Version 2.77

Panel Hierarchy

Details for each LOINC in Panel LHC-Forms

LOINC Name R/O/C Cardinality Example UCUM Units
101107-1 MDS v3.0 - RAI v1.18.11 - Nursing home discharge (ND) item set during assessment period [CMS Assessment]
Indent101591-6 Identification Information
IndentIndent58198-3 Type of Record
IndentIndent54581-4 Facility Provider Numbers
IndentIndentIndent76468-8 National Provider Identifier (NPI)
IndentIndentIndent69417-4 CMS Certification Number (CCN)
IndentIndentIndent45398-5 State Provider Number
IndentIndent85632-8 Type of Provider
IndentIndent86524-6 Type of Assessment
IndentIndentIndent54583-0 Federal OBRA Reason for Assessment
IndentIndentIndent54584-8 PPS Assessment
IndentIndentIndent54587-1 Is this assessment the first assessment (OBRA, Scheduled PPS, or Discharge) since the most recent admission/entry or reentry?
IndentIndentIndent58108-2 Entry/discharge reporting
IndentIndentIndent71440-2 Type of discharge
IndentIndentIndent90525-7 Is this a SNF Part A Interrupted Stay?
IndentIndentIndent86525-3 Is this a SNF Part A PPS Discharge Assessment?
IndentIndent86526-1 Unit Certification or Licensure Designation
IndentIndent54503-8 Legal Name of Resident
IndentIndentIndent45392-8 First name
IndentIndentIndent45393-6 Middle initial
IndentIndentIndent45394-4 Last name
IndentIndentIndent45395-1 Suffix
IndentIndent45966-9 Social Security and Medicare Numbers
IndentIndentIndent45396-9 Social Security Number
IndentIndentIndent45397-7 Medicare number
IndentIndent45400-9 Medicaid Number
IndentIndent46098-0 Gender
IndentIndent21112-8 Birth Date {mm/dd/yyyy}
IndentIndent69854-8 Ethnicity. Are you of Hispanic, Latino/a, or Spanish origin? 1..4
IndentIndent103708-4 Race. What is your race? 1..14
IndentIndent93186-5 Language
IndentIndentIndent54899-0 What is your preferred language?
IndentIndentIndent54588-9 Do you need or want an interpreter to communicate with a doctor or health care staff?
IndentIndent45404-1 Marital Status
IndentIndent101351-5 Transportation (from NACHC©). Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living?
IndentIndent54506-1 Optional Resident Items
IndentIndentIndent46106-1 Medical record number
IndentIndentIndent45403-3 Room number
IndentIndentIndent52462-9 Name by which resident prefers to be addressed
IndentIndentIndent21843-8 Lifetime occupation(s)
IndentIndent86528-7 Most Recent Admission/Entry or Reentry into this Facility
IndentIndentIndent50786-3 Entry Date {mm/dd/yyyy}
IndentIndentIndent54590-5 Type of Entry
IndentIndentIndent85398-6 Entered From
IndentIndent52455-3 Admission Date (Date this episode of care in this facility began) {mm/dd/yyyy}
IndentIndent52525-3 Discharge Date {mm/dd/yyyy}
IndentIndent55128-3 Discharge Status
IndentIndent93182-4 Provision of Current Reconciled Medication List to Subsequent Provider at Discharge. At the time of discharge to another provider, did your facility provide the resident's current reconciled medication list to the subsequent provider?
IndentIndent93184-0 Route of Current Reconciled Medication List Transmission to Subsequent Provider. 1..5
IndentIndent93181-6 Provision of Current Reconciled Medication List to Resident at Discharge. At the time of discharge, did your facility provide the resident's current reconciled medication list to the resident, family and/or caregiver?
IndentIndent93183-2 Route of Current Reconciled Medication List Transmission to Resident. 1..5
IndentIndent54593-9 Assessment Reference Date. Observation end date {mm/dd/yyyy}
IndentIndent54507-9 Medicare Stay
IndentIndentIndent54594-7 Has the resident had a Medicare-covered stay since the most recent entry?
