HIPPS code	Code Effective From Date	Code Effective Through Date	Payment System Indicator	Description					
1AFKS	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 1, supplies provided"					
1AFKT	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 2, supplies provided"					
1AFKU	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 3, supplies provided"					
1AFKV 	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 4, supplies provided"					
1AFKW	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 5, supplies provided"					
1AFKX	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 6, supplies provided"					
1AFK1	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 1, supplies not provided"					
1AFK2	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 2, supplies not provided"					
1AFK3	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 3, supplies not provided"					
1AFK4	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 4, supplies not provided"					
1AFK5	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 5, supplies not provided"					
1AFK6	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 6, supplies not provided"					
1AFLS	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 1, supplies provided"					
1AFLT	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 2, supplies provided"					
1AFLU	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 3, supplies provided"					
1AFLV 	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 4, supplies provided"					
1AFLW	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 5, supplies provided"					
1AFLX	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 6, supplies provided"					
1AFL1	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 1, supplies not provided"					
1AFL2	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 2, supplies not provided"					
1AFL3	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 3, supplies not provided"					
1AFL4	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 4, supplies not provided"					
1AFL5	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 5, supplies not provided"					
1AFL6	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 6, supplies not provided"					
1AFMS	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 1, supplies provided"					
1AFMT	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 2, supplies provided"					
1AFMU	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 3, supplies provided"					
1AFMV 	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 4, supplies provided"					
1AFMW	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 5, supplies provided"					
1AFMX	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 6, supplies provided"					
1AFM1	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 1, supplies not provided"					
1AFM2	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 2, supplies not provided"					
1AFM3	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 3, supplies not provided"					
1AFM4	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 4, supplies not provided"					
1AFM5	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 5, supplies not provided"					
1AFM6	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 6, supplies not provided"					
1AFNS	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 1, supplies provided"					
1AFNT	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 2, supplies provided"					
1AFNU	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 3, supplies provided"					
1AFNV 	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 4, supplies provided"					
1AFNW	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 5, supplies provided"					
1AFNX	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 6, supplies provided"					
1AFN1	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 1, supplies not provided"					
1AFN2	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 2, supplies not provided"					
1AFN3	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 3, supplies not provided"					
1AFN4	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 4, supplies not provided"					
1AFN5	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 5, supplies not provided"					
1AFN6	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 6, supplies not provided"					
1AFPS	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 1, supplies provided"					
1AFPT	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 2, supplies provided"					
1AFPU	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 3, supplies provided"					
1AFPV 	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 4, supplies provided"					
1AFPW	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 5, supplies provided"					
1AFPX	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 6, supplies provided"					
1AFP1	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 1, supplies not provided"					
1AFP2	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 2, supplies not provided"					
1AFP3	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 3, supplies not provided"					
1AFP4	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 4, supplies not provided"					
1AFP5	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 5, supplies not provided"					
1AFP6	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 6, supplies not provided"					
1AGKS	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 1, supplies provided"					
1AGKT	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 2, supplies provided"					
1AGKU	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 3, supplies provided"					
1AGKV 	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 4, supplies provided"					
1AGKW	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 5, supplies provided"					
1AGKX	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 6, supplies provided"					
1AGK1	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 1, supplies not provided"					
1AGK2	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 2, supplies not provided"					
1AGK3	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 3, supplies not provided"					
1AGK4	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 4, supplies not provided"					
1AGK5	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 5, supplies not provided"					
1AGK6	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 6, supplies not provided"					
1AGLS	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 1, supplies provided"					
1AGLT	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 2, supplies provided"					
1AGLU	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 3, supplies provided"					
1AGLV 	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 4, supplies provided"					
1AGLW	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 5, supplies provided"					
1AGLX	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 6, supplies provided"					
1AGL1	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 1, supplies not provided"					
1AGL2	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 2, supplies not provided"					
1AGL3	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 3, supplies not provided"					
1AGL4	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 4, supplies not provided"					
1AGL5	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 5, supplies not provided"					
1AGL6	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 6, supplies not provided"					
1AGMS	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 1, supplies provided"					
1AGMT	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 2, supplies provided"					
1AGMU	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 3, supplies provided"					
1AGMV 	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 4, supplies provided"					
1AGMW	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 5, supplies provided"					
1AGMX	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 6, supplies provided"					
1AGM1	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 1, supplies not provided"					
1AGM2	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 2, supplies not provided"					
1AGM3	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 3, supplies not provided"					
1AGM4	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 4, supplies not provided"					
1AGM5	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 5, supplies not provided"					
1AGM6	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 6, supplies not provided"					
1AGNS	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 1, supplies provided"					
1AGNT	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 2, supplies provided"					
1AGNU	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 3, supplies provided"					
1AGNV 	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 4, supplies provided"					
1AGNW	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 5, supplies provided"					
1AGNX	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 6, supplies provided"					
1AGN1	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 1, supplies not provided"					
1AGN2	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 2, supplies not provided"					
1AGN3	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 3, supplies not provided"					
1AGN4	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 4, supplies not provided"					
1AGN5	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 5, supplies not provided"					
1AGN6	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 6, supplies not provided"					
1AGPS	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 1, supplies provided"					
1AGPT	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 2, supplies provided"					
1AGPU	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 3, supplies provided"					
1AGPV 	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 4, supplies provided"					
1AGPW	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 5, supplies provided"					
1AGPX	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 6, supplies provided"					
1AGP1	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 1, supplies not provided"					
1AGP2	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 2, supplies not provided"					
1AGP3	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 3, supplies not provided"					
1AGP4	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 4, supplies not provided"					
1AGP5	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 5, supplies not provided"					
1AGP6	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 6, supplies not provided"					
1AHKS	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 1, supplies provided"					
1AHKT	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 2, supplies provided"					
1AHKU	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 3, supplies provided"					
1AHKV 	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 4, supplies provided"					
1AHKW	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 5, supplies provided"					
1AHKX	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 6, supplies provided"					
1AHK1	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 1, supplies not provided"					
1AHK2	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 2, supplies not provided"					
1AHK3	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 3, supplies not provided"					
1AHK4	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 4, supplies not provided"					
1AHK5	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 5, supplies not provided"					
1AHK6	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 6, supplies not provided"					
1AHLS	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 1, supplies provided"					
1AHLT	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 2, supplies provided"					
1AHLU	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 3, supplies provided"					
1AHLV 	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 4, supplies provided"					
1AHLW	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 5, supplies provided"					
1AHLX	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 6, supplies provided"					
1AHL1	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 1, supplies not provided"					
1AHL2	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 2, supplies not provided"					
1AHL3	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 3, supplies not provided"					
1AHL4	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 4, supplies not provided"					
1AHL5	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 5, supplies not provided"					
1AHL6	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 6, supplies not provided"					
1AHMS	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 1, supplies provided"					
1AHMT	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 2, supplies provided"					
1AHMU	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 3, supplies provided"					
1AHMV 	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 4, supplies provided"					
1AHMW	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 5, supplies provided"					
1AHMX	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 6, supplies provided"					
1AHM1	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 1, supplies not provided"					
1AHM2	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 2, supplies not provided"					
1AHM3	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 3, supplies not provided"					
1AHM4	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 4, supplies not provided"					
1AHM5	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 5, supplies not provided"					
1AHM6	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 6, supplies not provided"					
1AHNS	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 1, supplies provided"					
1AHNT	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 2, supplies provided"					
1AHNU	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 3, supplies provided"					
1AHNV 	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 4, supplies provided"					
1AHNW	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 5, supplies provided"					
1AHNX	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 6, supplies provided"					
1AHN1	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 1, supplies not provided"					
1AHN2	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 2, supplies not provided"					
1AHN3	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 3, supplies not provided"					
1AHN4	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 4, supplies not provided"					
1AHN5	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 5, supplies not provided"					
1AHN6	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 6, supplies not provided"					
1AHPS	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 1, supplies provided"					
1AHPT	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 2, supplies provided"					
1AHPU	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 3, supplies provided"					
1AHPV 	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 4, supplies provided"					
1AHPW	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 5, supplies provided"					
1AHPX	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 6, supplies provided"					
1AHP1	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 1, supplies not provided"					
1AHP2	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 2, supplies not provided"					
1AHP3	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 3, supplies not provided"					
1AHP4	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 4, supplies not provided"					
1AHP5	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 5, supplies not provided"					
1AHP6	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 6, supplies not provided"					
1BFKS	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 1, supplies provided"					
1BFKT	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 2, supplies provided"					
1BFKU	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 3, supplies provided"					
1BFKV 	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 4, supplies provided"					
1BFKW	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 5, supplies provided"					
1BFKX	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 6, supplies provided"					
1BFK1	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 1, supplies not provided"					
1BFK2	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 2, supplies not provided"					
1BFK3	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 3, supplies not provided"					
1BFK4	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 4, supplies not provided"					
1BFK5	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 5, supplies not provided"					
1BFK6	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 6, supplies not provided"					
1BFLS	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 1, supplies provided"					
1BFLT	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 2, supplies provided"					
1BFLU	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 3, supplies provided"					
1BFLV 	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 4, supplies provided"					
1BFLW	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 5, supplies provided"					
1BFLX	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 6, supplies provided"					
1BFL1	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 1, supplies not provided"					
1BFL2	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 2, supplies not provided"					
1BFL3	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 3, supplies not provided"					
1BFL4	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 4, supplies not provided"					
1BFL5	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 5, supplies not provided"					
1BFL6	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 6, supplies not provided"					
1BFMS	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 1, supplies provided"					
1BFMT	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 2, supplies provided"					
1BFMU	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 3, supplies provided"					
1BFMV 	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 4, supplies provided"					
1BFMW	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 5, supplies provided"					
1BFMX	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 6, supplies provided"					
1BFM1	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 1, supplies not provided"					
1BFM2	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 2, supplies not provided"					
1BFM3	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 3, supplies not provided"					
1BFM4	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 4, supplies not provided"					
1BFM5	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 5, supplies not provided"					
1BFM6	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 6, supplies not provided"					
1BFNS	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 1, supplies provided"					
1BFNT	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 2, supplies provided"					
1BFNU	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 3, supplies provided"					
1BFNV 	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 4, supplies provided"					
1BFNW	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 5, supplies provided"					
1BFNX	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 6, supplies provided"					
1BFN1	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 1, supplies not provided"					
1BFN2	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 2, supplies not provided"					
1BFN3	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 3, supplies not provided"					
1BFN4	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 4, supplies not provided"					
1BFN5	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 5, supplies not provided"					
1BFN6	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 6, supplies not provided"					
1BFPS	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 1, supplies provided"					
1BFPT	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 2, supplies provided"					
1BFPU	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 3, supplies provided"					
1BFPV 	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 4, supplies provided"					
1BFPW	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 5, supplies provided"					
1BFPX	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 6, supplies provided"					
1BFP1	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 1, supplies not provided"					
1BFP2	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 2, supplies not provided"					
1BFP3	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 3, supplies not provided"					
1BFP4	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 4, supplies not provided"					
1BFP5	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 5, supplies not provided"					
1BFP6	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 6, supplies not provided"					
1BGKS	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 1, supplies provided"					
1BGKT	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 2, supplies provided"					
1BGKU	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 3, supplies provided"					
1BGKV 	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 4, supplies provided"					
1BGKW	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 5, supplies provided"					
1BGKX	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 6, supplies provided"					
1BGK1	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 1, supplies not provided"					
1BGK2	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 2, supplies not provided"					
1BGK3	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 3, supplies not provided"					
1BGK4	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 4, supplies not provided"					
1BGK5	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 5, supplies not provided"					
1BGK6	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 6, supplies not provided"					
1BGLS	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 1, supplies provided"					
1BGLT	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 2, supplies provided"					
1BGLU	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 3, supplies provided"					
1BGLV 	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 4, supplies provided"					
1BGLW	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 5, supplies provided"					
1BGLX	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 6, supplies provided"					
1BGL1	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 1, supplies not provided"					
1BGL2	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 2, supplies not provided"					
1BGL3	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 3, supplies not provided"					
1BGL4	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 4, supplies not provided"					
1BGL5	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 5, supplies not provided"					
1BGL6	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 6, supplies not provided"					
1BGMS	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 1, supplies provided"					
