Version 2.78

Status Information

Status
DEPRECATED

Term Description

This panel should be used for CMS MDS3.0 v1.14.1 NO/SO assessments performed between October 1, 2016 and September 30, 2017.
Source: Regenstrief LOINC

Panel Hierarchy

Details for each LOINC in Panel LHC-Forms

LOINC Name R/O/C Cardinality Example UCUM Units
86870-3 Deprecated MDS v3.0 - RAI v1.14.1 - Nursing home and Swing bed OMRA (NO/SO) item set [CMS Assessment]
Indent86811-7 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
IndentIndentIndent54585-5 PPS Other Medicare Required Assessment - OMRA
IndentIndentIndent58107-4 Is this a Swing Bed clinical change 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
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 (or comparable railroad insurance number)
IndentIndent45400-9 Medicaid Number
IndentIndent46098-0 Gender
IndentIndent21112-8 Birth Date {mm/dd/yyyy}
IndentIndent59362-4 Race/Ethnicity 1..6
IndentIndent54505-3 Language
IndentIndentIndent54588-9 Does the resident need or want an interpreter to communicate with a doctor or health care staff?
IndentIndentIndent54899-0 Preferred language
IndentIndent45404-1 Marital Status
IndentIndent54506-1 Optional Resident Items
IndentIndentIndent46106-1 Medical record number [Identifier]
IndentIndentIndent45403-3 Room number [Location]
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
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}
Indent86813-3 Hearing, Speech, and Vision
IndentIndent54597-0 Comatose. Persistent vegetative state/no discernible consciousness
IndentIndent54601-0 Makes Self Understood. Ability to express ideas and wants, consider both verbal and non-verbal expression
Indent86883-6 Cognitive patterns
IndentIndent54605-1 Should Brief Interview for Mental Status (C0200-C0500) be Conducted?
IndentIndent52491-8 Brief Interview for Mental Status (BIMS)
IndentIndentIndent52731-7 Repetition of Three Words. Number of words repeated after first attempt
IndentIndentIndent54510-3 Temporal Orientation (orientation to year, month, and day)
IndentIndentIndentIndent52732-5 Able to report correct year
IndentIndentIndentIndent52733-3 Able to report correct month
IndentIndentIndentIndent54609-3 Able to report correct day of the week
IndentIndentIndent52493-4 Recall
IndentIndentIndentIndent52735-8 Able to recall "sock"
IndentIndentIndentIndent52736-6 Able to recall "blue"
IndentIndentIndentIndent52737-4 Able to recall "bed"
IndentIndentIndent54614-3 BIMS Summary Score {score}
IndentIndent54615-0 Should the Staff Assessment for Mental Status (C0700-C1000) be Conducted?
IndentIndent86814-1 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
Indent54633-3 Mood
IndentIndent54634-1 Should Resident Mood Interview be Conducted?
IndentIndent54635-8 Resident Mood Interview (PHQ-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
IndentIndent54654-9 Total Severity Score {score}
IndentIndent54655-6 Safety Notification. Was responsible staff or provider informed that there is a potential for resident self harm?
IndentIndent54657-2 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 s/he feels bad about self, is a failure, or has 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 s/he has 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 s/he feels bad about self, is a failure, or has 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 s/he has 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
IndentIndent54677-0 Total Severity Score {score}
IndentIndent54655-6 Safety Notification. Was responsible staff or provider informed that there is a potential for resident self harm?
Indent86815-8 Behavior
IndentIndent86597-2 Potential Indicators of Psychosis 1..2
IndentIndent54514-5 Behavioral Symptom - Presence & Frequency
IndentIndentIndent54682-0 Physical behavioral symptoms directed toward others d/(7.d)
IndentIndentIndent54683-8 Verbal behavioral symptoms directed toward others d/(7.d)
IndentIndentIndent54684-6 Other behavioral symptoms not directed toward others d/(7.d)