IndentIndentIndent54595-4 Start date of most recent Medicare stay {mm/dd/yyyy}
IndentIndentIndent54596-2 End date of most recent Medicare stay {mm/dd/yyyy}
Indent54508-7 Hearing, Speech, and Vision
IndentIndent54597-0 Comatose. Persistent vegetative state/no discernible consciousness
IndentIndent103709-2 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?
Indent101592-4 Cognitive Patterns
IndentIndent54605-1 Should Brief Interview for Mental Status (C0200-C0500) be Conducted?
IndentIndent103694-6 Brief Interview for Mental Status (BIMS)
IndentIndentIndent103696-1 Repetition of Three Words. Number of words repeated after first attempt
IndentIndentIndent103702-7 Temporal Orientation (orientation to year, month, and day)
IndentIndentIndentIndent103697-9 Able to report correct year
IndentIndentIndentIndent103698-7 Able to report correct month
IndentIndentIndentIndent103703-5 Able to report correct day of the week
IndentIndentIndent103695-3 Recall
IndentIndentIndentIndent103699-5 Able to recall "sock"
IndentIndentIndentIndent103700-1 Able to recall "blue"
IndentIndentIndentIndent103701-9 Able to recall "bed"
IndentIndentIndent103704-3 BIMS Summary Score {score}
IndentIndent54615-0 Should the Staff Assessment for Mental Status (C0700 - C1000) be Conducted?
IndentIndent83241-0 Staff Assessment for Mental Status
IndentIndentIndent54616-8 Short-term Memory OK. Seems or appears to recall after 5 minutes.
IndentIndentIndent54624-2 Cognitive Skills for Daily Decision Making. Made decisions regarding tasks of daily life.
IndentIndent101593-2 Delirium
IndentIndent95816-5 Signs and Symptoms of Delirium (from CAM©)
IndentIndentIndent95813-2 Acute Onset Mental Change
IndentIndentIndent95812-4 Inattention
IndentIndentIndent95814-0 Disorganized Thinking
IndentIndentIndent95815-7 Altered Level of Consciousness
Indent101594-0 Mood
IndentIndent54634-1 Should Resident Mood Interview be Conducted?
IndentIndent54635-8 Resident Mood Interview (PHQ-2 to 9)
IndentIndentIndent86843-0 Symptom Presence
IndentIndentIndentIndent54636-6 Little interest or pleasure in doing things
IndentIndentIndentIndent54638-2 Feeling down, depressed or hopeless
IndentIndentIndentIndent54640-8 Trouble falling or staying asleep, or sleeping too much
IndentIndentIndentIndent54642-4 Feeling tired or having little energy
IndentIndentIndentIndent54644-0 Poor appetite or overeating
IndentIndentIndentIndent54646-5 Feeling bad about yourself - or that you are a failure or have let yourself or your family down
IndentIndentIndentIndent54648-1 Trouble concentrating on things, such as reading the newspaper or watching television
IndentIndentIndentIndent54650-7 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
IndentIndentIndentIndent54652-3 Thoughts that you would be better off dead, or of hurting yourself in some way
IndentIndentIndent86844-8 Symptom Frequency
IndentIndentIndentIndent54637-4 Little interest or pleasure in doing things
IndentIndentIndentIndent54639-0 Feeling down, depressed or hopeless
IndentIndentIndentIndent54641-6 Trouble falling or staying asleep, or sleeping too much
IndentIndentIndentIndent54643-2 Feeling tired or having little energy
IndentIndentIndentIndent54645-7 Poor appetite or overeating
IndentIndentIndentIndent54647-3 Feeling bad about yourself - or that you are a failure or have let yourself or your family down
IndentIndentIndentIndent54649-9 Trouble concentrating on things, such as reading the newspaper or watching television
IndentIndentIndentIndent54651-5 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
IndentIndentIndentIndent54653-1 Thoughts that you would be better off dead, or of hurting yourself in some way
IndentIndent103705-0 Total Severity Score {score}
IndentIndent103706-8 Staff Assessment of Resident Mood (PHQ-9-OV)
IndentIndentIndent86833-1 Symptom Presence
IndentIndentIndentIndent54658-0 Little interest or pleasure in doing things
IndentIndentIndentIndent54660-6 Feeling or appearing down, depressed, or hopeless
IndentIndentIndentIndent54662-2 Trouble falling or staying asleep, or sleeping too much
IndentIndentIndentIndent54664-8 Feeling tired or having little energy
IndentIndentIndentIndent54666-3 Poor appetite or overeating