1BGMT	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 2, supplies provided"					
1BGMU	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 3, supplies provided"					
1BGMV 	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 4, supplies provided"					
1BGMW	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 5, supplies provided"					
1BGMX	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 6, supplies provided"					
1BGM1	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 1, supplies not provided"					
1BGM2	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 2, supplies not provided"					
1BGM3	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 3, supplies not provided"					
1BGM4	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 4, supplies not provided"					
1BGM5	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 5, supplies not provided"					
1BGM6	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 6, supplies not provided"					
1BGNS	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 1, supplies provided"					
1BGNT	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 2, supplies provided"					
1BGNU	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 3, supplies provided"					
1BGNV 	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 4, supplies provided"					
1BGNW	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 5, supplies provided"					
1BGNX	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 6, supplies provided"					
1BGN1	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 1, supplies not provided"					
1BGN2	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 2, supplies not provided"					
1BGN3	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 3, supplies not provided"					
1BGN4	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 4, supplies not provided"					
1BGN5	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 5, supplies not provided"					
1BGN6	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 6, supplies not provided"					
1BGPS	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 1, supplies provided"					
1BGPT	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 2, supplies provided"					
1BGPU	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 3, supplies provided"					
1BGPV 	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 4, supplies provided"					
1BGPW	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 5, supplies provided"					
1BGPX	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 6, supplies provided"					
1BGP1	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 1, supplies not provided"					
1BGP2	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 2, supplies not provided"					
1BGP3	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 3, supplies not provided"					
1BGP4	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 4, supplies not provided"					
1BGP5	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 5, supplies not provided"					
1BGP6	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 6, supplies not provided"					
1BHKS	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 1, supplies provided"					
1BHKT	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 2, supplies provided"					
1BHKU	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 3, supplies provided"					
1BHKV 	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 4, supplies provided"					
1BHKW	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 5, supplies provided"					
1BHKX	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 6, supplies provided"					
1BHK1	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 1, supplies not provided"					
1BHK2	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 2, supplies not provided"					
1BHK3	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 3, supplies not provided"					
1BHK4	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 4, supplies not provided"					
1BHK5	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 5, supplies not provided"					
1BHK6	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 6, supplies not provided"					
1BHLS	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 1, supplies provided"					
1BHLT	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 2, supplies provided"					
1BHLU	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 3, supplies provided"					
1BHLV 	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 4, supplies provided"					
1BHLW	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 5, supplies provided"					
1BHLX	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 6, supplies provided"					
1BHL1	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 1, supplies not provided"					
1BHL2	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 2, supplies not provided"					
1BHL3	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 3, supplies not provided"					
1BHL4	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 4, supplies not provided"					
1BHL5	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 5, supplies not provided"					
1BHL6	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 6, supplies not provided"					
1BHMS	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 1, supplies provided"					
1BHMT	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 2, supplies provided"					
1BHMU	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 3, supplies provided"					
1BHMV 	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 4, supplies provided"					
1BHMW	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 5, supplies provided"					
1BHMX	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 6, supplies provided"					
1BHM1	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 1, supplies not provided"					
1BHM2	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 2, supplies not provided"					
1BHM3	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 3, supplies not provided"					
1BHM4	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 4, supplies not provided"					
1BHM5	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 5, supplies not provided"					
1BHM6	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 6, supplies not provided"					
1BHNS	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 1, supplies provided"					
1BHNT	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 2, supplies provided"					
1BHNU	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 3, supplies provided"					
1BHNV 	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 4, supplies provided"					
1BHNW	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 5, supplies provided"					
1BHNX	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 6, supplies provided"					
1BHN1	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 1, supplies not provided"					
1BHN2	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 2, supplies not provided"					
1BHN3	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 3, supplies not provided"					
1BHN4	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 4, supplies not provided"					
1BHN5	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 5, supplies not provided"					
1BHN6	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 6, supplies not provided"					
1BHPS	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 1, supplies provided"					
1BHPT	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 2, supplies provided"					
1BHPU	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 3, supplies provided"					
1BHPV 	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 4, supplies provided"					
1BHPW	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 5, supplies provided"					
1BHPX	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 6, supplies provided"					
1BHP1	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 1, supplies not provided"					
1BHP2	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 2, supplies not provided"					
1BHP3	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 3, supplies not provided"					
1BHP4	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 4, supplies not provided"					
1BHP5	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 5, supplies not provided"					
1BHP6	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 6, supplies not provided"					
1CFKS	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 1, supplies provided"					
1CFKT	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 2, supplies provided"					
1CFKU	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 3, supplies provided"					
1CFKV 	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 4, supplies provided"					
1CFKW	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 5, supplies provided"					
1CFKX	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 6, supplies provided"					
1CFK1	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 1, supplies not provided"					
1CFK2	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 2, supplies not provided"					
1CFK3	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 3, supplies not provided"					
1CFK4	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 4, supplies not provided"					
1CFK5	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 5, supplies not provided"					
1CFK6	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 6, supplies not provided"					
1CFLS	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 1, supplies provided"					
1CFLT	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 2, supplies provided"					
1CFLU	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 3, supplies provided"					
1CFLV 	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 4, supplies provided"					
1CFLW	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 5, supplies provided"					
1CFLX	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 6, supplies provided"					
1CFL1	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 1, supplies not provided"					
1CFL2	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 2, supplies not provided"					
1CFL3	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 3, supplies not provided"					
1CFL4	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 4, supplies not provided"					
1CFL5	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 5, supplies not provided"					
1CFL6	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 6, supplies not provided"					
1CFMS	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 1, supplies provided"					
1CFMT	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 2, supplies provided"					
1CFMU	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 3, supplies provided"					
1CFMV 	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 4, supplies provided"					
1CFMW	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 5, supplies provided"					
1CFMX	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 6, supplies provided"					
1CFM1	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 1, supplies not provided"					
1CFM2	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 2, supplies not provided"					
1CFM3	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 3, supplies not provided"					
1CFM4	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 4, supplies not provided"					
1CFM5	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 5, supplies not provided"					
1CFM6	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 6, supplies not provided"					
1CFNS	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 1, supplies provided"					
1CFNT	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 2, supplies provided"					
1CFNU	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 3, supplies provided"					
1CFNV 	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 4, supplies provided"					
1CFNW	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 5, supplies provided"					
1CFNX	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 6, supplies provided"					
1CFN1	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 1, supplies not provided"					
1CFN2	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 2, supplies not provided"					
1CFN3	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 3, supplies not provided"					
1CFN4	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 4, supplies not provided"					
1CFN5	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 5, supplies not provided"					
1CFN6	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 6, supplies not provided"					
1CFPS	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 1, supplies provided"					
1CFPT	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 2, supplies provided"					
1CFPU	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 3, supplies provided"					
1CFPV 	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 4, supplies provided"					
1CFPW	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 5, supplies provided"					
1CFPX	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 6, supplies provided"					
1CFP1	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 1, supplies not provided"					
1CFP2	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 2, supplies not provided"					
1CFP3	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 3, supplies not provided"					
1CFP4	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 4, supplies not provided"					
1CFP5	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 5, supplies not provided"					
1CFP6	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 6, supplies not provided"					
1CGKS	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 1, supplies provided"					
1CGKT	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 2, supplies provided"					
1CGKU	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 3, supplies provided"					
1CGKV 	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 4, supplies provided"					
1CGKW	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 5, supplies provided"					
1CGKX	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 6, supplies provided"					
1CGK1	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 1, supplies not provided"					
1CGK2	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 2, supplies not provided"					
1CGK3	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 3, supplies not provided"					
1CGK4	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 4, supplies not provided"					
1CGK5	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 5, supplies not provided"					
1CGK6	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 6, supplies not provided"					
1CGLS	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 1, supplies provided"					
1CGLT	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 2, supplies provided"					
1CGLU	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 3, supplies provided"					
1CGLV 	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 4, supplies provided"					
1CGLW	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 5, supplies provided"					
1CGLX	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 6, supplies provided"					
1CGL1	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 1, supplies not provided"					
1CGL2	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 2, supplies not provided"					
1CGL3	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 3, supplies not provided"					
1CGL4	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 4, supplies not provided"					
1CGL5	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 5, supplies not provided"					
1CGL6	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 6, supplies not provided"					
1CGMS	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3, Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 1, supplies provided"					
1CGMT	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3, Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 2, supplies provided"					
1CGMU	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3, Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 3, supplies provided"					
1CGMV 	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3, Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 4, supplies provided"					
1CGMW	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3, Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 5, supplies provided"					
1CGMX	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3, Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 6, supplies provided"					
1CGM1	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3, Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 1, supplies not provided"					
1CGM2	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3, Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 2, supplies not provided"					
1CGM3	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3, Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 3, supplies not provided"					
1CGM4	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3, Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 4, supplies not provided"					
1CGM5	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3, Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 5, supplies not provided"					
1CGM6	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3, Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 6, supplies not provided"					
1CGNS	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 1, supplies provided"					
1CGNT	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 2, supplies provided"					
1CGNU	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 3, supplies provided"					
1CGNV 	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 4, supplies provided"					
1CGNW	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 5, supplies provided"					
1CGNX	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 6, supplies provided"					
1CGN1	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 1, supplies not provided"					
1CGN2	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 2, supplies not provided"					
1CGN3	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 3, supplies not provided"					
1CGN4	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 4, supplies not provided"					
1CGN5	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 5, supplies not provided"					
1CGN6	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 6, supplies not provided"					
1CGPS	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 1, supplies provided"					
1CGPT	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 2, supplies provided"					
1CGPU	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 3, supplies provided"					
1CGPV 	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 4, supplies provided"					
1CGPW	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 5, supplies provided"					
1CGPX	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 6, supplies provided"					
1CGP1	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 1, supplies not provided"					
1CGP2	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 2, supplies not provided"					
1CGP3	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 3, supplies not provided"					
1CGP4	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 4, supplies not provided"					
1CGP5	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 5, supplies not provided"					
1CGP6	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 6, supplies not provided"					
1CHKS	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 1, supplies provided"					
1CHKT	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 2, supplies provided"					
1CHKU	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 3, supplies provided"					
1CHKV 	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 4, supplies provided"					
1CHKW	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 5, supplies provided"					
1CHKX	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 6, supplies provided"					
1CHK1	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 1, supplies not provided"					
1CHK2	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 2, supplies not provided"					
1CHK3	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 3, supplies not provided"					
1CHK4	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 4, supplies not provided"					
1CHK5	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 5, supplies not provided"					
1CHK6	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 6, supplies not provided"					
1CHLS	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 1, supplies provided"					
1CHLT	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 2, supplies provided"					
1CHLU	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 3, supplies provided"					
1CHLV 	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 4, supplies provided"					
1CHLW	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 5, supplies provided"					
1CHLX	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 6, supplies provided"					
1CHL1	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 1, supplies not provided"					
1CHL2	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 2, supplies not provided"					
1CHL3	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 3, supplies not provided"					
1CHL4	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 4, supplies not provided"					
1CHL5	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 5, supplies not provided"					
1CHL6	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 6, supplies not provided"					
1CHMS	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 1, supplies provided"					
1CHMT	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 2, supplies provided"					
1CHMU	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 3, supplies provided"					
1CHMV 	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 4, supplies provided"					
1CHMW	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 5, supplies provided"					
1CHMX	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 6, supplies provided"					
1CHM1	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 1, supplies not provided"					
1CHM2	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 2, supplies not provided"					
1CHM3	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 3, supplies not provided"					
1CHM4	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 4, supplies not provided"					
1CHM5	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 5, supplies not provided"					
1CHM6	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 6, supplies not provided"					
1CHNS	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 1, supplies provided"					
1CHNT	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 2, supplies provided"					
1CHNU	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 3, supplies provided"					
1CHNV 	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 4, supplies provided"					
1CHNW	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 5, supplies provided"					
1CHNX	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 6, supplies provided"					
1CHN1	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 1, supplies not provided"					
1CHN2	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 2, supplies not provided"					