IndentIndent54692-9 Rejection of Care - Presence & Frequency. Did the resident reject evaluation or care (e.g., bloodwork, taking medications, ADL assistance) that is necessary to achieve the resident's goals for health and well-being? d/(7.d)
IndentIndent54693-7 Wandering - Presence & Frequency. Has the resident wandered? d/(7.d)
Indent86817-4 Functional Status
IndentIndent86885-1 Activities of Daily Living (ADL) Assistance. Self-Performance
IndentIndentIndent45588-1 Bed mobility
IndentIndentIndent45590-7 Transfer
IndentIndentIndent45602-0 Eating
IndentIndentIndent45604-6 Toilet use
IndentIndent86886-9 Activities of Daily Living (ADL) Assistance. Support Provided
IndentIndentIndent45589-9 Bed mobility
IndentIndentIndent45591-5 Transfer
IndentIndentIndent45603-8 Eating
IndentIndentIndent45605-3 Toilet use
Indent86878-6 Bladder and Bowel
IndentIndent86866-1 Urinary Toileting Program
IndentIndentIndent54767-9 Has a trial of a toileting program (e.g., scheduled toileting, prompted voiding, or bladder training) been attempted on admission/entry or reentry or since urinary incontinence was noted in this facility?
IndentIndentIndent54769-5 Current toileting program or trial - Is a toileting program (e.g., scheduled toileting, prompted voiding, or bladder training) currently being used to manage the resident's urinary continence?
IndentIndent54772-9 Bowel Toileting Program. Is a toileting program currently being used to manage the resident's bowel continence?
Indent86821-6 Active Diagnoses
IndentIndent86671-5 Active Diagnoses in the last 7 days 1..*
Indent86888-5 Health conditions
IndentIndent86889-3 Other Health Conditions
IndentIndentIndent86675-6 Shortness of Breath (dyspnea) 0..1
IndentIndentIndent86676-4 Problem Conditions 0..2
Indent86824-0 Swallowing/Nutritional Status
IndentIndent54863-6 Weight Loss. Loss of 5% or more in the last month or loss of 10% or more in last 6 months
IndentIndent86678-0 Weight Gain. Gain of 5% or more in the last month or gain of 10% or more in last 6 months
IndentIndent54568-1 Nutritional Approaches
IndentIndentIndent71444-4 Nutritional Approaches. While NOT a Resident 0..2
IndentIndentIndent71445-1 Nutritional Approaches. While a Resident 0..2
IndentIndent86679-8 Percent Intake by Artificial Route
IndentIndentIndent86680-6 Proportion of total calories the resident received through parenteral or tube feeding. While NOT a Resident
IndentIndentIndent86681-4 Proportion of total calories the resident received through parenteral or tube feeding. While a Resident
IndentIndentIndent86687-1 Proportion of total calories the resident received through parenteral or tube feeding. During Entire 7 Days
IndentIndentIndent86682-2 Average fluid intake per day by IV or tube feeding. While NOT a Resident mL/d;L/d
IndentIndentIndent86683-0 Average fluid intake per day by IV or tube feeding. While a Resident mL/d;L/d
IndentIndentIndent86684-8 Average fluid intake per day by IV or tube feeding. During Entire 7 Days mL/d;L/d
Indent86827-3 Skin Conditions
IndentIndent58214-8 Unhealed Pressure Ulcer(s). Does this resident have one or more unhealed pressure ulcer(s) at Stage 1 or higher?
IndentIndent86892-7 Current Number of Unhealed Pressure Ulcers at Each Stage
IndentIndentIndent55124-2 Number of Stage 2 pressure ulcers {#}
IndentIndentIndent55125-9 Number of Stage 3 pressure ulcers {#}
IndentIndentIndent55126-7 Number of Stage 4 pressure ulcers {#}
IndentIndentIndent54946-9 Number of unstageable pressure ulcers due to coverage of wound bed by slough and/or eschar {#}
IndentIndent54970-9 Number of Venous and Arterial Ulcers {#}
IndentIndent86747-3 Other Ulcers, Wounds and Skin Problems 1..8
IndentIndent86748-1 Skin and Ulcer Treatments 1..9
Indent86831-5 Medications
IndentIndent54982-4 Injections. Record the number of days that injections of any type were received during the last 7 days or since admission/entry or reentry if less than 7 days. d/(7.d)
IndentIndent58217-1 Insulin
IndentIndentIndent58127-2 Insulin injections - Record the number of days that insulin injections were received during the last 7 days or since admission/entry or reentry if less than 7 days d/(7.d)