IndentIndentIndentIndent54668-9 Indicating that they feel bad about self, are a failure, or have let self or family down
IndentIndentIndentIndent54670-5 Trouble concentrating on things, such as reading the newspaper or watching television
IndentIndentIndentIndent54672-1 Moving or speaking so slowly that other people have noticed. Or the opposite-being so fidgety or restless that they have been moving around a lot more than usual
IndentIndentIndentIndent54673-9 States that life isn't worth living, wishes for death, or attempts to harm self
IndentIndentIndentIndent54675-4 Being short-tempered, easily annoyed
IndentIndentIndent86891-9 Symptom Frequency
IndentIndentIndentIndent54659-8 Little interest or pleasure in doing things
IndentIndentIndentIndent54661-4 Feeling or appearing down, depressed, or hopeless
IndentIndentIndentIndent54663-0 Trouble falling or staying asleep, or sleeping too much
IndentIndentIndentIndent54665-5 Feeling tired or having little energy
IndentIndentIndentIndent54667-1 Poor appetite or overeating
IndentIndentIndentIndent54669-7 Indicating that they feel bad about self, are a failure, or have let self or family down
IndentIndentIndentIndent54671-3 Trouble concentrating on things, such as reading the newspaper or watching television
IndentIndentIndentIndent54904-8 Moving or speaking so slowly that other people have noticed. Or the opposite-being so fidgety or restless that they have been moving around a lot more than usual
IndentIndentIndentIndent54674-7 States that life isn't worth living, wishes for death, or attempts to harm self
IndentIndentIndentIndent54676-2 Being short-tempered, easily annoyed
IndentIndent103707-6 Total Severity Score {score}
IndentIndent93159-2 Social Isolation. How often do you feel lonely or isolated from those around you?
Indent86596-4 Behavior
IndentIndent86597-2 Potential Indicators of Psychosis 1..2
Indent54514-5 Behavioral Symptom - Presence & Frequency
IndentIndent54682-0 Physical behavioral symptoms directed toward others d/(7.d)
IndentIndent54683-8 Verbal behavioral symptoms directed toward others d/(7.d)
IndentIndent54684-6 Other behavioral symptoms not directed toward others d/(7.d)
Indent54692-9 Rejection of Care - Presence & Frequency d/(7.d)
Indent54693-7 Wandering - Presence & Frequency d/(7.d)
Indent101595-7 Functional Abilities and Goals
IndentIndent92908-3 Functional Limitation in Range of Motion
IndentIndentIndent92850-7 Upper extremity (shoulder, elbow, wrist, hand)
IndentIndentIndent92851-5 Lower extremity (hip, knee, ankle, foot)
IndentIndent86602-0 Mobility Devices 1..4
IndentIndent88483-3 Functional Abilities and Goals - Discharge
IndentIndentIndent83254-3 Self-Care - Discharge Performance (Assessment period is the last 3 days of the stay)
IndentIndentIndentIndent89409-7 Eating
IndentIndentIndentIndent89404-8 Oral hygiene
IndentIndentIndentIndent89389-1 Toileting hygiene
IndentIndentIndentIndent89396-6 Shower/bathe self
IndentIndentIndentIndent89387-5 Upper body dressing
IndentIndentIndentIndent89406-3 Lower body dressing
IndentIndentIndentIndent89400-6 Putting on/taking off footwear
IndentIndentIndentIndent45606-1 Personal hygiene
IndentIndentIndent88331-4 Mobility - Discharge Performance (Assessment period is the last 3 days of the stay)
IndentIndentIndentIndent89398-2 Roll left and right
IndentIndentIndentIndent89394-1 Sit to lying
IndentIndentIndentIndent95009-7 Lying to sitting on side of bed
IndentIndentIndentIndent89392-5 Sit to stand
IndentIndentIndentIndent89414-7 Chair/bed-to-chair transfer
IndentIndentIndentIndent89390-9 Toilet transfer
IndentIndentIndentIndent101597-3 Tub/shower transfer
IndentIndentIndentIndent89412-1 Car transfer
IndentIndentIndentIndent89385-9 Walk 10 feet
IndentIndentIndentIndent89381-8 Walk 50 feet with two turns
IndentIndentIndentIndent89383-4 Walk 150 feet
IndentIndentIndentIndent89379-2 Walking 10 feet on uneven surfaces
IndentIndentIndentIndent95000-6 1 step (curb)
IndentIndentIndentIndent89416-2 4 steps
IndentIndentIndentIndent89418-8 12 steps
IndentIndentIndentIndent89402-2 Picking up object
IndentIndentIndentIndent95738-1 Does the resident use a wheelchair and/or scooter?