1CHN3	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 3, supplies not provided"					
1CHN4	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 4, supplies not provided"					
1CHN5	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 5, supplies not provided"					
1CHN6	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 6, supplies not provided"					
1CHPS	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 1, supplies provided"					
1CHPT	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 2, supplies provided"					
1CHPU	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 3, supplies provided"					
1CHPV 	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 4, supplies provided"					
1CHPW	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 5, supplies provided"					
1CHPX	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 6, supplies provided"					
1CHP1	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 1, supplies not provided"					
1CHP2	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 2, supplies not provided"					
1CHP3	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 3, supplies not provided"					
1CHP4	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 4, supplies not provided"					
1CHP5	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 5, supplies not provided"					
1CHP6	01/01/08		HHA	"Early Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 6, supplies not provided"					
2AFKS	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 1, supplies provided"					
2AFKT	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 2, supplies provided"					
2AFKU	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 3, supplies provided"					
2AFKV 	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 4, supplies provided"					
2AFKW	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 5, supplies provided"					
2AFKX	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 6, supplies provided"					
2AFK1	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 1, supplies not provided"					
2AFK2	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 2, supplies not provided"					
2AFK3	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 3, supplies not provided"					
2AFK4	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 4, supplies not provided"					
2AFK5	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 5, supplies not provided"					
2AFK6	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 6, supplies not provided"					
2AFLS	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 1, supplies provided"					
2AFLT	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 2, supplies provided"					
2AFLU	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 3, supplies provided"					
2AFLV 	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 4, supplies provided"					
2AFLW	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 5, supplies provided"					
2AFLX	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 6, supplies provided"					
2AFL1	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 1, supplies not provided"					
2AFL2	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 2, supplies not provided"					
2AFL3	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 3, supplies not provided"					
2AFL4	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 4, supplies not provided"					
2AFL5	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 5, supplies not provided"					
2AFL6	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 6, supplies not provided"					
2AFMS	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 1, supplies provided"					
2AFMT	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 2, supplies provided"					
2AFMU	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 3, supplies provided"					
2AFMV 	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 4, supplies provided"					
2AFMW	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 5, supplies provided"					
2AFMX	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 6, supplies provided"					
2AFM1	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 1, supplies not provided"					
2AFM2	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 2, supplies not provided"					
2AFM3	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 3, supplies not provided"					
2AFM4	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 4, supplies not provided"					
2AFM5	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 5, supplies not provided"					
2AFM6	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 6, supplies not provided"					
2AGKS	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 1, supplies provided"					
2AGKT	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 2, supplies provided"					
2AGKU	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 3, supplies provided"					
2AGKV 	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 4, supplies provided"					
2AGKW	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 5, supplies provided"					
2AGKX	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 6, supplies provided"					
2AGK1	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 1, supplies not provided"					
2AGK2	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 2, supplies not provided"					
2AGK3	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 3, supplies not provided"					
2AGK4	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 4, supplies not provided"					
2AGK5	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 5, supplies not provided"					
2AGK6	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 6, supplies not provided"					
2AGLS	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 1, supplies provided"					
2AGLT	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 2, supplies provided"					
2AGLU	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 3, supplies provided"					
2AGLV 	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 4, supplies provided"					
2AGLW	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 5, supplies provided"					
2AGLX	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 6, supplies provided"					
2AGL1	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 1, supplies not provided"					
2AGL2	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 2, supplies not provided"					
2AGL3	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 3, supplies not provided"					
2AGL4	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 4, supplies not provided"					
2AGL5	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 5, supplies not provided"					
2AGL6	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 6, supplies not provided"					
2AGMS	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 1, supplies provided"					
2AGMT	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 2, supplies provided"					
2AGMU	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 3, supplies provided"					
2AGMV 	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 4, supplies provided"					
2AGMW	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 5, supplies provided"					
2AGMX	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 6, supplies provided"					
2AGM1	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 1, supplies not provided"					
2AGM2	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 2, supplies not provided"					
2AGM3	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 3, supplies not provided"					
2AGM4	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 4, supplies not provided"					
2AGM5	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 5, supplies not provided"					
2AGM6	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 6, supplies not provided"					
2AHKS	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 1, supplies provided"					
2AHKT	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 2, supplies provided"					
2AHKU	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 3, supplies provided"					
2AHKV 	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 4, supplies provided"					
2AHKW	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 5, supplies provided"					
2AHKX	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 6, supplies provided"					
2AHK1	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 1, supplies not provided"					
2AHK2	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 2, supplies not provided"					
2AHK3	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 3, supplies not provided"					
2AHK4	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 4, supplies not provided"					
2AHK5	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 5, supplies not provided"					
2AHK6	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 6, supplies not provided"					
2AHLS	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 1, supplies provided"					
2AHLT	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 2, supplies provided"					
2AHLU	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 3, supplies provided"					
2AHLV 	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 4, supplies provided"					
2AHLW	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 5, supplies provided"					
2AHLX	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 6, supplies provided"					
2AHL1	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 1, supplies not provided"					
2AHL2	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 2, supplies not provided"					
2AHL3	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 3, supplies not provided"					
2AHL4	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 4, supplies not provided"					
2AHL5	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 5, supplies not provided"					
2AHL6	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 6, supplies not provided"					
2AHMS	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 1, supplies provided"					
2AHMT	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 2, supplies provided"					
2AHMU	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 3, supplies provided"					
2AHMV 	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 4, supplies provided"					
2AHMW	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 5, supplies provided"					
2AHMX	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 6, supplies provided"					
2AHM1	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 1, supplies not provided"					
2AHM2	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 2, supplies not provided"					
2AHM3	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 3, supplies not provided"					
2AHM4	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 4, supplies not provided"					
2AHM5	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 5, supplies not provided"					
2AHM6	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 1,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 6, supplies not provided"					
2BFKS	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 1, supplies provided"					
2BFKT	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 2, supplies provided"					
2BFKU	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 3, supplies provided"					
2BFKV 	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 4, supplies provided"					
2BFKW	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 5, supplies provided"					
2BFKX	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 6, supplies provided"					
2BFK1	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 1, supplies not provided"					
2BFK2	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 2, supplies not provided"					
2BFK3	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 3, supplies not provided"					
2BFK4	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 4, supplies not provided"					
2BFK5	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 5, supplies not provided"					
2BFK6	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 6, supplies not provided"					
2BFLS	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 1, supplies provided"					
2BFLT	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 2, supplies provided"					
2BFLU	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 3, supplies provided"					
2BFLV 	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 4, supplies provided"					
2BFLW	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 5, supplies provided"					
2BFLX	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 6, supplies provided"					
2BFL1	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 1, supplies not provided"					
2BFL2	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 2, supplies not provided"					
2BFL3	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 3, supplies not provided"					
2BFL4	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 4, supplies not provided"					
2BFL5	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 5, supplies not provided"					
2BFL6	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 6, supplies not provided"					
2BFMS	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 1, supplies provided"					
2BFMT	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 2, supplies provided"					
2BFMU	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 3, supplies provided"					
2BFMV 	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 4, supplies provided"					
2BFMW	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 5, supplies provided"					
2BFMX	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 6, supplies provided"					
2BFM1	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 1, supplies not provided"					
2BFM2	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 2, supplies not provided"					
2BFM3	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 3, supplies not provided"					
2BFM4	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 4, supplies not provided"					
2BFM5	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 5, supplies not provided"					
2BFM6	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 6, supplies not provided"					
2BGKS	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 1, supplies provided"					
2BGKT	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 2, supplies provided"					
2BGKU	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 3, supplies provided"					
2BGKV 	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 4, supplies provided"					
2BGKW	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 5, supplies provided"					
2BGKX	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 6, supplies provided"					
2BGK1	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 1, supplies not provided"					
2BGK2	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 2, supplies not provided"					
2BGK3	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 3, supplies not provided"					
2BGK4	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 4, supplies not provided"					
2BGK5	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 5, supplies not provided"					
2BGK6	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 6, supplies not provided"					
2BGLS	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 1, supplies provided"					
2BGLT	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 2, supplies provided"					
2BGLU	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 3, supplies provided"					
2BGLV 	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 4, supplies provided"					
2BGLW	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 5, supplies provided"					
2BGLX	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 6, supplies provided"					
2BGL1	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 1, supplies not provided"					
2BGL2	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 2, supplies not provided"					
2BGL3	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 3, supplies not provided"					
2BGL4	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 4, supplies not provided"					
2BGL5	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 5, supplies not provided"					
2BGL6	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 6, supplies not provided"					
2BGMS	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 1, supplies provided"					
2BGMT	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 2, supplies provided"					
2BGMU	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 3, supplies provided"					
2BGMV 	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 4, supplies provided"					
2BGMW	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 5, supplies provided"					
2BGMX	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 6, supplies provided"					
2BGM1	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 1, supplies not provided"					
2BGM2	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 2, supplies not provided"					
2BGM3	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 3, supplies not provided"					
2BGM4	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 4, supplies not provided"					
2BGM5	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 5, supplies not provided"					
2BGM6	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 6, supplies not provided"					
2BHKS	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 1, supplies provided"					
2BHKT	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 2, supplies provided"					
2BHKU	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 3, supplies provided"					
2BHKV 	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 4, supplies provided"					
2BHKW	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 5, supplies provided"					
2BHKX	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 6, supplies provided"					
2BHK1	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 1, supplies not provided"					
2BHK2	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 2, supplies not provided"					
2BHK3	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 3, supplies not provided"					
2BHK4	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 4, supplies not provided"					
2BHK5	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 5, supplies not provided"					
2BHK6	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 6, supplies not provided"					
2BHLS	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 1, supplies provided"					
2BHLT	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 2, supplies provided"					
2BHLU	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 3, supplies provided"					
2BHLV 	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 4, supplies provided"					
2BHLW	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 5, supplies provided"					
2BHLX	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 6, supplies provided"					
2BHL1	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 1, supplies not provided"					
2BHL2	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 2, supplies not provided"					
2BHL3	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 3, supplies not provided"					
2BHL4	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 4, supplies not provided"					
2BHL5	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 5, supplies not provided"					
2BHL6	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 6, supplies not provided"					
2BHMS	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 1, supplies provided"					
2BHMT	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 2, supplies provided"					
2BHMU	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 3, supplies provided"					
2BHMV 	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 4, supplies provided"					
2BHMW	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 5, supplies provided"					
2BHMX	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 6, supplies provided"					
2BHM1	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 1, supplies not provided"					
2BHM2	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 2, supplies not provided"					
2BHM3	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 3, supplies not provided"					
2BHM4	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 4, supplies not provided"					
2BHM5	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 5, supplies not provided"					
2BHM6	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 6, supplies not provided"					
2CFKS	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 1, supplies provided"					
2CFKT	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 2, supplies provided"					
2CFKU	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 3, supplies provided"					
2CFKV 	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 4, supplies provided"					
2CFKW	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 5, supplies provided"					
2CFKX	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 6, supplies provided"					
2CFK1	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 1, supplies not provided"					
2CFK2	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 2, supplies not provided"					
2CFK3	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 3, supplies not provided"					
2CFK4	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 4, supplies not provided"					
2CFK5	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 5, supplies not provided"					
2CFK6	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 6, supplies not provided"					
2CFLS	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 1, supplies provided"					
2CFLT	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 2, supplies provided"					
2CFLU	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 3, supplies provided"					
2CFLV 	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 4, supplies provided"					
2CFLW	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 5, supplies provided"					
2CFLX	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 6, supplies provided"					
2CFL1	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 1, supplies not provided"					
2CFL2	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 2, supplies not provided"					
2CFL3	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 3, supplies not provided"					
2CFL4	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 4, supplies not provided"					
2CFL5	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 5, supplies not provided"					
2CFL6	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 6, supplies not provided"					
2CFMS	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 1, supplies provided"					
2CFMT	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 2, supplies provided"					
2CFMU	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 3, supplies provided"					
2CFMV 	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 4, supplies provided"					
2CFMW	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 5, supplies provided"					
2CFMX	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 6, supplies provided"					
2CFM1	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 1, supplies not provided"					
2CFM2	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 2, supplies not provided"					
2CFM3	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 3, supplies not provided"					
