Version 2.77

99550-6 Are you worried or concerned that in the next two months you may not have stable housing that you own, rent, or stay in as part of a household?

Observation ID in Form

1

Form Context

https://www.va.gov/HOMELESS/Universal_Screener_to_Identify_Veterans_Experiencing_Housing_Instability_2014.pdf

Source: American Academy of Family Physicians

Fully-Specified Name

Component
Worried about housing stability in next 2Mo
Property
Find
Time
2Mo
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.SDOH
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL361-7

Answer Code Score Answer ID
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) LA33-6
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) LA32-8

Member of these Panels

LOINC Long Common Name
99593-6 American Academy of Family Physicians Social Needs Screening Tool
99549-8 Health Leads screening panel

Member of these Groups Get Info

LOINC Group Group Name
LG51306-5 SDOH

96778-6 Think about the place you live. Do you have problems with any of the following?

Reference Information

Type Source Reference
Form Coding Instructions Centers for Medicare & Medicaid Services Choose all that apply

Observation ID in Form

2

Form Context

Nuruzzaman N, Broadwin M, Kourouma K, Olson DP. Making the social determinants of health a routine part of medical Care. J Health Care Poor Underserved. 2015;26(2):321-327.

Source: American Academy of Family Physicians

Fully-Specified Name

Component
Problems with place where you live
Property
Find
Time
Pt
System
^Patient
Scale
Nom
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.70
Last Updated
Version 2.70
Order vs. Observation
Observation

Normative Answer List LL6078-1

Answer Code Score Answer ID
Bug infestation LA32691-0
Mold LA28580-1
Lead paint/pipes LA32693-6
Inadequate heat LA32694-4
Non-functioning oven/stove LA32695-1
No or non-working smoke detectors LA32696-9
Water leaks LA32001-2

Member of these Panels

LOINC Long Common Name
96777-8 Accountable health communities (AHC) health-related social needs screening (HRSN) tool
99593-6 American Academy of Family Physicians Social Needs Screening Tool
99595-1 American Academy of Family Physicians Social Needs Screening Tool - short form

Member of these Groups Get Info

LOINC Group Group Name
LG51306-5 SDOH

88122-7 Within the past 12 months, you worried that your food would run out before you got money to buy more.

Observation ID in Form

3

Form Context

Hager ER, Quigg AM, Black MM, et al. Development and validity of a 2-item screen to identify families at risk for food insecurity. Pediatrics. 2010;126(1):e26-e32.

Source: American Academy of Family Physicians

Fully-Specified Name

Component
Within the past 12Mo we worried whether our food would run out before we got money to buy more
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
U.S. Food Security Survey

Basic Attributes

Class
SURVEY.SDOH
Type
Surveys
First Released
Version 2.63
Last Updated
Version 2.70
Change Reason
Release 2.70: AnswerListId: Updated answer list to align with form;
Order vs. Observation
Observation

Survey Question

Text
(I/We) worried whether (my/our) food would run out before (I/we) got money to buy more.
Source
U.S. Household Food Security Survey Module.HH2

Normative Answer List LL5890-0

Answer Code Score Answer ID
Often true LA28397-0
Sometimes true LA6729-3
Never true LA28398-8

Member of these Panels

LOINC Long Common Name
96777-8 Accountable health communities (AHC) health-related social needs screening (HRSN) tool
99593-6 American Academy of Family Physicians Social Needs Screening Tool
99595-1 American Academy of Family Physicians Social Needs Screening Tool - short form
88121-9 Hunger Vital Sign [HVS]
95353-9 U.S. Adult Food Security Survey [U.S. FSS]
95246-5 U.S. Household Food Security Survey [U.S. FSS]

Member of these Groups Get Info

LOINC Group Group Name
LG51306-5 SDOH

88123-5 Within the past 12 months, the food you bought just didn't last and you didn't have money to get more.

Observation ID in Form

4

Form Context

Hager ER, Quigg AM, Black MM, et al. Development and validity of a 2-item screen to identify families at risk for food insecurity. Pediatrics. 2010;126(1):e26-e32.

