101430-7 Self-Care - OBRA/Interim Performance

Observation ID in Form

GG0130_5

Form Coding Instructions

(Assessment period is the ARD plus 2 previous calendar days) Code the resident's usual performance for each activity using the 6-point scale. If an activity was not attempted, code the reason. Safety and Quality of Performance - If helper assistance is required because resident's performance is unsafe or of poor quality, score according to amount of assistance provided. Activities may be completed with or without assistive devices. If activity was not attempted, code reason

Fully-Specified Name

Component

Self-Care - OBRA/Interim Performance

Property

-

Time

RptPeriod

System

^Patient

Scale

-

Method

CMS Assessment

Basic Attributes

Class

PANEL.SURVEY.CMS

Type

Surveys

First Released

Version 2.74

Last Updated

Version 2.75

Order vs. Observation

Subset

Panel Type

Organizer

Member of these Panels

Related Names

• Centers for Medicare and Medicaid Assessment
• Pan
• Panel
• PANEL.SURVEY.CMS
• Panl
• Pnl
• Report period
• Survey

Related Codes

89409-7 Eating

Observation ID in Form

GG0130A5

Form Context

The ability to use suitable utensils to bring food and/or liquid to the mouth and swallow food and/or liquid once the meal is placed before the resident

Fully-Specified Name

Component

Eating - functional goal

Property

Find

Time

RptPeriod

System

^Patient

Scale

Ord

Method

CMS Assessment

Basic Attributes

Class

SURVEY.CMS

Type

Surveys

First Released

Version 2.64

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

Observation

Normative Answer List LL4971-9

Member of these Panels

Related Names

• Centers for Medicare and Medicaid Assessment
• Finding
• Findings
• Ordinal
• Ql
• Qual
• Qualitative
• Report period
• Screen
• Survey

Related Codes

89404-8 Oral hygiene

Observation ID in Form

GG0130B5

Form Context

The ability to use suitable items to clean teeth. Dentures (if applicable): The ability to insert and remove dentures into and from the mouth, and manage denture soaking and rinsing with use of equipment

Fully-Specified Name

Component

Oral hygiene - functional goal

Property

Find

Time

RptPeriod

System

^Patient

Scale

Ord

Method

CMS Assessment

Basic Attributes

Class

SURVEY.CMS

Type

Surveys

First Released

Version 2.64

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

Observation

Normative Answer List LL4971-9

Member of these Panels

Related Names

• ADL
• Centers for Medicare and Medicaid Assessment
• Finding
• Findings
• FunctionalStatus
• IADL
• Ordinal
• QL
• Qual
• Qualitative
• Report period
• Screen
• Survey

Related Codes

89389-1 Toileting hygiene

Observation ID in Form

GG0130C5

Form Context

The ability to maintain perineal hygiene, adjust clothes before and after voiding or having a bowel movement. If managing an ostomy, include wiping the opening but not managing equipment

Fully-Specified Name

Component

Toileting hygiene - functional goal

Property

Find

Time

RptPeriod

System

^Patient

Scale

Ord

Method

CMS Assessment

Basic Attributes

Class

SURVEY.CMS

Type

Surveys

First Released

Version 2.64

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

Observation

Normative Answer List LL4971-9

Member of these Panels

Related Names

• ADL
• Centers for Medicare and Medicaid Assessment
• Finding
• Findings
• FunctionalStatus
• IADL
• Ordinal
• QL
• Qual
• Qualitative
• Report period
• Screen
• Survey

Related Codes

101432-3 Mobility - OBRA/Interim Performance

Observation ID in Form

GG0170_5

Form Coding Instructions

(Assessment period is the ARD plus 2 previous calendar days) Code the resident's usual performance for each activity using the 6-point scale. If an activity was not attempted, code the reason. Safety and Quality of Performance - If helper assistance is required because resident's performance is unsafe or of poor quality, score according to amount of assistance provided. Activities may be completed with or without assistive devices. If activity was not attempted, code reason

Fully-Specified Name

Component

Mobility - OBRA/Interim Performance

Property

-

Time

RptPeriod

System

^Patient

Scale

-

Method

CMS Assessment

Basic Attributes

Class

PANEL.SURVEY.CMS

Type

Surveys

First Released

Version 2.74

Last Updated

Version 2.75

Order vs. Observation

Subset

Panel Type

Organizer

Member of these Panels

Related Names

• Centers for Medicare and Medicaid Assessment
• Pan
• Panel
• PANEL.SURVEY.CMS
• Panl
• Pnl
• Report period
• Survey

Related Codes

89394-1 Sit to lying

Observation ID in Form

GG0170B5

Form Context

The ability to move from sitting on side of bed to lying flat on the bed

Fully-Specified Name

Component

Sit to lying - functional goal

Property

Find

Time

RptPeriod

System

^Patient

Scale

Ord

Method

CMS Assessment

Basic Attributes

Class

SURVEY.CMS

Type

Surveys

First Released

Version 2.64

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

Observation

Normative Answer List LL4971-9

Member of these Panels

Related Names

• ADL
• Centers for Medicare and Medicaid Assessment
• Finding
• Findings
• FunctionalStatus
• IADL
• Ordinal
• QL
• Qual
• Qualitative
• Report period
• Screen
• Survey

Related Codes

85927-2 Lying to sitting on side of bed

Term Description

Expected functional performance for the patient's usual ability to move from lying on the back to sitting on the side of the bed with feet flat on the floor, and with no back support.
Source: Regenstrief LOINC

