Each Stage | |||
Indent Indent Indent Indent54884-2 | Number of Stage 1 pressure injuries | {#} | ||
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/injuries due to non-removable dressing/device | {#} | ||
Indent Indent Indent Indent54894-1 | Number of these unstageable pressure ulcers/injuries 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 injuries presenting as deep tissue injury | {#} | ||
Indent Indent Indent Indent54951-9 | Number of these unstageable pressure injuries that were present upon admission | {#} | ||
Indent Indent93169-1 | Medications | |||
Indent Indent Indent93155-0 | High-Risk Drug Classes: Use and Indication | |||
Indent Indent Indent Indent93153-5 | Is taking. Check if the patient is taking any medications by pharmacological classification, not how it is used, in the following classes | 1..6 | ||
Indent Indent Indent Indent93154-3 | Indication noted. If column 1 [Is Taking] is checked, check if there is an indication noted for all medications in the drug class | 0..6 | ||
Indent Indent Indent57256-0 | 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? | |||
Indent Indent93204-6 | Special Treatments, Procedures, and Programs | |||
Indent Indent Indent93185-7 | Special Treatments, Procedures, and Programs - At Discharge. Check all of the following treatments, procedures, and programs that apply at discharge. | |||
Indent Indent Indent86851-3 | Ventilator Liberation Rate. Invasive Mechanical Ventilator: Liberation Status at Discharge | |||
Indent93219-4 | Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Expired - version 5.00 [CMS Assessment] | |||
Indent Indent93216-0 | 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 Indent93228-5 | 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 | Last 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 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 Indent87522-9 | Medications | |||
Indent Indent Indent57256-0 | 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? |
Fully-Specified Name
- Component
- Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - version 5.00
- Property
- -
- Time
- Pt
- System
- ^Patient
- Scale
- -
- Method
- CMS Assessment
Basic Attributes
- Class
- PANEL.SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.67
- Last Updated
- Version 2.68
- Order vs. Observation
- Order
- Panel Type
- Convenience group
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