Source: American Academy of Family Physicians

Fully-Specified Name

Component
Within the past 12Mo the food we bought just didn't last and we didn't have money to get more
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
U.S. Food Security Survey

Basic Attributes

Class
SURVEY.SDOH
Type
Surveys
First Released
Version 2.63
Last Updated
Version 2.70
Change Reason
Release 2.70: AnswerListId: Updated answer list to align with form;
Order vs. Observation
Observation

Survey Question

Text
The food that (I/we) bought just didn't last, and (I/we) didn't have money to get more.
Source
U.S. Household Food Security Survey Module.HH3

Normative Answer List LL5890-0

Answer Code Score Answer ID
Often true LA28397-0
Sometimes true LA6729-3
Never true LA28398-8

Member of these Panels

LOINC Long Common Name
96777-8 Accountable health communities (AHC) health-related social needs screening (HRSN) tool
99593-6 American Academy of Family Physicians Social Needs Screening Tool
99595-1 American Academy of Family Physicians Social Needs Screening Tool - short form
88121-9 Hunger Vital Sign [HVS]
95353-9 U.S. Adult Food Security Survey [U.S. FSS]
95361-2 U.S. Household Food Security Survey - Six-Item Short Form [U.S. FSS]
95246-5 U.S. Household Food Security Survey [U.S. FSS]

Member of these Groups Get Info

LOINC Group Group Name
LG51306-5 SDOH

99594-4 Do you put off or neglect going to the doctor because of distance or transportation?

Observation ID in Form

5

Form Context

https://www.va.gov/HOMELESS/Universal_Screener_to_Identify_Veterans_Experiencing_Housing_Instability_2014.pdf

Source: American Academy of Family Physicians

Fully-Specified Name

Component
Delayed medical care due to distance or lack of transportation
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.SDOH
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL361-7

Answer Code Score Answer ID
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) LA33-6
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) LA32-8

Member of these Panels

LOINC Long Common Name
99593-6 American Academy of Family Physicians Social Needs Screening Tool
99595-1 American Academy of Family Physicians Social Needs Screening Tool - short form

96779-4 In the past 12 months has the electric, gas, oil, or water copmany threatened to shut off services in your home?

Observation ID in Form

6

Form Context

Cook JT, Frank DA, Casey PH, et al. A brief indicator of household energy security: associations with food security, child health, and child development in US infants and toddlers. Pediatrics. 2008;122(4):e867-e875.

Source: American Academy of Family Physicians

Fully-Specified Name

Component
Has the electric, gas, oil, or water company threatened to shut off services in your home in past 12Mo
Property
Find
Time
12Mo
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.70
Last Updated
Version 2.70
Order vs. Observation
Observation

Normative Answer List LL5878-5

Answer Code Score Answer ID
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) LA33-6
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) LA32-8
Already shut off LA32002-0

Member of these Panels

LOINC Long Common Name
96777-8 Accountable health communities (AHC) health-related social needs screening (HRSN) tool
99593-6 American Academy of Family Physicians Social Needs Screening Tool
99595-1 American Academy of Family Physicians Social Needs Screening Tool - short form
99549-8 Health Leads screening panel

99551-4 Do problems getting child care make it difficult for you to work or study?

Observation ID in Form

7

Form Context

Children's HealthWatch. Final: 2013 Children's Healthwatch survey. http://www.childrenshealthwatch.org/methods/our-survey/. Accessed October 3, 2018.

Source: American Academy of Family Physicians

Fully-Specified Name

Component
Problems getting child care make work or study difficult
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.SDOH
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL361-7

Answer Code Score Answer ID
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) LA33-6
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) LA32-8

Member of these Panels

LOINC Long Common Name
99593-6 American Academy of Family Physicians Social Needs Screening Tool
99549-8 Health Leads screening panel

96444-5 Do you have a job?

Observation ID in Form

8

Form Context

Garg A, Butz AM, Dworkin PH, Lewis RA, Thompson RE, Serwint JR. Improving the management of family psychosocial problems at low-income children's well-child care visits: the WE CARE project. Pediatrics. 2007;120(3):547-558.

Source: American Academy of Family Physicians

Fully-Specified Name

Component
Has a job
Property
Find
Time
Pt
System
^Caregiver
Scale
Ord
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.70
Last Updated
Version 2.70
Order vs. Observation
Observation

Normative Answer List LL361-7

Answer Code Score Answer ID
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) LA33-6
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) LA32-8

Member of these Panels

LOINC Long Common Name
99593-6 American Academy of Family Physicians Social Needs Screening Tool
96447-8 WE CARE Survey [WE CARE] Caregiver

Member of these Groups Get Info

LOINC Group Group Name
LG51306-5 SDOH

96446-0 Do you have a high school degree?

Observation ID in Form

9

Form Context

Garg A, Butz AM, Dworkin PH, Lewis RA, Thompson RE, Serwint JR. Improving the management of family psychosocial problems at low-income children's well-child care visits: the WE CARE project. Pediatrics. 2007;120(3):547-558.