Observation ID in Form

GG0170C5

Form Context

The ability to move from lying on the back to sitting on the side of the bed and with no back support

Fully-Specified Name

Component

Lying to sitting on side of bed - functional goal

Property

Find

Time

RptPeriod

System

^Patient

Scale

Ord

Method

CMS Assessment

Basic Attributes

Class

SURVEY.CMS

Type

Surveys

First Released

Version 2.63

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

Observation

Normative Answer List LL4971-9

Member of these Panels

Related Names

• ADL
• Centers for Medicare and Medicaid Assessment
• Finding
• Findings
• FunctionalStatus
• IADL
• Ordinal
• QL
• Qual
• Qualitative
• Report period
• Screen
• Survey

Related Codes

89392-5 Sit to stand

Observation ID in Form

GG0170D5

Form Context

The ability to come to a standing position from sitting in a chair, wheelchair, or on the side of the bed

Fully-Specified Name

Component

Sit to stand - functional goal

Property

Find

Time

RptPeriod

System

^Patient

Scale

Ord

Method

CMS Assessment

Basic Attributes

Class

SURVEY.CMS

Type

Surveys

First Released

Version 2.64

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

Observation

Normative Answer List LL4971-9

Member of these Panels

Related Names

• 30s CST
• 30-Second Chair Stand
• 30sSTS
• ADL
• Centers for Medicare and Medicaid Assessment
• Finding
• Findings
• FunctionalStatus
• IADL
• Ordinal
• QL
• Qual
• Qualitative
• Report period
• Screen
• Stands
• Survey

Related Codes

89414-7 Chair/bed-to-chair transfer

Observation ID in Form

GG0170E5

Form Context

The ability to transfer to and from a bed to a chair (or wheelchair)

Fully-Specified Name

Component

Chair &or bed-to-chair transfer - functional goal

Property

Find

Time

RptPeriod

System

^Patient

Scale

Ord

Method

CMS Assessment

Basic Attributes

Class

SURVEY.CMS

Type

Surveys

First Released

Version 2.64

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; Release 2.69: COMPONENT: Updated for consistency across terms and to clarify that assessment is for transfer from a chair and/or bed to a chair.;

Order vs. Observation

Observation

Normative Answer List LL4971-9

Member of these Panels

Related Names

• ADL
• Centers for Medicare and Medicaid Assessment
• Finding
• Findings
• FunctionalStatus
• IADL
• Ordinal
• QL
• Qual
• Qualitative
• Report period
• Screen
• Survey

Related Codes

89390-9 Toilet transfer

Observation ID in Form

GG0170F5

Form Context

The ability to get on and off a toilet or commode

Fully-Specified Name

Component

Toilet transfer - functional goal

Property

Find

Time

RptPeriod

System

^Patient

Scale

Ord

Method

CMS Assessment

Basic Attributes

Class

SURVEY.CMS

Type

Surveys

First Released

Version 2.64

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

Observation

Normative Answer List LL4971-9

Member of these Panels

Related Names

• ADL
• Centers for Medicare and Medicaid Assessment
• Finding
• Findings
• FunctionalStatus
• IADL
• Ordinal
• QL
• Qual
• Qualitative
• Report period
• Screen
• Survey

Related Codes

89385-9 Walk 10 feet

Observation ID in Form

GG0170I5

Skip Logic

If interim performance is coded 07, 09, 10, or 88, Skip to H0100, Appliances

Form Context

Once standing, the ability to walk at least 10 feet in a room, corridor, or similar space

Fully-Specified Name

Component

Walk 10 feet - functional goal

Property

Find

Time

RptPeriod

System

^Patient

Scale

Ord

Method

CMS Assessment

Basic Attributes

Class

SURVEY.CMS

Type

Surveys

First Released

Version 2.64

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

Observation

Normative Answer List LL4971-9

Member of these Panels

Related Names

• ADL
• Centers for Medicare and Medicaid Assessment
• Finding
• Findings
• FunctionalStatus
• IADL
• Ordinal
• QL
• Qual
• Qualitative
• Report period
• Screen
• Survey

Related Codes

89381-8 Walk 50 feet with two turns

Observation ID in Form

GG0170J5

Form Context

Once standing, the ability to walk at least 50 feet and make two turns

Fully-Specified Name

Component

Walk 50 feet with two turns - functional goal

Property

Find

Time

RptPeriod

System

^Patient

Scale

Ord

Method

CMS Assessment

Basic Attributes

Class

SURVEY.CMS

Type

Surveys

First Released

Version 2.64

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

Observation

Normative Answer List LL4971-9

Member of these Panels

Related Names

• 2
• ADL
• Centers for Medicare and Medicaid Assessment
• Finding
• Findings
• FunctionalStatus
• IADL
• Ordinal
• QL
• Qual
• Qualitative
• Report period
• Screen
• Survey

Related Codes

89383-4 Walk 150 feet

Observation ID in Form

GG0170K5

Form Context

Once standing, the ability to walk at least 150 feet in a corridor or similar space

Fully-Specified Name

Component

Walk 150 feet - functional goal

Property

Find

Time

RptPeriod

System

^Patient

Scale

Ord

Method

CMS Assessment

Basic Attributes

Class

SURVEY.CMS

Type

Surveys

First Released

Version 2.64

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

Observation

Normative Answer List LL4971-9

Member of these Panels

Related Names

• ADL
• Centers for Medicare and Medicaid Assessment
• Finding
• Findings
• FunctionalStatus
• IADL
• Ordinal
• QL
• Qual
• Qualitative
• Report period
• Screen
• Survey

Related Codes