IndentIndentIndentIndent94992-5 Wheel 50 feet with two turns
IndentIndentIndentIndent95739-9 Indicate the type of wheelchair or scooter used
IndentIndentIndentIndent94991-7 Wheel 150 feet
IndentIndentIndentIndent95739-9 Indicate the type of wheelchair or scooter used
Indent83237-8 Bladder and Bowel
IndentIndent86624-4 Appliances 1..4
IndentIndent95735-7 Urinary Continence 1..1
IndentIndent95736-5 Bowel Continence 1..1
Indent101601-3 Active Diagnoses
IndentIndent86671-5 Active Diagnoses in the last 7 days 1..*
IndentIndent52797-8 Additional active diagnoses 0..10
Indent101602-1 Health Conditions
IndentIndent54557-4 Pain Management
IndentIndentIndent71447-7 At any time in the last 5 days, has the resident: Received scheduled pain medication regimen?
IndentIndentIndent71448-5 At any time in the last 5 days, has the resident: Received PRN pain medications OR was offered and declined?
IndentIndentIndent71449-3 At any time in the last 5 days, has the resident: Received non-medication intervention for pain?
IndentIndent54828-9 Should Pain Assessment Interview be Conducted?
IndentIndent101603-9 Pain Assessment Interview
IndentIndentIndent54829-7 Pain Presence
IndentIndentIndent54830-5 Pain Frequency
IndentIndentIndent93156-8 Pain Effect on Sleep
IndentIndentIndent93160-0 Pain Interference with Therapy Activities
IndentIndentIndent93158-4 Pain Interference with Day-to-Day Activities
IndentIndentIndent54560-8 Pain Intensity
IndentIndentIndentIndent54833-9 Numeric Rating Scale (00-10)
IndentIndentIndentIndent54834-7 Verbal Descriptor Scale
IndentIndent86674-9 Other Health Conditions
IndentIndentIndent86675-6 Shortness of Breath (dyspnea) 1..3
IndentIndentIndent54846-1 Prognosis. Does the resident have a condition or chronic disease that may result in a life expectancy of less than 6 months?
IndentIndentIndent86676-4 Problem Conditions 1..4
IndentIndentIndent54853-7 Any Falls Since Admission/Entry or Reentry or Prior Assessment (OBRA or Scheduled PPS), whichever is more recent
IndentIndentIndent54854-5 Number of Falls Since Admission/Entry or Reentry or Prior Assessment (OBRA or Scheduled PPS), whichever is more recent
IndentIndentIndentIndent54855-2 No injury
IndentIndentIndentIndent54856-0 Injury (except major)
IndentIndentIndentIndent54857-8 Major injury
Indent101604-7 Swallowing &or Nutritional Status
IndentIndent54567-3 Height and Weight
IndentIndentIndent103692-0 Height (in inches) [in_us];cm;m
IndentIndentIndent103693-8 Weight (in pounds) [lb_av];kg
IndentIndent54863-6 Weight Loss
IndentIndent86678-0 Weight Gain
IndentIndent54568-1 Nutritional Approaches
IndentIndentIndent71445-1 Nutritional Approaches. While a Resident 1..4
IndentIndentIndent101605-4 Nutritional Approaches. At Discharge. 1..4
Indent101607-0 Skin Conditions
IndentIndent101608-8 Determination of Pressure Ulcer/Injury Risk 1..3
IndentIndent58214-8 Unhealed Pressure Ulcers/Injuries. Does this resident have one or more unhealed pressure ulcers/injuries?