Source: American Academy of Family Physicians

Fully-Specified Name

Component
High school degree
Property
Find
Time
Pt
System
^Caregiver
Scale
Ord
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.70
Last Updated
Version 2.70
Order vs. Observation
Observation

Normative Answer List LL361-7

Answer Code Score Answer ID
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) LA33-6
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) LA32-8

Member of these Panels

LOINC Long Common Name
99593-6 American Academy of Family Physicians Social Needs Screening Tool
96447-8 WE CARE Survey [WE CARE] Caregiver

Member of these Groups Get Info

LOINC Group Group Name
LG51306-5 SDOH

99627-2 How often does this describe you, I don't have enough money to pay my bills

Observation ID in Form

10

Form Context

Aldana SG, Liljenquist W. Validity and reliability of a financial strain survey. J Financ Couns Plan. 1998;9(2):11-19.

Source: American Academy of Family Physicians

Fully-Specified Name

Component
How often does this describe you, I don't have enough money to pay my bills
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.SDOH
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL5869-4

Answer Code Score Answer ID
Never LA6270-8
Rarely LA10066-1
Sometimes LA10082-8
Often LA10044-8
Always LA9933-8

Member of these Panels

LOINC Long Common Name
99593-6 American Academy of Family Physicians Social Needs Screening Tool

95619-3 Hurts, insults, threatens, and screams [HITS]

Term Description

The Hurt-Insult-Threaten-Scream (HITS) screening tool was developed as a quick, four question, domestic violence screen. Each response has a corresponding numeric value, ranging from 1(rarely) to 5 (frequently). The four individual values are summed for a total score between 4 and 20. A cumulative score greater than 10 indicates the possibility of domestic partner abuse. PMID: 24652635
Source: Regenstrief LOINC

Fully-Specified Name

Component
Hurts, insults, threatens, and screams
Property
-
Time
12Mo
System
^Patient
Scale
-
Method
HITS

Basic Attributes

Class
PANEL.SURVEY.HITS
Type
Surveys
First Released
Version 2.69
Last Updated
Version 2.72
Order vs. Observation
Order
Panel Type
Panel

Member of these Panels

LOINC Long Common Name
99593-6 American Academy of Family Physicians Social Needs Screening Tool
99595-1 American Academy of Family Physicians Social Needs Screening Tool - short form

Member of these Groups Get Info

LOINC Group Group Name
LG51306-5 SDOH

95618-5 How often does anyone, including family, physically hurt you?

Observation ID in Form

11

Form Context

Sherin KM, Sinacore JM, Li XQ, Zitter RE, Shakil A. HITS: a short domestic violence screening tool for use in a family practice setting. Fam Med. 1998;30(7):508-512.

Source: American Academy of Family Physicians

Fully-Specified Name

Component
Physically hurt you
Property
Find
Time
12Mo
System
^Patient
Scale
Ord
Method
HITS

Basic Attributes

Class
SURVEY.HITS
Type
Surveys
First Released
Version 2.69
Last Updated
Version 2.69
Order vs. Observation
Observation

Survey Question

Text
Over the last 12 months how often did your partner physically hurt you?

Normative Answer List LL5622-7

Answer Code Score Answer ID
Never 1 LA6270-8
Rarely 2 LA10066-1
Sometimes 3 LA10082-8
Fairly often 4 LA16644-9
Frequently 5 LA6482-9

Member of these Panels

LOINC Long Common Name
96777-8 Accountable health communities (AHC) health-related social needs screening (HRSN) tool
99593-6 American Academy of Family Physicians Social Needs Screening Tool
99595-1 American Academy of Family Physicians Social Needs Screening Tool - short form
95619-3 Hurts, insults, threatens, and screams [HITS]

Member of these Groups Get Info

LOINC Group Group Name
LG51306-5 SDOH

95617-7 How often does anyone, including family, insult or talk down to you?

Observation ID in Form

12

Form Context

Sherin KM, Sinacore JM, Li XQ, Zitter RE, Shakil A. HITS: a short domestic violence screening tool for use in a family practice setting. Fam Med. 1998;30(7):508-512.

Source: American Academy of Family Physicians

Fully-Specified Name

Component
Insult you or talk down to you
Property
Find
Time
12Mo
System
^Patient
Scale
Ord
Method
HITS

Basic Attributes

Class
SURVEY.HITS
Type
Surveys
First Released
Version 2.69
Last Updated
Version 2.69
Order vs. Observation
Observation

Survey Question

Text
Over the last 12 months how often did your partner insult you or talk down to you?