2CFM4	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 4, supplies not provided"					
2CFM5	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 5, supplies not provided"					
2CFM6	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 6, supplies not provided"					
2CGKS	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 1, supplies provided"					
2CGKT	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 2, supplies provided"					
2CGKU	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 3, supplies provided"					
2CGKV 	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 4, supplies provided"					
2CGKW	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 5, supplies provided"					
2CGKX	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 6, supplies provided"					
2CGK1	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 1, supplies not provided"					
2CGK2	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 2, supplies not provided"					
2CGK3	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 3, supplies not provided"					
2CGK4	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 4, supplies not provided"					
2CGK5	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 5, supplies not provided"					
2CGK6	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 6, supplies not provided"					
2CGLS	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 1, supplies provided"					
2CGLT	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 2, supplies provided"					
2CGLU	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 3, supplies provided"					
2CGLV 	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 4, supplies provided"					
2CGLW	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 5, supplies provided"					
2CGLX	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 6, supplies provided"					
2CGL1	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 1, supplies not provided"					
2CGL2	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 2, supplies not provided"					
2CGL3	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 3, supplies not provided"					
2CGL4	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 4, supplies not provided"					
2CGL5	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 5, supplies not provided"					
2CGL6	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 6, supplies not provided"					
2CGMS	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 1, supplies provided"					
2CGMT	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 2, supplies provided"					
2CGMU	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 3, supplies provided"					
2CGMV 	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 4, supplies provided"					
2CGMW	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 5, supplies provided"					
2CGMX	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 6, supplies provided"					
2CGM1	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 1, supplies not provided"					
2CGM2	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 2, supplies not provided"					
2CGM3	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 3, supplies not provided"					
2CGM4	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 4, supplies not provided"					
2CGM5	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 5, supplies not provided"					
2CGM6	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 6, supplies not provided"					
2CHKS	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 1, supplies provided"					
2CHKT	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 2, supplies provided"					
2CHKU	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 3, supplies provided"					
2CHKV 	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 4, supplies provided"					
2CHKW	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 5, supplies provided"					
2CHKX	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 6, supplies provided"					
2CHK1	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 1, supplies not provided"					
2CHK2	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 2, supplies not provided"					
2CHK3	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 3, supplies not provided"					
2CHK4	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 4, supplies not provided"					
2CHK5	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 5, supplies not provided"					
2CHK6	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 6, supplies not provided"					
2CHLS	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 1, supplies provided"					
2CHLT	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 2, supplies provided"					
2CHLU	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 3, supplies provided"					
2CHLV 	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 4, supplies provided"					
2CHLW	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 5, supplies provided"					
2CHLX	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 6, supplies provided"					
2CHL1	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 1, supplies not provided"					
2CHL2	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 2, supplies not provided"					
2CHL3	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 3, supplies not provided"					
2CHL4	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 4, supplies not provided"					
2CHL5	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 5, supplies not provided"					
2CHL6	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 6, supplies not provided"					
2CHMS	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3, Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 1, supplies provided"					
2CHMT	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3, Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 2, supplies provided"					
2CHMU	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3, Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 3, supplies provided"					
2CHMV 	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3, Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 4, supplies provided"					
2CHMW	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3, Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 5, supplies provided"					
2CHMX	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3, Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 6, supplies provided"					
2CHM1	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3, Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 1, supplies not provided"					
2CHM2	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3, Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 2, supplies not provided"					
2CHM3	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3, Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 3, supplies not provided"					
2CHM4	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3, Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 4, supplies not provided"					
2CHM5	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3, Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 5, supplies not provided"					
2CHM6	01/01/08		HHA	"Early Episode, 14-19 therapies,Clinical Severity Level 3, Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 6, supplies not provided"					
3AFKS	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 1, supplies provided"					
3AFKT	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 2, supplies provided"					
3AFKU	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 3, supplies provided"					
3AFKV 	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 4, supplies provided"					
3AFKW	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 5, supplies provided"					
3AFKX	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 6, supplies provided"					
3AFK1	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 1, supplies not provided"					
3AFK2	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 2, supplies not provided"					
3AFK3	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 3, supplies not provided"					
3AFK4	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 4, supplies not provided"					
3AFK5	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 5, supplies not provided"					
3AFK6	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 6, supplies not provided"					
3AFLS	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 1, supplies provided"					
3AFLT	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 2, supplies provided"					
3AFLU	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 3, supplies provided"					
3AFLV 	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 4, supplies provided"					
3AFLW	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 5, supplies provided"					
3AFLX	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 6, supplies provided"					
3AFL1	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 1, supplies not provided"					
3AFL2	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 2, supplies not provided"					
3AFL3	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 3, supplies not provided"					
3AFL4	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 4, supplies not provided"					
3AFL5	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 5, supplies not provided"					
3AFL6	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 6, supplies not provided"					
3AFMS	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 1, supplies provided"					
3AFMT	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 2, supplies provided"					
3AFMU	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 3, supplies provided"					
3AFMV 	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 4, supplies provided"					
3AFMW	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 5, supplies provided"					
3AFMX	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 6, supplies provided"					
3AFM1	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 1, supplies not provided"					
3AFM2	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 2, supplies not provided"					
3AFM3	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 3, supplies not provided"					
3AFM4	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 4, supplies not provided"					
3AFM5	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 5, supplies not provided"					
3AFM6	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 6, supplies not provided"					
3AFNS	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 1, supplies provided"					
3AFNT	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 2, supplies provided"					
3AFNU	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 3, supplies provided"					
3AFNV 	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 4, supplies provided"					
3AFNW	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 5, supplies provided"					
3AFNX	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 6, supplies provided"					
3AFN1	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 1, supplies not provided"					
3AFN2	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 2, supplies not provided"					
3AFN3	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 3, supplies not provided"					
3AFN4	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 4, supplies not provided"					
3AFN5	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 5, supplies not provided"					
3AFN6	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 6, supplies not provided"					
3AFPS	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 1, supplies provided"					
3AFPT	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 2, supplies provided"					
3AFPU	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 3, supplies provided"					
3AFPV 	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 4, supplies provided"					
3AFPW	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 5, supplies provided"					
3AFPX	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 6, supplies provided"					
3AFP1	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 1, supplies not provided"					
3AFP2	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 2, supplies not provided"					
3AFP3	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 3, supplies not provided"					
3AFP4	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 4, supplies not provided"					
3AFP5	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 5, supplies not provided"					
3AFP6	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 6, supplies not provided"					
3AGKS	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 1, supplies provided"					
3AGKT	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 2, supplies provided"					
3AGKU	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 3, supplies provided"					
3AGKV 	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 4, supplies provided"					
3AGKW	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 5, supplies provided"					
3AGKX	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 6, supplies provided"					
3AGK1	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 1, supplies not provided"					
3AGK2	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 2, supplies not provided"					
3AGK3	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 3, supplies not provided"					
3AGK4	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 4, supplies not provided"					
3AGK5	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 5, supplies not provided"					
3AGK6	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 6, supplies not provided"					
3AGLS	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 1, supplies provided"					
3AGLT	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 2, supplies provided"					
3AGLU	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 3, supplies provided"					
3AGLV 	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 4, supplies provided"					
3AGLW	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 5, supplies provided"					
3AGLX	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 6, supplies provided"					
3AGL1	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 1, supplies not provided"					
3AGL2	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 2, supplies not provided"					
3AGL3	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 3, supplies not provided"					
3AGL4	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 4, supplies not provided"					
3AGL5	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 5, supplies not provided"					
3AGL6	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 6, supplies not provided"					
3AGMS	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 1, supplies provided"					
3AGMT	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 2, supplies provided"					
3AGMU	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 3, supplies provided"					
3AGMV 	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 4, supplies provided"					
3AGMW	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 5, supplies provided"					
3AGMX	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 6, supplies provided"					
3AGM1	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 1, supplies not provided"					
3AGM2	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 2, supplies not provided"					
3AGM3	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 3, supplies not provided"					
3AGM4	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 4, supplies not provided"					
3AGM5	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 5, supplies not provided"					
3AGM6	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 6, supplies not provided"					
3AGNS	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 1, supplies provided"					
3AGNT	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 2, supplies provided"					
3AGNU	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 3, supplies provided"					
3AGNV 	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 4, supplies provided"					
3AGNW	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 5, supplies provided"					
3AGNX	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 6, supplies provided"					
3AGN1	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 1, supplies not provided"					
3AGN2	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 2, supplies not provided"					
3AGN3	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 3, supplies not provided"					
3AGN4	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 4, supplies not provided"					
3AGN5	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 5, supplies not provided"					
3AGN6	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 6, supplies not provided"					
3AGPS	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 1, supplies provided"					
3AGPT	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 2, supplies provided"					
3AGPU	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 3, supplies provided"					
3AGPV 	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 4, supplies provided"					
3AGPW	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 5, supplies provided"					
3AGPX	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 6, supplies provided"					
3AGP1	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 1, supplies not provided"					
3AGP2	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 2, supplies not provided"					
3AGP3	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 3, supplies not provided"					
3AGP4	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 4, supplies not provided"					
3AGP5	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 5, supplies not provided"					
3AGP6	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 6, supplies not provided"					
3AHKS	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 1, supplies provided"					
3AHKT	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 2, supplies provided"					
3AHKU	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 3, supplies provided"					
3AHKV 	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 4, supplies provided"					
3AHKW	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 5, supplies provided"					
3AHKX	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 6, supplies provided"					
3AHK1	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 1, supplies not provided"					
3AHK2	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 2, supplies not provided"					
3AHK3	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 3, supplies not provided"					
3AHK4	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 4, supplies not provided"					
3AHK5	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 5, supplies not provided"					
3AHK6	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 6, supplies not provided"					
3AHLS	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 1, supplies provided"					
3AHLT	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 2, supplies provided"					
3AHLU	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 3, supplies provided"					
3AHLV 	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 4, supplies provided"					
3AHLW	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 5, supplies provided"					
3AHLX	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 6, supplies provided"					
3AHL1	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 1, supplies not provided"					
3AHL2	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 2, supplies not provided"					
3AHL3	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 3, supplies not provided"					
3AHL4	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 4, supplies not provided"					
3AHL5	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 5, supplies not provided"					
3AHL6	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 6, supplies not provided"					
3AHMS	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 1, supplies provided"					
3AHMT	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 2, supplies provided"					
3AHMU	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 3, supplies provided"					
3AHMV 	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 4, supplies provided"					
3AHMW	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 5, supplies provided"					
3AHMX	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 6, supplies provided"					
3AHM1	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 1, supplies not provided"					
3AHM2	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 2, supplies not provided"					
3AHM3	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 3, supplies not provided"					
3AHM4	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 4, supplies not provided"					
3AHM5	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 5, supplies not provided"					
3AHM6	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 6, supplies not provided"					
3AHNS	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 1, supplies provided"					
3AHNT	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 2, supplies provided"					
3AHNU	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 3, supplies provided"					
3AHNV 	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 4, supplies provided"					
3AHNW	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 5, supplies provided"					
3AHNX	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 6, supplies provided"					
3AHN1	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 1, supplies not provided"					
3AHN2	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 2, supplies not provided"					
3AHN3	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 3, supplies not provided"					
3AHN4	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 4, supplies not provided"					
3AHN5	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 5, supplies not provided"					
3AHN6	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 6, supplies not provided"					
3AHPS	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 1, supplies provided"					
3AHPT	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 2, supplies provided"					
3AHPU	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 3, supplies provided"					
3AHPV 	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 4, supplies provided"					
3AHPW	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 5, supplies provided"					
3AHPX	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 6, supplies provided"					
3AHP1	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 1, supplies not provided"					
3AHP2	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 2, supplies not provided"					
3AHP3	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 3, supplies not provided"					
3AHP4	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 4, supplies not provided"					
3AHP5	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 5, supplies not provided"					
3AHP6	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 6, supplies not provided"					
3BFKS	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 1, supplies provided"					
3BFKT	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 2, supplies provided"					
3BFKU	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 3, supplies provided"					
3BFKV 	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 4, supplies provided"					