IndentIndent101611-2 Current Number of Unhealed Pressure Ulcers/Injuries at Each Stage
IndentIndentIndent55124-2 Number of Stage 2 pressure ulcers {#}
IndentIndentIndent54886-7 Number of these Stage 2 pressure ulcers that were present upon admission/entry or reentry {#}
IndentIndentIndent55125-9 Number of Stage 3 pressure ulcers {#}
IndentIndentIndent54887-5 Number of these Stage 3 pressure ulcers that were present upon admission/entry or reentry {#}
IndentIndentIndent55126-7 Number of Stage 4 pressure ulcers {#}
IndentIndentIndent54890-9 Number of these Stage 4 pressure ulcers that were present upon admission/entry or reentry {#}
IndentIndentIndent54893-3 Number of unstageable pressure ulcers/injuries due to non-removable dressing/device {#}
IndentIndentIndent54894-1 Number of these unstageable pressure ulcers/injuries that were present upon admission/entry or reentry {#}
IndentIndentIndent54946-9 Number of unstageable pressure ulcers due to coverage of wound bed by slough and/or eschar {#}
IndentIndentIndent54947-7 Number of these unstageable pressure ulcers that were present upon admission/entry or reentry {#}
IndentIndentIndent54950-1 Number of unstageable pressure injuries presenting as deep tissue injury {#}
IndentIndentIndent54951-9 Number of these unstageable pressure injuries that were present upon admission/entry or reentry {#}
Indent86749-9 Medications
IndentIndent101612-0 High-Risk Drug Classes: Use and Indication
IndentIndentIndent93153-5 Is taking 1..10
IndentIndentIndent93154-3 Indication noted 1..10
IndentIndent57256-0 Medication Intervention
Indent101613-8 Special Treatments, Procedures, and Programs
IndentIndent101614-6 Special Treatments, Procedures, and Programs
IndentIndentIndent86761-4 Special Treatments, Procedures, and Programs - While a Resident 1..1
IndentIndentIndent93185-7 Special Treatments, Procedures, and Programs - At Discharge 1..30
IndentIndent69339-0 Influenza Vaccine
IndentIndentIndent55019-4 Did the resident receive the influenza vaccine in this facility for this year's influenza vaccination season?
IndentIndentIndent58131-4 Date influenza vaccine received {mm/dd/yyyy}
IndentIndentIndent55020-2 If influenza vaccine not received, state reason:
IndentIndent55021-0 Pneumococcal Vaccine
IndentIndentIndent55022-8 Is the resident's Pneumococcal vaccination up to date?
IndentIndentIndent45956-0 If Pneumococcal vaccine not received, state reason:
IndentIndent90544-8 Part A Therapies
IndentIndentIndent90545-5 Speech-Language Pathology and Audiology Services
IndentIndentIndentIndent90539-8 Individual minutes min
IndentIndentIndentIndent90536-4 Concurrent minutes min
IndentIndentIndentIndent90538-0 Group minutes min
IndentIndentIndentIndent90537-2 Co-treatment minutes min
IndentIndentIndentIndent90551-3 Days d/{#}
IndentIndentIndent90546-3 Occupational Therapy
IndentIndentIndentIndent90531-5 Individual minutes min
IndentIndentIndentIndent90527-3 Concurrent minutes min
IndentIndentIndentIndent90529-9 Group minutes min
IndentIndentIndentIndent90528-1 Co-treatment minutes min
IndentIndentIndentIndent90530-7 Days d/{#}
IndentIndentIndent90547-1 Physical Therapy
IndentIndentIndentIndent90535-6 Individual minutes min
IndentIndentIndentIndent90532-3 Concurrent minutes min
IndentIndentIndentIndent90534-9 Group minutes min
IndentIndentIndentIndent90533-1 Co-treatment minutes min
IndentIndentIndentIndent90550-5 Days d/{#}
IndentIndent90548-9 Distinct Calendar Days of Part A Therapy {#}
Indent88307-4 Restraints and Alarms
IndentIndent86785-3 Physical Restraints
IndentIndentIndent86786-1 Used in Bed. Bed rail d/(7.d)
IndentIndentIndent86787-9 Used in Bed. Trunk restraint d/(7.d)
IndentIndentIndent86788-7 Used in Bed. Limb restraint d/(7.d)
IndentIndentIndent86789-5 Used in Bed. Other d/(7.d)
IndentIndentIndent86790-3 Used in Chair or Out of Bed. Trunk restraint d/(7.d)
IndentIndentIndent86791-1 Used in Chair or Out of Bed. Limb restraint d/(7.d)
IndentIndentIndent86792-9 Used in Chair or Out of Bed. Chair prevents rising d/(7.d)
IndentIndentIndent86793-7 Used in Chair or Out of Bed. Other d/(7.d)
Indent101615-3 Participation in Assessment and Goal Setting
IndentIndent101617-9 Discharge Plan
IndentIndentIndent58146-2 Is active discharge planning already occurring for the resident to return to the community?