Normative Answer List LL5622-7

Answer Code Score Answer ID
Never 1 LA6270-8
Rarely 2 LA10066-1
Sometimes 3 LA10082-8
Fairly often 4 LA16644-9
Frequently 5 LA6482-9

Member of these Panels

LOINC Long Common Name
96777-8 Accountable health communities (AHC) health-related social needs screening (HRSN) tool
99593-6 American Academy of Family Physicians Social Needs Screening Tool
99595-1 American Academy of Family Physicians Social Needs Screening Tool - short form
95619-3 Hurts, insults, threatens, and screams [HITS]

Member of these Groups Get Info

LOINC Group Group Name
LG51306-5 SDOH

95616-9 How often does anyone, including family, threaten you with harm?

Observation ID in Form

13

Form Context

Sherin KM, Sinacore JM, Li XQ, Zitter RE, Shakil A. HITS: a short domestic violence screening tool for use in a family practice setting. Fam Med. 1998;30(7):508-512.

Source: American Academy of Family Physicians

Fully-Specified Name

Component
Threaten you with physical harm
Property
Find
Time
12Mo
System
^Patient
Scale
Ord
Method
HITS

Basic Attributes

Class
SURVEY.HITS
Type
Surveys
First Released
Version 2.69
Last Updated
Version 2.69
Order vs. Observation
Observation

Survey Question

Text
Over the last 12 months how often did your partner threaten you with physical harm?

Normative Answer List LL5622-7

Answer Code Score Answer ID
Never 1 LA6270-8
Rarely 2 LA10066-1
Sometimes 3 LA10082-8
Fairly often 4 LA16644-9
Frequently 5 LA6482-9

Member of these Panels

LOINC Long Common Name
96777-8 Accountable health communities (AHC) health-related social needs screening (HRSN) tool
99593-6 American Academy of Family Physicians Social Needs Screening Tool
99595-1 American Academy of Family Physicians Social Needs Screening Tool - short form
95619-3 Hurts, insults, threatens, and screams [HITS]

Member of these Groups Get Info

LOINC Group Group Name
LG51306-5 SDOH

95615-1 How often does anyone, including family, scream or curse at you?

Observation ID in Form

14

Form Context

Sherin KM, Sinacore JM, Li XQ, Zitter RE, Shakil A. HITS: a short domestic violence screening tool for use in a family practice setting. Fam Med. 1998;30(7):508-512.

Source: American Academy of Family Physicians

Fully-Specified Name

Component
Scream or curse at you
Property
Find
Time
12Mo
System
^Patient
Scale
Ord
Method
HITS

Basic Attributes

Class
SURVEY.HITS
Type
Surveys
First Released
Version 2.69
Last Updated
Version 2.69
Order vs. Observation
Observation

Survey Question

Text
Over the last 12 months how often did your partner scream or curse at you?

Normative Answer List LL5622-7

Answer Code Score Answer ID
Never 1 LA6270-8
Rarely 2 LA10066-1
Sometimes 3 LA10082-8
Fairly often 4 LA16644-9
Frequently 5 LA6482-9

Member of these Panels

LOINC Long Common Name
96777-8 Accountable health communities (AHC) health-related social needs screening (HRSN) tool
99593-6 American Academy of Family Physicians Social Needs Screening Tool
99595-1 American Academy of Family Physicians Social Needs Screening Tool - short form
95619-3 Hurts, insults, threatens, and screams [HITS]

Member of these Groups Get Info

LOINC Group Group Name
LG51306-5 SDOH

95614-4 Total score [HITS]

Fully-Specified Name

Component
Total score
Property
Score
Time
Pt
System
^Patient
Scale
Qn
Method
HITS

Basic Attributes

Class
SURVEY.HITS
Type
Surveys
First Released
Version 2.69
Last Updated
Version 2.69
Order vs. Observation
Observation

Member of these Panels

LOINC Long Common Name
96777-8 Accountable health communities (AHC) health-related social needs screening (HRSN) tool
99593-6 American Academy of Family Physicians Social Needs Screening Tool
99595-1 American Academy of Family Physicians Social Needs Screening Tool - short form
95619-3 Hurts, insults, threatens, and screams [HITS]

Member of these Groups Get Info

LOINC Group Group Name
LG51306-5 SDOH

Example Units

Unit Source
{score} Example UCUM Units

99555-5 Would you like help with any of these needs?

Observation ID in Form

15

Fully-Specified Name

Component
Want assistance with personal needs
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.SDOH
Type
Surveys
First Released
Version 2.72
Last Updated
Version 2.72
Order vs. Observation
Observation

Normative Answer List LL361-7

Answer Code Score Answer ID
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) LA33-6
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) LA32-8

Member of these Panels

LOINC Long Common Name
99593-6 American Academy of Family Physicians Social Needs Screening Tool
99595-1 American Academy of Family Physicians Social Needs Screening Tool - short form
99549-8 Health Leads screening panel

Member of these Groups Get Info

LOINC Group Group Name
LG51306-5 SDOH