3BFKW	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 5, supplies provided"					
3BFKX	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 6, supplies provided"					
3BFK1	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 1, supplies not provided"					
3BFK2	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 2, supplies not provided"					
3BFK3	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 3, supplies not provided"					
3BFK4	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 4, supplies not provided"					
3BFK5	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 5, supplies not provided"					
3BFK6	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 6, supplies not provided"					
3BFLS	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 1, supplies provided"					
3BFLT	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 2, supplies provided"					
3BFLU	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 3, supplies provided"					
3BFLV 	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 4, supplies provided"					
3BFLW	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 5, supplies provided"					
3BFLX	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 6, supplies provided"					
3BFL1	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 1, supplies not provided"					
3BFL2	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 2, supplies not provided"					
3BFL3	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 3, supplies not provided"					
3BFL4	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 4, supplies not provided"					
3BFL5	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 5, supplies not provided"					
3BFL6	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 6, supplies not provided"					
3BFMS	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 1, supplies provided"					
3BFMT	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 2, supplies provided"					
3BFMU	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 3, supplies provided"					
3BFMV 	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 4, supplies provided"					
3BFMW	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 5, supplies provided"					
3BFMX	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 6, supplies provided"					
3BFM1	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 1, supplies not provided"					
3BFM2	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 2, supplies not provided"					
3BFM3	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 3, supplies not provided"					
3BFM4	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 4, supplies not provided"					
3BFM5	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 5, supplies not provided"					
3BFM6	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 6, supplies not provided"					
3BFNS	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 1, supplies provided"					
3BFNT	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 2, supplies provided"					
3BFNU	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 3, supplies provided"					
3BFNV 	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 4, supplies provided"					
3BFNW	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 5, supplies provided"					
3BFNX	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 6, supplies provided"					
3BFN1	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 1, supplies not provided"					
3BFN2	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 2, supplies not provided"					
3BFN3	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 3, supplies not provided"					
3BFN4	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 4, supplies not provided"					
3BFN5	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 5, supplies not provided"					
3BFN6	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 6, supplies not provided"					
3BFPS	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 1, supplies provided"					
3BFPT	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 2, supplies provided"					
3BFPU	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 3, supplies provided"					
3BFPV 	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 4, supplies provided"					
3BFPW	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 5, supplies provided"					
3BFPX	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 6, supplies provided"					
3BFP1	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 1, supplies not provided"					
3BFP2	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 2, supplies not provided"					
3BFP3	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 3, supplies not provided"					
3BFP4	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 4, supplies not provided"					
3BFP5	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 5, supplies not provided"					
3BFP6	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 6, supplies not provided"					
3BGKS	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 1, supplies provided"					
3BGKT	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 2, supplies provided"					
3BGKU	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 3, supplies provided"					
3BGKV 	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 4, supplies provided"					
3BGKW	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 5, supplies provided"					
3BGKX	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 6, supplies provided"					
3BGK1	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 1, supplies not provided"					
3BGK2	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 2, supplies not provided"					
3BGK3	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 3, supplies not provided"					
3BGK4	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 4, supplies not provided"					
3BGK5	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 5, supplies not provided"					
3BGK6	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 6, supplies not provided"					
3BGLS	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 1, supplies provided"					
3BGLT	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 2, supplies provided"					
3BGLU	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 3, supplies provided"					
3BGLV 	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 4, supplies provided"					
3BGLW	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 5, supplies provided"					
3BGLX	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 6, supplies provided"					
3BGL1	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 1, supplies not provided"					
3BGL2	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 2, supplies not provided"					
3BGL3	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 3, supplies not provided"					
3BGL4	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 4, supplies not provided"					
3BGL5	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 5, supplies not provided"					
3BGL6	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 6, supplies not provided"					
3BGMS	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 1, supplies provided"					
3BGMT	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 2, supplies provided"					
3BGMU	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 3, supplies provided"					
3BGMV 	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 4, supplies provided"					
3BGMW	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 5, supplies provided"					
3BGMX	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 6, supplies provided"					
3BGM1	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 1, supplies not provided"					
3BGM2	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 2, supplies not provided"					
3BGM3	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 3, supplies not provided"					
3BGM4	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 4, supplies not provided"					
3BGM5	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 5, supplies not provided"					
3BGM6	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 6, supplies not provided"					
3BGNS	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 1, supplies provided"					
3BGNT	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 2, supplies provided"					
3BGNU	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 3, supplies provided"					
3BGNV 	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 4, supplies provided"					
3BGNW	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 5, supplies provided"					
3BGNX	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 6, supplies provided"					
3BGN1	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 1, supplies not provided"					
3BGN2	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 2, supplies not provided"					
3BGN3	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 3, supplies not provided"					
3BGN4	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 4, supplies not provided"					
3BGN5	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 5, supplies not provided"					
3BGN6	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 6, supplies not provided"					
3BGPS	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 1, supplies provided"					
3BGPT	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 2, supplies provided"					
3BGPU	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 3, supplies provided"					
3BGPV 	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 4, supplies provided"					
3BGPW	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 5, supplies provided"					
3BGPX	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 6, supplies provided"					
3BGP1	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 1, supplies not provided"					
3BGP2	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 2, supplies not provided"					
3BGP3	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 3, supplies not provided"					
3BGP4	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 4, supplies not provided"					
3BGP5	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 5, supplies not provided"					
3BGP6	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 6, supplies not provided"					
3BHKS	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 1, supplies provided"					
3BHKT	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 2, supplies provided"					
3BHKU	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 3, supplies provided"					
3BHKV 	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 4, supplies provided"					
3BHKW	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 5, supplies provided"					
3BHKX	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 6, supplies provided"					
3BHK1	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 1, supplies not provided"					
3BHK2	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 2, supplies not provided"					
3BHK3	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 3, supplies not provided"					
3BHK4	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 4, supplies not provided"					
3BHK5	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 5, supplies not provided"					
3BHK6	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 6, supplies not provided"					
3BHLS	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 1, supplies provided"					
3BHLT	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 2, supplies provided"					
3BHLU	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 3, supplies provided"					
3BHLV 	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 4, supplies provided"					
3BHLW	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 5, supplies provided"					
3BHLX	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 6, supplies provided"					
3BHL1	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 1, supplies not provided"					
3BHL2	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 2, supplies not provided"					
3BHL3	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 3, supplies not provided"					
3BHL4	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 4, supplies not provided"					
3BHL5	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 5, supplies not provided"					
3BHL6	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 6, supplies not provided"					
3BHMS	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 1, supplies provided"					
3BHMT	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 2, supplies provided"					
3BHMU	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 3, supplies provided"					
3BHMV 	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 4, supplies provided"					
3BHMW	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 5, supplies provided"					
3BHMX	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 6, supplies provided"					
3BHM1	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 1, supplies not provided"					
3BHM2	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 2, supplies not provided"					
3BHM3	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 3, supplies not provided"					
3BHM4	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 4, supplies not provided"					
3BHM5	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 5, supplies not provided"					
3BHM6	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 6, supplies not provided"					
3BHNS	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 1, supplies provided"					
3BHNT	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 2, supplies provided"					
3BHNU	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 3, supplies provided"					
3BHNV 	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 4, supplies provided"					
3BHNW	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 5, supplies provided"					
3BHNX	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 6, supplies provided"					
3BHN1	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 1, supplies not provided"					
3BHN2	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 2, supplies not provided"					
3BHN3	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 3, supplies not provided"					
3BHN4	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 4, supplies not provided"					
3BHN5	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 5, supplies not provided"					
3BHN6	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 6, supplies not provided"					
3BHPS	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 1, supplies provided"					
3BHPT	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 2, supplies provided"					
3BHPU	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 3, supplies provided"					
3BHPV 	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 4, supplies provided"					
3BHPW	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 5, supplies provided"					
3BHPX	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 6, supplies provided"					
3BHP1	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 1, supplies not provided"					
3BHP2	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 2, supplies not provided"					
3BHP3	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 3, supplies not provided"					
3BHP4	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 4, supplies not provided"					
3BHP5	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 5, supplies not provided"					
3BHP6	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 6, supplies not provided"					
3CFKS	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 1, supplies provided"					
3CFKT	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 2, supplies provided"					
3CFKU	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 3, supplies provided"					
3CFKV 	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 4, supplies provided"					
3CFKW	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 5, supplies provided"					
3CFKX	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 6, supplies provided"					
3CFK1	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 1, supplies not provided"					
3CFK2	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 2, supplies not provided"					
3CFK3	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 3, supplies not provided"					
3CFK4	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 4, supplies not provided"					
3CFK5	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 5, supplies not provided"					
3CFK6	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 6, supplies not provided"					
3CFLS	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 1, supplies provided"					
3CFLT	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 2, supplies provided"					
3CFLU	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 3, supplies provided"					
3CFLV 	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 4, supplies provided"					
3CFLW	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 5, supplies provided"					
3CFLX	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 6, supplies provided"					
3CFL1	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 1, supplies not provided"					
3CFL2	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 2, supplies not provided"					
3CFL3	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 3, supplies not provided"					
3CFL4	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 4, supplies not provided"					
3CFL5	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 5, supplies not provided"					
3CFL6	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 6, supplies not provided"					
3CFMS	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 1, supplies provided"					
3CFMT	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 2, supplies provided"					
3CFMU	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 3, supplies provided"					
3CFMV 	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 4, supplies provided"					
3CFMW	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 5, supplies provided"					
3CFMX	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 6, supplies provided"					
3CFM1	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 1, supplies not provided"					
3CFM2	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 2, supplies not provided"					
3CFM3	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 3, supplies not provided"					
3CFM4	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 4, supplies not provided"					
3CFM5	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 5, supplies not provided"					
3CFM6	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 6, supplies not provided"					
3CFNS	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 1, supplies provided"					
3CFNT	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 2, supplies provided"					
3CFNU	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 3, supplies provided"					
3CFNV 	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 4, supplies provided"					
3CFNW	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 5, supplies provided"					
3CFNX	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 6, supplies provided"					
3CFN1	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 1, supplies not provided"					
3CFN2	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 2, supplies not provided"					
3CFN3	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 3, supplies not provided"					
3CFN4	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 4, supplies not provided"					
3CFN5	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 5, supplies not provided"					
3CFN6	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 4,Supply Severity Level 6, supplies not provided"					
3CFPS	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 1, supplies provided"					
3CFPT	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 2, supplies provided"					
3CFPU	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 3, supplies provided"					
3CFPV 	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 4, supplies provided"					
3CFPW	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 5, supplies provided"					
3CFPX	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 6, supplies provided"					
3CFP1	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 1, supplies not provided"					
3CFP2	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 2, supplies not provided"					
3CFP3	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 3, supplies not provided"					
3CFP4	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 4, supplies not provided"					
3CFP5	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 5, supplies not provided"					
3CFP6	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 5,Supply Severity Level 6, supplies not provided"					
3CGKS	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 1, supplies provided"					
3CGKT	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 2, supplies provided"					
3CGKU	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 3, supplies provided"					
3CGKV 	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 4, supplies provided"					
3CGKW	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 5, supplies provided"					
3CGKX	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 6, supplies provided"					
3CGK1	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 1, supplies not provided"					
3CGK2	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 2, supplies not provided"					
3CGK3	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 3, supplies not provided"					
3CGK4	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 4, supplies not provided"					
3CGK5	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 5, supplies not provided"					
3CGK6	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 6, supplies not provided"					
3CGLS	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 1, supplies provided"					
3CGLT	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 2, supplies provided"					
3CGLU	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 3, supplies provided"					
3CGLV 	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 4, supplies provided"					
3CGLW	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 5, supplies provided"					
3CGLX	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 6, supplies provided"					
3CGL1	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 1, supplies not provided"					
3CGL2	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 2, supplies not provided"					
3CGL3	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 3, supplies not provided"					
3CGL4	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 4, supplies not provided"					
3CGL5	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 5, supplies not provided"					
3CGL6	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 6, supplies not provided"					
3CGMS	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 1, supplies provided"					
3CGMT	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 2, supplies provided"					
3CGMU	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 3, supplies provided"					
3CGMV 	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 4, supplies provided"					
3CGMW	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 5, supplies provided"					