IndentIndentIndent58128-0 Orders for insulin - Record the number of days the physician (or authorized assistant or practitioner) changed the resident's insulin orders during the last 7 days or since admission/entry or reentry if less than 7 days d/(7.d)
Indent86836-4 Special Treatments, Procedures, and Programs
IndentIndent86761-4 While a Resident 0..9
IndentIndent86846-3 Therapies
IndentIndentIndent86763-0 Speech-Language Pathology and Audiology Services
IndentIndentIndentIndent58218-9 Individual minutes - record the total number of minutes this therapy was administered to the resident individually in the last 7 days min
IndentIndentIndentIndent58133-0 Concurrent minutes - record the total number of minutes this therapy was administered to the resident concurrently with one other resident in the last 7 days min
IndentIndentIndentIndent58134-8 Group minutes - record the total number of minutes this therapy was administered to the resident as part of a group of residents in the last 7 days min
IndentIndentIndentIndent86765-5 Co-treatment minutes - record the total number of minutes this therapy was administered to the resident in co-treatment sessions in the last 7 days min
IndentIndentIndentIndent45760-6 Days - record the number of days this therapy was administered for at least 15 minutes a day in the last 7 days d/(7.d)
IndentIndentIndentIndent55025-1 Therapy start date - record the date the most recent therapy regimen (since the most recent entry) started {mm/dd/yyyy}
IndentIndentIndentIndent55026-9 Therapy end date - record the date the most recent therapy regimen (since the most recent entry) ended {mm/dd/yyyy}
IndentIndentIndent86767-1 Occupational Therapy
IndentIndentIndentIndent58219-7 Individual minutes - record the total number of minutes this therapy was administered to the resident individually in the last 7 days min
IndentIndentIndentIndent58136-3 Concurrent minutes - record the total number of minutes this therapy was administered to the resident concurrently with one other resident in the last 7 days min
IndentIndentIndentIndent58137-1 Group minutes - record the total number of minutes this therapy was administered to the resident as part of a group of residents in the last 7 days min
IndentIndentIndentIndent86764-8 Co-treatment minutes - record the total number of minutes this therapy was administered to the resident in co-treatment sessions in the last 7 days min
IndentIndentIndentIndent45762-2 Days - record the number of days this therapy was administered for at least 15 minutes a day in the last 7 days d/(7.d)
IndentIndentIndentIndent55027-7 Therapy start date - record the date the most recent therapy regimen (since the most recent entry) started {mm/dd/yyyy}
IndentIndentIndentIndent55028-5 Therapy end date - record the date the most recent therapy regimen (since the most recent entry) ended {mm/dd/yyyy}
IndentIndentIndent86768-9 Physical Therapy
IndentIndentIndentIndent58220-5 Individual minutes - record the total number of minutes this therapy was administered to the resident individually in the last 7 days min
IndentIndentIndentIndent58139-7 Concurrent minutes - record the total number of minutes this therapy was administered to the resident concurrently with one other resident in the last 7 days min
IndentIndentIndentIndent58140-5 Group minutes - record the total number of minutes this therapy was administered to the resident as part of a group of residents in the last 7 days min
IndentIndentIndentIndent86766-3 Co-treatment minutes - record the total number of minutes this therapy was administered to the resident in co-treatment sessions in the last 7 days min
IndentIndentIndentIndent45764-8 Days - record the number of days this therapy was administered for at least 15 minutes a day in the last 7 days d/(7.d)
IndentIndentIndentIndent55029-3 Therapy start date - record the date the most recent therapy regimen (since the most recent entry) started {mm/dd/yyyy}
IndentIndentIndentIndent55030-1 Therapy end date - record the date the most recent therapy regimen (since the most recent entry) ended {mm/dd/yyyy}
IndentIndentIndent86849-7 Respiratory therapy
