99147-1
Preferences for Customary Routine Activities
Active
85950-4 Patient Living Situation: Which of the following best describes the patient's residential circumstance and availability of assistance?
Observation ID in Form
M1100
Form Coding Instructions
Check one box only
Source: Centers for Medicare & Medicaid ServicesFully-Specified Name
- Component
- Living situation and availability of assistance
- Property
- Find
- Time
- RptPeriod
- System
- ^Patient
- Scale
- Nom
- Method
- CMS Assessment
Long Common Name
Living situation and availability of assistance during assessment period [CMS Assessment]
Basic Attributes
- Class
- SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.63
- Last Updated
- Version 2.77 (MAJ)
- 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
- Observation
Normative Answer List LL4514-7
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Patient lives alone - around the clock | 01 | LA27650-3 | |
| Patient lives alone - regular daytime | 02 | LA27651-1 | |
| Patient lives alone - regular nighttime | 03 | LA27652-9 | |
| Patient lives alone - occasional/short-term assistance | 04 | LA27653-7 | |
| Patient lives alone - no assistance available | 05 | LA27654-5 | |
| Patient lives with other person(s) in the home - around the clock | 06 | LA27655-2 | |
| Patient lives with other person(s) in the home - regular daytime | 07 | LA27656-0 | |
| Patient lives with other person(s) in the home - regular nighttime | 08 | LA27657-8 | |
| Patient lives with other person(s) in the home - occasional/short-term assistance | 09 | LA27658-6 | |
| Patient lives with other person(s) in the home - no assistance available | 10 | LA27659-4 | |
| Patient lives in congregate situation (for example, assisted living, residential care home) - around the clock | 11 | LA27660-2 | |
| Patient lives in congregate situation (for example, assisted living, residential care home) - regular daytime | 12 | LA27661-0 | |
| Patient lives in congregate situation (for example, assisted living, residential care home) - regular nighttime | 13 | LA27662-8 | |
| Patient lives in congregate situation (for example, assisted living, residential care home) - occasional/short-term assistance | 14 | LA27663-6 | |
| Patient lives in congregate situation (for example, assisted living, residential care home) - no assistance available | 15 | LA27664-4 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 86189-8 | Deprecated Outcome and assessment information set (OASIS) form - version C2 - Resumption of care [CMS Assessment] |
| 85907-4 | Deprecated Outcome and assessment information set (OASIS) form - version C2 - Start of care [CMS Assessment] |
| 106623-2 | Hospice Outcomes and Patient Evaluation (HOPE) Admission v1.0 during assessment period [CMS Assessment] |
| 107632-2 | Hospice Outcomes and Patient Evaluation (HOPE) Admission v1.01 during assessment period [CMS Assessment] |
| 88368-6 | Outcome and assessment information set (OASIS) form - version D, D1 - Resumption of care during assessment period [CMS Assessment] |
| 88373-6 | Outcome and assessment information set (OASIS) form - version D, D1 - Start of care during assessment period [CMS Assessment] |
| 99160-4 | Outcome and assessment information set (OASIS) form - version E - Resumption of Care during assessment period [CMS Assessment] |
| 99131-5 | Outcome and assessment information set (OASIS) form - version E - Start of Care during assessment period [CMS Assessment] |
| 106525-9 | Outcome and assessment information set (OASIS) form - version E1 - Resumption of Care during assessment period [CMS Assessment] |
| 106523-4 | Outcome and assessment information set (OASIS) form - version E1 - Start of Care during assessment period [CMS Assessment] |
| 108292-4 | Outcome and assessment information set (OASIS) form - version E2 - Resumption of Care during assessment period [CMS Assessment] |
| 108291-6 | Outcome and assessment information set (OASIS) form - version E2 - Start of Care during assessment period [CMS Assessment] |
88465-0 Types and Sources of Assistance
Observation ID in Form
M2102
Form Context
Determine the ability and willingness of non-agency caregivers (such as family members, friends, or privately paid caregivers) to provide assistance for the following activities, if assistance is needed. Excludes all care by your agency staff
Source: Centers for Medicare & Medicaid ServicesFully-Specified Name
- Component
- Types and sources of assistance - start of care
- Property
- -
- Time
- RptPeriod
- System
- ^Patient
- Scale
- -
- Method
- CMS Assessment
Long Common Name
Types and sources of assistance - start of care during assessment period [CMS Assessment]
Basic Attributes
- Class
- PANEL.SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.64
- Last Updated
- Version 2.83 (NAM)
- 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
- Subset
- Panel Type
- Organizer