3CGMX	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 6, supplies provided"					
3CGM1	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 1, supplies not provided"					
3CGM2	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 2, supplies not provided"					
3CGM3	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 3, supplies not provided"					
3CGM4	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 4, supplies not provided"					
3CGM5	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 5, supplies not provided"					
3CGM6	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 6, supplies not provided"					
3CGNS	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 1, supplies provided"					
3CGNT	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 2, supplies provided"					
3CGNU	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 3, supplies provided"					
3CGNV 	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 4, supplies provided"					
3CGNW	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 5, supplies provided"					
3CGNX	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 6, supplies provided"					
3CGN1	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 1, supplies not provided"					
3CGN2	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 2, supplies not provided"					
3CGN3	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 3, supplies not provided"					
3CGN4	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 4, supplies not provided"					
3CGN5	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 5, supplies not provided"					
3CGN6	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 4,Supply Severity Level 6, supplies not provided"					
3CGPS	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 1, supplies provided"					
3CGPT	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 2, supplies provided"					
3CGPU	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 3, supplies provided"					
3CGPV 	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 4, supplies provided"					
3CGPW	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 5, supplies provided"					
3CGPX	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 6, supplies provided"					
3CGP1	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 1, supplies not provided"					
3CGP2	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 2, supplies not provided"					
3CGP3	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 3, supplies not provided"					
3CGP4	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 4, supplies not provided"					
3CGP5	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 5, supplies not provided"					
3CGP6	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 5,Supply Severity Level 6, supplies not provided"					
3CHKS	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 1, supplies provided"					
3CHKT	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 2, supplies provided"					
3CHKU	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 3, supplies provided"					
3CHKV 	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 4, supplies provided"					
3CHKW	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 5, supplies provided"					
3CHKX	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 6, supplies provided"					
3CHK1	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 1, supplies not provided"					
3CHK2	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 2, supplies not provided"					
3CHK3	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 3, supplies not provided"					
3CHK4	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 4, supplies not provided"					
3CHK5	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 5, supplies not provided"					
3CHK6	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 6, supplies not provided"					
3CHLS	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 1, supplies provided"					
3CHLT	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 2, supplies provided"					
3CHLU	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 3, supplies provided"					
3CHLV 	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 4, supplies provided"					
3CHLW	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 5, supplies provided"					
3CHLX	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 6, supplies provided"					
3CHL1	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 1, supplies not provided"					
3CHL2	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 2, supplies not provided"					
3CHL3	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 3, supplies not provided"					
3CHL4	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 4, supplies not provided"					
3CHL5	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 5, supplies not provided"					
3CHL6	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 6, supplies not provided"					
3CHMS	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 1, supplies provided"					
3CHMT	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 2, supplies provided"					
3CHMU	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 3, supplies provided"					
3CHMV 	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 4, supplies provided"					
3CHMW	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 5, supplies provided"					
3CHMX	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 6, supplies provided"					
3CHM1	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 1, supplies not provided"					
3CHM2	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 2, supplies not provided"					
3CHM3	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 3, supplies not provided"					
3CHM4	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 4, supplies not provided"					
3CHM5	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 5, supplies not provided"					
3CHM6	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 6, supplies not provided"					
3CHNS	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 1, supplies provided"					
3CHNT	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 2, supplies provided"					
3CHNU	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 3, supplies provided"					
3CHNV 	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 4, supplies provided"					
3CHNW	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 5, supplies provided"					
3CHNX	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 6, supplies provided"					
3CHN1	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 1, supplies not provided"					
3CHN2	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 2, supplies not provided"					
3CHN3	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 3, supplies not provided"					
3CHN4	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 4, supplies not provided"					
3CHN5	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 5, supplies not provided"					
3CHN6	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 4,Supply Severity Level 6, supplies not provided"					
3CHPS	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 1, supplies provided"					
3CHPT	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 2, supplies provided"					
3CHPU	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 3, supplies provided"					
3CHPV 	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 4, supplies provided"					
3CHPW	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 5, supplies provided"					
3CHPX	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 6, supplies provided"					
3CHP1	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 1, supplies not provided"					
3CHP2	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 2, supplies not provided"					
3CHP3	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 3, supplies not provided"					
3CHP4	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 4, supplies not provided"					
3CHP5	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 5, supplies not provided"					
3CHP6	01/01/08		HHA	"Late Episode, 0-13 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 5,Supply Severity Level 6, supplies not provided"					
4AFKS	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 1, supplies provided"					
4AFKT	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 2, supplies provided"					
4AFKU	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 3, supplies provided"					
4AFKV 	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 4, supplies provided"					
4AFKW	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 5, supplies provided"					
4AFKX	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 6, supplies provided"					
4AFK1	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 1, supplies not provided"					
4AFK2	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 2, supplies not provided"					
4AFK3	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 3, supplies not provided"					
4AFK4	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 4, supplies not provided"					
4AFK5	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 5, supplies not provided"					
4AFK6	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 6, supplies not provided"					
4AFLS	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 1, supplies provided"					
4AFLT	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 2, supplies provided"					
4AFLU	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 3, supplies provided"					
4AFLV 	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 4, supplies provided"					
4AFLW	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 5, supplies provided"					
4AFLX	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 6, supplies provided"					
4AFL1	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 1, supplies not provided"					
4AFL2	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 2, supplies not provided"					
4AFL3	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 3, supplies not provided"					
4AFL4	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 4, supplies not provided"					
4AFL5	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 5, supplies not provided"					
4AFL6	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 6, supplies not provided"					
4AFMS	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 1, supplies provided"					
4AFMT	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 2, supplies provided"					
4AFMU	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 3, supplies provided"					
4AFMV 	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 4, supplies provided"					
4AFMW	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 5, supplies provided"					
4AFMX	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 6, supplies provided"					
4AFM1	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 1, supplies not provided"					
4AFM2	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 2, supplies not provided"					
4AFM3	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 3, supplies not provided"					
4AFM4	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 4, supplies not provided"					
4AFM5	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 5, supplies not provided"					
4AFM6	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 6, supplies not provided"					
4AGKS	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 1, supplies provided"					
4AGKT	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 2, supplies provided"					
4AGKU	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 3, supplies provided"					
4AGKV 	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 4, supplies provided"					
4AGKW	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 5, supplies provided"					
4AGKX	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 6, supplies provided"					
4AGK1	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 1, supplies not provided"					
4AGK2	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 2, supplies not provided"					
4AGK3	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 3, supplies not provided"					
4AGK4	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 4, supplies not provided"					
4AGK5	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 5, supplies not provided"					
4AGK6	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 6, supplies not provided"					
4AGLS	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 2, Supply Severity Level 1, supplies provided"					
4AGLT	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 2, Supply Severity Level 2, supplies provided"					
4AGLU	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 2, Supply Severity Level 3, supplies provided"					
4AGLV 	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 2, Supply Severity Level 4, supplies provided"					
4AGLW	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 2, Supply Severity Level 5, supplies provided"					
4AGLX	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 2, Supply Severity Level 6, supplies provided"					
4AGL1	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 2, Supply Severity Level 1, supplies not provided"					
4AGL2	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 2, Supply Severity Level 2, supplies not provided"					
4AGL3	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 2, Supply Severity Level 3, supplies not provided"					
4AGL4	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 2, Supply Severity Level 4, supplies not provided"					
4AGL5	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 2, Supply Severity Level 5, supplies not provided"					
4AGL6	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 2, Supply Severity Level 6, supplies not provided"					
4AGMS	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 1, supplies provided"					
4AGMT	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 2, supplies provided"					
4AGMU	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 3, supplies provided"					
4AGMV 	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 4, supplies provided"					
4AGMW	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 5, supplies provided"					
4AGMX	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 6, supplies provided"					
4AGM1	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 1, supplies not provided"					
4AGM2	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 2, supplies not provided"					
4AGM3	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 3, supplies not provided"					
4AGM4	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 4, supplies not provided"					
4AGM5	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 5, supplies not provided"					
4AGM6	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 6, supplies not provided"					
4AHKS	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 1, supplies provided"					
4AHKT	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 2, supplies provided"					
4AHKU	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 3, supplies provided"					
4AHKV 	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 4, supplies provided"					
4AHKW	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 5, supplies provided"					
4AHKX	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 6, supplies provided"					
4AHK1	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 1, supplies not provided"					
4AHK2	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 2, supplies not provided"					
4AHK3	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 3, supplies not provided"					
4AHK4	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 4, supplies not provided"					
4AHK5	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 5, supplies not provided"					
4AHK6	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 6, supplies not provided"					
4AHLS	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 1, supplies provided"					
4AHLT	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 2, supplies provided"					
4AHLU	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 3, supplies provided"					
4AHLV 	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 4, supplies provided"					
4AHLW	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 5, supplies provided"					
4AHLX	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 6, supplies provided"					
4AHL1	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 1, supplies not provided"					
4AHL2	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 2, supplies not provided"					
4AHL3	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 3, supplies not provided"					
4AHL4	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 4, supplies not provided"					
4AHL5	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 5, supplies not provided"					
4AHL6	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 6, supplies not provided"					
4AHMS	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 1, supplies provided"					
4AHMT	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 2, supplies provided"					
4AHMU	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 3, supplies provided"					
4AHMV 	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 4, supplies provided"					
4AHMW	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 5, supplies provided"					
4AHMX	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 6, supplies provided"					
4AHM1	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 1, supplies not provided"					
4AHM2	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 2, supplies not provided"					
4AHM3	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 3, supplies not provided"					
4AHM4	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 4, supplies not provided"					
4AHM5	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 5, supplies not provided"					
4AHM6	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 1, Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 6, supplies not provided"					
4BFKS	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 1, supplies provided"					
4BFKT	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 2, supplies provided"					
4BFKU	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 3, supplies provided"					
4BFKV 	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 4, supplies provided"					
4BFKW	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 5, supplies provided"					
4BFKX	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 6, supplies provided"					
4BFK1	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 1, supplies not provided"					
4BFK2	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 2, supplies not provided"					
4BFK3	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 3, supplies not provided"					
4BFK4	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 4, supplies not provided"					
4BFK5	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 5, supplies not provided"					
4BFK6	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 6, supplies not provided"					
4BFLS	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 1, supplies provided"					
4BFLT	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 2, supplies provided"					
4BFLU	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 3, supplies provided"					
4BFLV 	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 4, supplies provided"					
4BFLW	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 5, supplies provided"					
4BFLX	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 6, supplies provided"					
4BFL1	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 1, supplies not provided"					
4BFL2	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 2, supplies not provided"					
4BFL3	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 3, supplies not provided"					
4BFL4	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 4, supplies not provided"					
4BFL5	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 5, supplies not provided"					
4BFL6	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 6, supplies not provided"					
4BFMS	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 1, supplies provided"					
4BFMT	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 2, supplies provided"					
4BFMU	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 3, supplies provided"					
4BFMV 	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 4, supplies provided"					
4BFMW	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 5, supplies provided"					
4BFMX	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 6, supplies provided"					
4BFM1	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 1, supplies not provided"					
4BFM2	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 2, supplies not provided"					
4BFM3	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 3, supplies not provided"					
4BFM4	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 4, supplies not provided"					
4BFM5	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 5, supplies not provided"					
4BFM6	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 6, supplies not provided"					
4BGKS	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 1, supplies provided"					
4BGKT	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 2, supplies provided"					
4BGKU	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 3, supplies provided"					
4BGKV 	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 4, supplies provided"					
4BGKW	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 5, supplies provided"					
4BGKX	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 6, supplies provided"					
4BGK1	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 1, supplies not provided"					
4BGK2	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 2, supplies not provided"					
4BGK3	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 3, supplies not provided"					
4BGK4	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 4, supplies not provided"					
4BGK5	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 5, supplies not provided"					
4BGK6	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 6, supplies not provided"					
4BGLS	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 1, supplies provided"					
4BGLT	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 2, supplies provided"					
4BGLU	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 3, supplies provided"					
4BGLV 	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 4, supplies provided"					
4BGLW	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 5, supplies provided"					
4BGLX	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 6, supplies provided"					
4BGL1	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 1, supplies not provided"					
4BGL2	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 2, supplies not provided"					
4BGL3	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 3, supplies not provided"					
4BGL4	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 4, supplies not provided"					
4BGL5	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 5, supplies not provided"					
4BGL6	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 6, supplies not provided"					
4BGMS	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 1, supplies provided"					
4BGMT	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 2, supplies provided"					