IndentIndent101619-5 Referral
IndentIndentIndent101620-3 Has a referral been made to the Local Contact Agency (LCA)?
IndentIndent101621-1 Reason Referral to Local Contact Agency (LCA) Not Made
Indent101622-9 Correction Request
IndentIndent85632-8 Type of Provider
IndentIndent87226-7 Name of Resident
IndentIndentIndent45392-8 First name
IndentIndentIndent45394-4 Last name
IndentIndent46098-0 Gender
IndentIndent21112-8 Birth Date {mm/dd/yyyy}
IndentIndent45396-9 Social Security Number
IndentIndent86524-6 Type of Assessment
IndentIndentIndent54583-0 Federal OBRA Reason for Assessment
IndentIndentIndent54584-8 PPS Assessment
IndentIndentIndent58108-2 Entry/discharge reporting
IndentIndentIndent86525-3 Is this a SNF Part A PPS Discharge Assessment?
IndentIndent87216-8 Date on existing record to be modified/inactivated
IndentIndentIndent54593-9 Assessment Reference Date {mm/dd/yyyy}
IndentIndentIndent52525-3 Discharge Date {mm/dd/yyyy}
IndentIndentIndent50786-3 Entry Date {mm/dd/yyyy}
Indent87209-3 Correction Attestation Section
IndentIndent58200-7 Correction Number {#}
IndentIndent87217-6 Reasons for Modification 1..5
IndentIndent87225-9 Reasons for Inactivation 1..2
IndentIndent87218-4 RN Assessment Coordinator Attestation of Completion
IndentIndentIndent87219-2 Attesting individual's first name
IndentIndentIndent87220-0 Attesting individual's last name
IndentIndentIndent87221-8 Attesting individual's title
IndentIndentIndent87222-6 Attestation date {mm/dd/yyyy}
Indent87223-4 Assessment Administration
IndentIndent55070-7 Insurance Billing
IndentIndentIndent55071-5 Billing code
IndentIndentIndent55081-4 Billing version
IndentIndent85648-4 Signature of Persons Completing the Assessment or Entry/Death Reporting
IndentIndent70127-6 Signature of RN Assessment Coordinator Verifying Assessment Completion
IndentIndentIndent70127-6 Signature:
IndentIndentIndent30947-6 Date RN Assessment Coordinator signed assessment as complete: {mm/dd/yyyy}

Fully-Specified Name

Component
MDS v3.0 - RAI v1.18.11 - Nursing home discharge (ND) item set
Property
-
Time
RptPeriod
System
^Patient
Scale
-
Method
CMS Assessment

Basic Attributes

Class
PANEL.SURVEY.CMS
Type
Surveys
First Released
Version 2.75
Last Updated
Version 2.77
Change Reason
Release 2.77: TIME_ASPCT: Decision by CMS to update the Timing to RptPeriod from Pt for all CMS Assessments;
Order vs. Observation
Order
Panel Type
Panel

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

CodeSystem lookup
https://fhir.loinc.org/CodeSystem/$lookup?system=http://loinc.org&code=101107-1
Questionnaire definition
https://fhir.loinc.org/Questionnaire/?url=http://loinc.org/q/101107-1