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 88368-6 | Outcome and assessment information set (OASIS) form - version D, D1 - Resumption of care during assessment period [CMS Assessment] |
| 88373-6 | Outcome and assessment information set (OASIS) form - version D, D1 - Start of care during assessment period [CMS Assessment] |
| 99160-4 | Outcome and assessment information set (OASIS) form - version E - Resumption of Care during assessment period [CMS Assessment] |
| 99131-5 | Outcome and assessment information set (OASIS) form - version E - Start of Care during assessment period [CMS Assessment] |
| 106525-9 | Outcome and assessment information set (OASIS) form - version E1 - Resumption of Care during assessment period [CMS Assessment] |
| 106523-4 | Outcome and assessment information set (OASIS) form - version E1 - Start of Care during assessment period [CMS Assessment] |
57265-1 Supervision and safety (for example, due to cognitive impairment)
Observation ID in Form
M2102f
Fully-Specified Name
- Component
- Non-agency caregiver ability and willingness to assist with supervision and safety
- Property
- Find
- Time
- RptPeriod
- System
- ^Patient
- Scale
- Ord
- Method
- CMS Assessment
Long Common Name
Non-agency caregiver ability and willingness to assist with supervision and safety during assessment period [CMS Assessment]
Basic Attributes
- Class
- SURVEY.CMS
- Type
- Surveys
- First Released
- Version 2.29
- Last Updated
- Version 2.77 (MAJ)
- Change Reason
- Release 2.77: TIME_ASPCT: Decision by CMS to update the Timing to RptPeriod from Pt for all CMS Assessments; Previous Releases: Updated METHOD from OASIS-C to CMS Assessment to use term across CMS instruments as approved by the Clinical LOINC committee; Added to Component to more thoroughly represent the form text;Added "non-agency" to Component to more clearly reflect CMS assessment form text
- Order vs. Observation
- Observation
Normative Answer List LL4492-6
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| No assistance needed -patient is independent or does not have needs in this area | 0 | LA27608-1 | |
| Non-agency caregiver(s) currently provide assistance | 1 | LA27610-7 | |
| Non-agency caregiver(s) need training/ supportive services to provide assistance | 2 | LA27611-5 | |
| Non-agency caregiver(s) are not likely to provide assistance OR it is unclear if they will provide assistance | 3 | LA27612-3 | |
| Assistance needed, but no non-agency caregiver(s) available | 4 | LA27613-1 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 57039-0 | Deprecated Outcome and assessment information set (OASIS) form - version C |
| 57194-3 | Deprecated Outcome and assessment information set (OASIS) form - version C - Discharge from agency |
| 57191-9 | Deprecated Outcome and assessment information set (OASIS) form - version C - Resumption of Care |
| 57190-1 | Deprecated Outcome and assessment information set (OASIS) form - version C - Start of care |
| 86264-9 | Deprecated Outcome and assessment information set (OASIS) form - version C2 - Discharged from agency [CMS Assessment] |
| 86189-8 | Deprecated Outcome and assessment information set (OASIS) form - version C2 - Resumption of care [CMS Assessment] |
| 85907-4 | Deprecated Outcome and assessment information set (OASIS) form - version C2 - Start of care [CMS Assessment] |
| 108293-2 | OASIS E2 - DC during assessment period [CMS Assessment] |
| 88371-0 | Outcome and assessment information set (OASIS) form - version D, D1 - Discharged from agency during assessment period [CMS Assessment] |
| 88368-6 | Outcome and assessment information set (OASIS) form - version D, D1 - Resumption of care during assessment period [CMS Assessment] |
| 88373-6 | Outcome and assessment information set (OASIS) form - version D, D1 - Start of care during assessment period [CMS Assessment] |
| 99178-6 | Outcome and assessment information set (OASIS) form - version E - Discharge from Agency during assessment period [CMS Assessment] |
| 99160-4 | Outcome and assessment information set (OASIS) form - version E - Resumption of Care during assessment period [CMS Assessment] |
| 99131-5 | Outcome and assessment information set (OASIS) form - version E - Start of Care during assessment period [CMS Assessment] |
| 106529-1 | Outcome and assessment information set (OASIS) form - version E1 - Discharge from Agency during assessment period [CMS Assessment] |
| 106525-9 | Outcome and assessment information set (OASIS) form - version E1 - Resumption of Care during assessment period [CMS Assessment] |
| 106523-4 | Outcome and assessment information set (OASIS) form - version E1 - Start of Care during assessment period [CMS Assessment] |
| 108292-4 | Outcome and assessment information set (OASIS) form - version E2 - Resumption of Care during assessment period [CMS Assessment] |
| 108291-6 | Outcome and assessment information set (OASIS) form - version E2 - Start of Care during assessment period [CMS Assessment] |