4BGMU	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 3, supplies provided"					
4BGMV 	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 4, supplies provided"					
4BGMW	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 5, supplies provided"					
4BGMX	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 6, supplies provided"					
4BGM1	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 1, supplies not provided"					
4BGM2	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 2, supplies not provided"					
4BGM3	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 3, supplies not provided"					
4BGM4	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 4, supplies not provided"					
4BGM5	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 5, supplies not provided"					
4BGM6	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 6, supplies not provided"					
4BHKS	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 1, supplies provided"					
4BHKT	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 2, supplies provided"					
4BHKU	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 3, supplies provided"					
4BHKV 	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 4, supplies provided"					
4BHKW	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 5, supplies provided"					
4BHKX	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 6, supplies provided"					
4BHK1	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 1, supplies not provided"					
4BHK2	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 2, supplies not provided"					
4BHK3	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 3, supplies not provided"					
4BHK4	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 4, supplies not provided"					
4BHK5	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 5, supplies not provided"					
4BHK6	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 6, supplies not provided"					
4BHLS	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 1, supplies provided"					
4BHLT	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 2, supplies provided"					
4BHLU	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 3, supplies provided"					
4BHLV 	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 4, supplies provided"					
4BHLW	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 5, supplies provided"					
4BHLX	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 6, supplies provided"					
4BHL1	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 1, supplies not provided"					
4BHL2	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 2, supplies not provided"					
4BHL3	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 3, supplies not provided"					
4BHL4	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 4, supplies not provided"					
4BHL5	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 5, supplies not provided"					
4BHL6	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 6, supplies not provided"					
4BHMS	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 1, supplies provided"					
4BHMT	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 2, supplies provided"					
4BHMU	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 3, supplies provided"					
4BHMV 	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 4, supplies provided"					
4BHMW	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 5, supplies provided"					
4BHMX	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 6, supplies provided"					
4BHM1	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 1, supplies not provided"					
4BHM2	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 2, supplies not provided"					
4BHM3	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 3, supplies not provided"					
4BHM4	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 4, supplies not provided"					
4BHM5	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 5, supplies not provided"					
4BHM6	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 2,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 6, supplies not provided"					
4CFKS	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 1, supplies provided"					
4CFKT	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 2, supplies provided"					
4CFKU	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 3, supplies provided"					
4CFKV 	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 4, supplies provided"					
4CFKW	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 5, supplies provided"					
4CFKX	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 6, supplies provided"					
4CFK1	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 1, supplies not provided"					
4CFK2	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 2, supplies not provided"					
4CFK3	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 3, supplies not provided"					
4CFK4	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 4, supplies not provided"					
4CFK5	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 5, supplies not provided"					
4CFK6	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 6, supplies not provided"					
4CFLS	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 1, supplies provided"					
4CFLT	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 2, supplies provided"					
4CFLU	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 3, supplies provided"					
4CFLV 	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 4, supplies provided"					
4CFLW	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 5, supplies provided"					
4CFLX	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 6, supplies provided"					
4CFL1	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 1, supplies not provided"					
4CFL2	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 2, supplies not provided"					
4CFL3	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 3, supplies not provided"					
4CFL4	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 4, supplies not provided"					
4CFL5	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 5, supplies not provided"					
4CFL6	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 2,Supply Severity Level 6, supplies not provided"					
4CFMS	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 1, supplies provided"					
4CFMT	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 2, supplies provided"					
4CFMU	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 3, supplies provided"					
4CFMV 	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 4, supplies provided"					
4CFMW	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 5, supplies provided"					
4CFMX	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 6, supplies provided"					
4CFM1	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 1, supplies not provided"					
4CFM2	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 2, supplies not provided"					
4CFM3	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 3, supplies not provided"					
4CFM4	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 4, supplies not provided"					
4CFM5	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 5, supplies not provided"					
4CFM6	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 1,Service Severity Level 3,Supply Severity Level 6, supplies not provided"					
4CGKS	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 1, supplies provided"					
4CGKT	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 2, supplies provided"					
4CGKU	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 3, supplies provided"					
4CGKV 	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 4, supplies provided"					
4CGKW	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 5, supplies provided"					
4CGKX	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 6, supplies provided"					
4CGK1	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 1, supplies not provided"					
4CGK2	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 2, supplies not provided"					
4CGK3	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 3, supplies not provided"					
4CGK4	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 4, supplies not provided"					
4CGK5	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 5, supplies not provided"					
4CGK6	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 6, supplies not provided"					
4CGLS	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 1, supplies provided"					
4CGLT	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 2, supplies provided"					
4CGLU	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 3, supplies provided"					
4CGLV 	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 4, supplies provided"					
4CGLW	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 5, supplies provided"					
4CGLX	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 6, supplies provided"					
4CGL1	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 1, supplies not provided"					
4CGL2	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 2, supplies not provided"					
4CGL3	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 3, supplies not provided"					
4CGL4	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 4, supplies not provided"					
4CGL5	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 5, supplies not provided"					
4CGL6	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 2,Supply Severity Level 6, supplies not provided"					
4CGMS	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 1, supplies provided"					
4CGMT	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 2, supplies provided"					
4CGMU	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 3, supplies provided"					
4CGMV 	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 4, supplies provided"					
4CGMW	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 5, supplies provided"					
4CGMX	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 6, supplies provided"					
4CGM1	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 1, supplies not provided"					
4CGM2	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 2, supplies not provided"					
4CGM3	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 3, supplies not provided"					
4CGM4	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 4, supplies not provided"					
4CGM5	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 5, supplies not provided"					
4CGM6	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 2,Service Severity Level 3,Supply Severity Level 6, supplies not provided"					
4CHKS	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 1, supplies provided"					
4CHKT	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 2, supplies provided"					
4CHKU	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 3, supplies provided"					
4CHKV 	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 4, supplies provided"					
4CHKW	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 5, supplies provided"					
4CHKX	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 6, supplies provided"					
4CHK1	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 1, supplies not provided"					
4CHK2	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 2, supplies not provided"					
4CHK3	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 3, supplies not provided"					
4CHK4	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 4, supplies not provided"					
4CHK5	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 5, supplies not provided"					
4CHK6	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 6, supplies not provided"					
4CHLS	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 1, supplies provided"					
4CHLT	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 2, supplies provided"					
4CHLU	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 3, supplies provided"					
4CHLV 	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 4, supplies provided"					
4CHLW	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 5, supplies provided"					
4CHLX	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 6, supplies provided"					
4CHL1	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 1, supplies not provided"					
4CHL2	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 2, supplies not provided"					
4CHL3	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 3, supplies not provided"					
4CHL4	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 4, supplies not provided"					
4CHL5	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 5, supplies not provided"					
4CHL6	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 2,Supply Severity Level 6, supplies not provided"					
4CHMS	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 1, supplies provided"					
4CHMT	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 2, supplies provided"					
4CHMU	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 3, supplies provided"					
4CHMV 	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 4, supplies provided"					
4CHMW	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 5, supplies provided"					
4CHMX	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 6, supplies provided"					
4CHM1	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 1, supplies not provided"					
4CHM2	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 2, supplies not provided"					
4CHM3	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 3, supplies not provided"					
4CHM4	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 4, supplies not provided"					
4CHM5	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 5, supplies not provided"					
4CHM6	01/01/08		HHA	"Late Episode, 14-19 therapies,Clinical Severity Level 3,  Functional Severity Level 3,Service Severity Level 3,Supply Severity Level 6, supplies not provided"					
5AFKS	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 1,Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 1, supplies provided"					
5AFKT	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 1,Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 2, supplies provided"					
5AFKU	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 1,Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 3, supplies provided"					
5AFKV 	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 1,Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 4, supplies provided"					
5AFKW	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 1,Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 5, supplies provided"					
5AFKX	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 1,Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 6, supplies provided"					
5AFK1	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 1,Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 1, supplies not provided"					
5AFK2	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 1,Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 2, supplies not provided"					
5AFK3	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 1,Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 3, supplies not provided"					
5AFK4	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 1,Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 4, supplies not provided"					
5AFK5	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 1,Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 5, supplies not provided"					
5AFK6	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 1,Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 6, supplies not provided"					
5AGKS	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 1,Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 1, supplies provided"					
5AGKT	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 1,Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 2, supplies provided"					
5AGKU	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 1,Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 3, supplies provided"					
5AGKV 	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 1,Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 4, supplies provided"					
5AGKW	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 1,Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 5, supplies provided"					
5AGKX	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 1,Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 6, supplies provided"					
5AGK1	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 1,Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 1, supplies not provided"					
5AGK2	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 1,Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 2, supplies not provided"					
5AGK3	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 1,Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 3, supplies not provided"					
5AGK4	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 1,Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 4, supplies not provided"					
5AGK5	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 1,Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 5, supplies not provided"					
5AGK6	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 1,Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 6, supplies not provided"					
5AHKS	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 1,Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 1, supplies provided"					
5AHKT	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 1,Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 2, supplies provided"					
5AHKU	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 1,Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 3, supplies provided"					
5AHKV 	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 1,Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 4, supplies provided"					
5AHKW	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 1,Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 5, supplies provided"					
5AHKX	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 1,Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 6, supplies provided"					
5AHK1	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 1,Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 1, supplies not provided"					
5AHK2	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 1,Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 2, supplies not provided"					
5AHK3	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 1,Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 3, supplies not provided"					
5AHK4	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 1,Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 4, supplies not provided"					
5AHK5	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 1,Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 5, supplies not provided"					
5AHK6	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 1,Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 6, supplies not provided"					
5BFKS	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 2, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 1, supplies provided"					
5BFKT	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 2, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 2, supplies provided"					
5BFKU	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 2, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 3, supplies provided"					
5BFKV 	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 2, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 4, supplies provided"					
5BFKW	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 2, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 5, supplies provided"					
5BFKX	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 2, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 6, supplies provided"					
5BFK1	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 2, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 1, supplies not provided"					
5BFK2	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 2, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 2, supplies not provided"					
5BFK3	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 2, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 3, supplies not provided"					
5BFK4	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 2, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 4, supplies not provided"					
5BFK5	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 2, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 5, supplies not provided"					
5BFK6	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 2, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 6, supplies not provided"					
5BGKS	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 2, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 1, supplies provided"					
5BGKT	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 2, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 2, supplies provided"					
5BGKU	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 2, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 3, supplies provided"					
5BGKV 	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 2, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 4, supplies provided"					
5BGKW	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 2, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 5, supplies provided"					
5BGKX	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 2, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 6, supplies provided"					
5BGK1	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 2, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 1, supplies not provided"					
5BGK2	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 2, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 2, supplies not provided"					
5BGK3	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 2, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 3, supplies not provided"					
5BGK4	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 2, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 4, supplies not provided"					
5BGK5	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 2, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 5, supplies not provided"					
5BGK6	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 2, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 6, supplies not provided"					
5BHKS	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 2, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 1, supplies provided"					
5BHKT	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 2, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 2, supplies provided"					
5BHKU	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 2, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 3, supplies provided"					
5BHKV 	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 2, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 4, supplies provided"					
5BHKW	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 2, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 5, supplies provided"					
5BHKX	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 2, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 6, supplies provided"					
5BHK1	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 2, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 1, supplies not provided"					