IndentIndentIndentIndent45766-3 Days - record the number of days this therapy was administered for at least 15 minutes a day in the last 7 days d/(7.d)
IndentIndent86769-7 Distinct Calendar Days of Therapy. Record the number of calendar days that the resident received Speech-Language Pathology and Audiology Services, Occupational Therapy, or Physical Therapy for at least 15 minutes in the past 7 days. d
IndentIndent86770-5 Resumption of Therapy
IndentIndentIndent86772-1 Has a previous rehabilitation therapy regimen (speech, occupational, and/or physical therapy) ended, as reported on this End of Therapy OMRA, and has this regimen now resumed at exactly the same level for each discipline?
IndentIndentIndent86771-3 Date on which therapy regimen resumed {mm/dd/yyyy}
IndentIndent86773-9 Restorative Nursing Programs
IndentIndentIndent86774-7 Technique. Range of motion (passive) d/(7.d)
IndentIndentIndent86775-4 Technique. Range of motion (active) d/(7.d)
IndentIndentIndent86776-2 Technique. Splint or brace assistance d/(7.d)
IndentIndentIndent86777-0 Training and Skill Practice In: Bed mobility d/(7.d)
IndentIndentIndent86778-8 Training and Skill Practice In: Transfer d/(7.d)
IndentIndentIndent86779-6 Training and Skill Practice In: Walking d/(7.d)
IndentIndentIndent86780-4 Training and Skill Practice In: Dressing and/or grooming d/(7.d)
IndentIndentIndent86781-2 Training and Skill Practice In: Eating and/or swallowing d/(7.d)
IndentIndentIndent86782-0 Training and Skill Practice In: Amputation/prostheses care d/(7.d)
IndentIndentIndent86783-8 Training and Skill Practice In: Communication d/(7.d)
Indent86852-1 Participation in Assessment and Goal Setting
IndentIndent55053-3 Participation in Assessment
IndentIndentIndent55054-1 Resident participated in assessment
IndentIndentIndent55074-9 Family or significant other participated in assessment
IndentIndentIndent58221-3 Guardian or legally authorized representative participated in assessment
Indent87224-2 Correction Request
IndentIndent85632-8 Type of Provider
IndentIndent87226-7 Name of Resident
IndentIndentIndent45392-8 Patient First (Given) name
IndentIndentIndent45394-4 Patient Last (Family) name
IndentIndent46098-0 Gender
IndentIndent21112-8 Birth Date {mm/dd/yyyy}
IndentIndent45396-9 Social Security Number
IndentIndent87227-5 Type of Assessment
IndentIndentIndent54583-0 Federal OBRA Reason for Assessment
IndentIndentIndent54584-8 PPS Assessment
IndentIndentIndent54585-5 PPS Other Medicare Required Assessment - OMRA
IndentIndentIndent58107-4 Is this a Swing Bed clinical change 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}
IndentIndent87209-3 Correction Attestation Section
IndentIndentIndent58200-7 Correction Number {#}
IndentIndentIndent87217-6 Reasons for Modification 1..6
IndentIndentIndent87225-9 Reasons for Inactivation 1..2
IndentIndentIndent87218-4 RN Assessment Coordinator Attestation of Completion
IndentIndentIndentIndent87219-2 Attesting individual's first name
IndentIndentIndentIndent87220-0 Attesting individual's last name
IndentIndentIndentIndent87221-8 Attesting individual's title
IndentIndentIndentIndent87222-6 Attestation date {mm/dd/yyyy}
Indent87228-3 Assessment Administration
IndentIndent55064-0 Medicare Part A Billing
IndentIndentIndent55065-7 Medicare Part A HIPPS code
IndentIndentIndent55066-5 RUG version code
IndentIndentIndent58421-9 Is this a Medicare Short Stay assessment?
IndentIndent59375-6 Medicare Part A Non-Therapy Billing
IndentIndentIndent58210-6 Medicare Part A non-therapy HIPPS code
IndentIndentIndent58211-4 RUG version code
IndentIndent55070-7 Insurance Billing
IndentIndentIndent55071-5 RUG billing code
IndentIndentIndent55072-3 RUG billing version

Fully-Specified Name

Component
MDS v3.0 - RAI v1.14.1 - Nursing home & Swing bed OMRA (NO & SO) item set
Property
-
Time
Pt
System
^Patient
Scale
-
Method
CMS Assessment

Basic Attributes

Class
PANEL.SURVEY.CMS
Type
Surveys
First Released
Version 2.63
Last Updated
Version 2.73
Change Reason
Release 2.73: Status: LOINC will keep most current version and one prior version of CMS assessments active and discourage all older versions.;
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=86870-3