Version 2.80

45584-0 Strong identification with past roles and life status [Minimum Data Set]

Observation ID in Form

F3a

Type of Entry

Question expects user entry - requires response [Q]

Form Consistency Checks

*1. Value must be blank if B1 = 1; value must be 0 (zero), 1, or - if B1 not = 1.
*2. See F3d consistency notes #2 and #3.

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Strong identification with past roles and life status
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
MDS

Basic Attributes

Class
SURVEY.MDS
Type
Surveys
First Released
Version 2.17
Last Updated
Version 2.50 (MIN)

Normative Answer List LL50-6

Answer Code Score Answer ID
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) 0 LA32-8
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) 1 LA33-6
UTD LA1-0

Member of these Panels

LOINC Long Common Name
45981-8 Deprecated MDS full assessment form - version 2.0

45585-7 Expresses sadness/anger/empty feeling over lost roles/status [Minimum Data Set]

Observation ID in Form

F3b

Type of Entry

Question expects user entry - requires response [Q]

Form Consistency Checks

*1. Value must be blank if B1 = 1; value must be 0 (zero), 1, or - if B1 not = 1.
*2. See F3d consistency notes #2 and #3.

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Expresses sadness &or anger &or empty feeling over lost roles &or status
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
MDS

Basic Attributes

Class
SURVEY.MDS
Type
Surveys
First Released
Version 2.17
Last Updated
Version 2.50 (MIN)

Normative Answer List LL50-6

Answer Code Score Answer ID
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) 0 LA32-8
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) 1 LA33-6
UTD LA1-0

Member of these Panels

LOINC Long Common Name
45981-8 Deprecated MDS full assessment form - version 2.0

45586-5 Resident perceives that daily routine (customary routine, activities) is very different from prior pattern in the community [Minimum Data Set]

Observation ID in Form

F3c

Type of Entry

Question expects user entry - requires response [Q]

Form Consistency Checks

*1. Value must be blank if B1 = 1; value must be 0 (zero), 1, or - if B1 not = 1.
*2. See F3d consistency notes #2 and #3.

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Resident perceives that daily routine (customary routine, activities) is very different from prior pattern in the community
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
MDS

Basic Attributes

Class
SURVEY.MDS
Type
Surveys
First Released
Version 2.17
Last Updated
Version 2.50 (MIN)

Normative Answer List LL50-6

Answer Code Score Answer ID
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) 0 LA32-8
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) 1 LA33-6
UTD LA1-0

Member of these Panels

LOINC Long Common Name
45981-8 Deprecated MDS full assessment form - version 2.0

45587-3 Past roles - none of above [Minimum Data Set]

Observation ID in Form

F3d

Type of Entry

Question expects user entry - requires response [Q]

Form Consistency Checks

*1. Value must be blank if B1 = 1; value must be 0 (zero), 1, or - if B1 not = 1.

*2. If REC_TYPE A,AM,AO,Y,YM, or YO, F3d must be 0 (zero) if any F3a thru F3c = 1; F3d must be 1 if each F3a thru F3c = 0 (zero); F3d must be - if any F3a thru F3c = - and no F3a thru F3c = 1.

3. If REC_TYPE is Q, QM, or QO, and F3d is active by State option, then F3d must be 0 (zero) if any active (State option) F3a thru F3c = 1; F3d must be 1 if each active (State option) F3a thru F3c = 0 (zero); F3d must be - if any active (State option) F3a thru F3c = - and no active (State option) F3a thru F3c = 1.

Source: Centers for Medicare & Medicaid Services

Fully-Specified Name

Component
Past roles - none of above
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
MDS

Basic Attributes

Class
SURVEY.MDS
Type
Surveys
First Released
Version 2.17
Last Updated
Version 2.50 (MIN)

Normative Answer List LL50-6

Answer Code Score Answer ID
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) 0 LA32-8
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) 1 LA33-6
UTD LA1-0

Member of these Panels

LOINC Long Common Name
45981-8 Deprecated MDS full assessment form - version 2.0