5BHK2	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 2, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 2, supplies not provided"					
5BHK3	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 2, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 3, supplies not provided"					
5BHK4	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 2, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 4, supplies not provided"					
5BHK5	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 2, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 5, supplies not provided"					
5BHK6	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 2, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 6, supplies not provided"					
5CFKS	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 3, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 1, supplies provided"					
5CFKT	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 3, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 2, supplies provided"					
5CFKU	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 3, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 3, supplies provided"					
5CFKV 	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 3, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 4, supplies provided"					
5CFKW	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 3, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 5, supplies provided"					
5CFKX	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 3, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 6, supplies provided"					
5CFK1	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 3, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 1, supplies not provided"					
5CFK2	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 3, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 2, supplies not provided"					
5CFK3	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 3, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 3, supplies not provided"					
5CFK4	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 3, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 4, supplies not provided"					
5CFK5	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 3, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 5, supplies not provided"					
5CFK6	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 3, Functional Severity Level 1,Service Severity Level 1,Supply Severity Level 6, supplies not provided"					
5CGKS	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 3, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 1, supplies provided"					
5CGKT	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 3, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 2, supplies provided"					
5CGKU	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 3, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 3, supplies provided"					
5CGKV 	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 3, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 4, supplies provided"					
5CGKW	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 3, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 5, supplies provided"					
5CGKX	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 3, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 6, supplies provided"					
5CGK1	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 3, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 1, supplies not provided"					
5CGK2	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 3, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 2, supplies not provided"					
5CGK3	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 3, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 3, supplies not provided"					
5CGK4	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 3, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 4, supplies not provided"					
5CGK5	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 3, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 5, supplies not provided"					
5CGK6	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 3, Functional Severity Level 2,Service Severity Level 1,Supply Severity Level 6, supplies not provided"					
5CHKS	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 3, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 1, supplies provided"					
5CHKT	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 3, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 2, supplies provided"					
5CHKU	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 3, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 3, supplies provided"					
5CHKV 	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 3, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 4, supplies provided"					
5CHKW	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 3, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 5, supplies provided"					
5CHKX	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 3, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 6, supplies provided"					
5CHK1	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 3, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 1, supplies not provided"					
5CHK2	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 3, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 2, supplies not provided"					
5CHK3	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 3, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 3, supplies not provided"					
5CHK4	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 3, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 4, supplies not provided"					
5CHK5	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 3, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 5, supplies not provided"					
5CHK6	01/01/08		HHA	"Early or Late Episode, 20+ therapies,Clinical Severity Level 3, Functional Severity Level 3,Service Severity Level 1,Supply Severity Level 6, supplies not provided"					
HAEJ1	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Min, Service=Min, all positions computed"					
HAEJ2	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Min, Service=Min, 2nd position derived"					
HAEJ3	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Min, Service=Min, 3rd position derived"					
HAEJ4	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Min, Service=Min, 4th position derived"					
HAEJ5	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Min, Service=Min, 2nd & 3rd positions derived"					
HAEJ6	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Min, Service=Min, 3rd & 4th positions derived"					
HAEJ7	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Min, Service=Min, 2nd & 4th positions derived"		 			
HAEJ8	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Min, Service=Min, all positions derived"					
HAEK1	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Min, Service=Low, all positions computed"					
HAEK2	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Min, Service=Low, 2nd position derived"					
HAEK3	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Min, Service=Low, 3rd position derived"					
HAEK4	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Min, Service=Low, 4th position derived"					
HAEK5	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Min, Service=Low, 2nd & 3rd positions derived"					
HAEK6	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Min, Service=Low, 3rd & 4th positions derived"					
HAEK7	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Min, Service=Low, 2nd & 4th positions derived"					
HAEK8	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Min, Service=Low, all positions derived"					
HAEL1	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Min, Service=Mod, all positions computed"					
HAEL2	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Min, Service=Mod, 2nd position derived"					
HAEL3	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Min, Service=Mod, 3rd position derived"					
HAEL4	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Min, Service=Mod, 4th position derived"					
HAEL5	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Min, Service=Mod, 2nd & 3rd positions derived"					
HAEL6	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Min, Service=Mod, 3rd & 4th positions derived"					
HAEL7	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Min, Service=Mod, 2nd & 4th positions derived"					
HAEL8	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Min, Service=Mod, all positions derived"					
HAEM1	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Min, Service=High, all positions computed"					
HAEM2	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Min, Service=High, 2nd position derived"					
HAEM3	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Min, Service=High, 3rd position derived"					
HAEM4	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Min, Service=High, 4th position derived"					
HAEM5	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Min, Service=High, 2nd & 3rd positions derived"					
HAEM6	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Min, Service=High, 3rd & 4th positions derived"					
HAEM7	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Min, Service=High, 2nd & 4th positions derived"					
HAEM8	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Min, Service=High, all positions derived"					
HAFJ1	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Low, Service=Min, all positions computed"					
HAFJ2	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Low, Service=Min, 2nd position derived"					
HAFJ3	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Low, Service=Min, 3rd position derived"					
HAFJ4	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Low, Service=Min, 4th position derived"					
HAFJ5	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Low, Service=Min, 2nd & 3rd positions derived"					
HAFJ6	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Low, Service=Min, 3rd & 4th positions derived"					
HAFJ7	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Low, Service=Min, 2nd & 4th positions derived"					
HAFJ8	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Low, Service=Min, all positions derived"					
HAFK1	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Low, Service=Low, all positions computed"					
HAFK2	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Low, Service=Low, 2nd position derived"					
HAFK3	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Low, Service=Low, 3rd position derived"					
HAFK4	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Low, Service=Low, 4th position derived"					
HAFK5	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Low, Service=Low, 2nd & 3rd positions derived"					
HAFK6	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Low, Service=Low, 3rd & 4th positions derived"					
HAFK7	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Low, Service=Low, 2nd & 4th positions derived"					
HAFK8	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Low, Service=Low, all positions derived"					
HAFL1	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Low, Service=Mod, all positions computed"					
HAFL2	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Low, Service=Mod, 2nd position derived"					
HAFL3	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Low, Service=Mod, 3rd position derived"					
HAFL4	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Low, Service=Mod, 4th position derived"					
HAFL5	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Low, Service=Mod, 2nd & 3rd positions derived"					
HAFL6	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Low, Service=Mod, 3rd & 4th positions derived"					
HAFL7	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Low, Service=Mod, 2nd & 4th positions derived"					
HAFL8	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Low, Service=Mod, all positions derived"					
HAFM1	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Low, Service=High, all positions computed"					
HAFM2	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Low, Service=High, 2nd position derived"					
HAFM3	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Low, Service=High, 3rd position derived"					
HAFM4	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Low, Service=High, 4th position derived"					
HAFM5	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Low, Service=High, 2nd & 3rd positions derived"					
HAFM6	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Low, Service=High, 3rd & 4th positions derived"					
HAFM7	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Low, Service=High, 2nd & 4th positions derived"					
HAFM8	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Low, Service=High, all positions derived"					
HAGJ1	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Mod, Service=Min, all positions computed"					
HAGJ2	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Mod, Service=Min, 2nd position derived"					
HAGJ3	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Mod, Service=Min, 3rd position derived"					
HAGJ4	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Mod, Service=Min, 4th position derived"					
HAGJ5	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Mod, Service=Min, 2nd & 3rd positions derived"					
HAGJ6	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Mod, Service=Min, 3rd & 4th positions derived"					
HAGJ7	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Mod, Service=Min, 2nd & 4th positions derived"					
HAGJ8	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Mod, Service=Min, all positions derived"					
HAGK1	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Mod, Service=Low, all positions computed"					
HAGK2	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Mod, Service=Low, 2nd position derived"					
HAGK3	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Mod, Service=Low, 3rd position derived"					
HAGK4	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Mod, Service=Low, 4th position derived"					
HAGK5	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Mod, Service=Low, 2nd & 3rd positions derived"					
HAGK6	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Mod, Service=Low, 3rd & 4th positions derived"					
HAGK7	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Mod, Service=Low, 2nd & 4th positions derived"					
HAGK8	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Mod, Service=Low, all positions derived"					
HAGL1	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Mod, Service=Mod, all positions computed"					
HAGL2	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Mod, Service=Mod, 2nd position derived"					
HAGL3	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Mod, Service=Mod, 3rd position derived"					
HAGL4	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Mod, Service=Mod, 4th position derived"					
HAGL5	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Mod, Service=Mod, 2nd & 3rd positions derived"					
HAGL6	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Mod, Service=Mod, 3rd & 4th positions derived"					
HAGL7	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Mod, Service=Mod, 2nd & 4th positions derived"					
HAGL8	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Mod, Service=Mod, all positions derived"					
HAGM1	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Mod, Service=High, all positions computed"					
HAGM2	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Mod, Service=High, 2nd position derived"					
HAGM3	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Mod, Service=High, 3rd position derived"					
HAGM4	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Mod, Service=High, 4th position derived"					
HAGM5	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Mod, Service=High, 2nd & 3rd positions derived"					
HAGM6	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Mod, Service=High, 3rd & 4th positions derived"					
HAGM7	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Mod, Service=High, 2nd & 4th positions derived"					
HAGM8	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Mod, Service=High, all positions derived"					
HAHJ1	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=High, Service=Min, all positions computed"					
HAHJ2	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=High, Service=Min, 2nd position derived"					
HAHJ3	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=High, Service=Min, 3rd position derived"					
HAHJ4	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=High, Service=Min, 4th position derived"					
HAHJ5	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=High, Service=Min, 2nd & 3rd positions derived"					
HAHJ6	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=High, Service=Min, 3rd & 4th positions derived"					
HAHJ7	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=High, Service=Min, 2nd & 4th positions derived"					
HAHJ8	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=High, Service=Min, all positions derived"					
HAHK1	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=High, Service=Low, all positions computed"					
HAHK2	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=High, Service=Low, 2nd position derived"					
HAHK3	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=High, Service=Low, 3rd position derived"					
HAHK4	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=High, Service=Low, 4th position derived"					
HAHK5	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=High, Service=Low, 2nd & 3rd positions derived"					
HAHK6	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=High, Service=Low, 3rd & 4th positions derived"					
HAHK7	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=High, Service=Low, 2nd & 4th positions derived"					
HAHK8	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=High, Service=Low, all positions derived"					
HAHL1	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=High, Service=Mod, all positions computed"					
HAHL2	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=High, Service=Mod, 2nd position derived"					
HAHL3	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=High, Service=Mod, 3rd position derived"					
HAHL4	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=High, Service=Mod, 4th position derived"					
HAHL5	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=High, Service=Mod, 2nd & 3rd positions derived"					
HAHL6	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=High, Service=Mod, 3rd & 4th positions derived"					
HAHL7	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=High, Service=Mod, 2nd & 4th positions derived"					
HAHL8	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=High, Service=Mod, all positions derived"					
HAHM1	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=High, Service=High, all positions computed"					
HAHM2	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=High, Service=High, 2nd position derived"					
HAHM3	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=High, Service=High, 3rd position derived"					
HAHM4	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=High, Service=High, 4th position derived"					
HAHM5	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=High, Service=High, 2nd & 3rd positions derived"					
HAHM6	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=High, Service=High, 3rd & 4th positions derived"					
HAHM7	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=High, Service=High, 2nd & 4th positions derived"					
HAHM8	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=High, Service=High, all positions derived"					
HAIJ1	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Max, Service=Min, all positions computed"					
HAIJ2	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Max, Service=Min, 2nd position derived"					
HAIJ3	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Max, Service=Min, 3rd position derived"					
HAIJ4	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Max, Service=Min, 4th position derived"					
HAIJ5	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Max, Service=Min, 2nd & 3rd positions derived"					
HAIJ6	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Max, Service=Min, 3rd & 4th positions derived"					
HAIJ7	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Max, Service=Min, 2nd & 4th positions derived"					
HAIJ8	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Max, Service=Min, all positions derived"					
HAIK1	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Max, Service=Low, all positions computed"					
HAIK2	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Max, Service=Low, 2nd position derived"					
HAIK3	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Max, Service=Low, 3rd position derived"					
HAIK4	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Max, Service=Low, 4th position derived"					
HAIK5	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Max, Service=Low, 2nd & 3rd positions derived"					
HAIK6	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Max, Service=Low, 3rd & 4th positions derived"					
HAIK7	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Max, Service=Low, 2nd & 4th positions derived"					
HAIK8	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Max, Service=Low, all positions derived"					
HAIL1	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Max, Service=Mod, all positions computed"					
HAIL2	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Max, Service=Mod, 2nd position derived"					
HAIL3	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Max, Service=Mod, 3rd position derived"					
HAIL4	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Max, Service=Mod, 4th position derived"					
HAIL5	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Max, Service=Mod, 2nd & 3rd positions derived"					
HAIL6	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Max, Service=Mod, 3rd & 4th positions derived"					
HAIL7	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Max, Service=Mod, 2nd & 4th positions derived"					
HAIL8	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Max, Service=Mod, all positions derived"					
HAIM1	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Max, Service=High, all positions computed"					
HAIM2	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Max, Service=High, 2nd position derived"					
HAIM3	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Max, Service=High, 3rd position derived"					
HAIM4	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Max, Service=High, 4th position derived"					
HAIM5	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Max, Service=High, 2nd & 3rd positions derived"					
HAIM6	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Max, Service=High, 3rd & 4th positions derived"					
HAIM7	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Max, Service=High, 2nd & 4th positions derived"					
HAIM8	10/01/00	12/31/07	HHA	"Clinical=Min, Functional=Max, Service=High, all positions derived"					
HBEJ1	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Min, Service=Min, all positions computed"					
HBEJ2	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Min, Service=Min, 2nd position derived"					
HBEJ3	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Min, Service=Min, 3rd position derived"					
HBEJ4	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Min, Service=Min, 4th position derived"					
HBEJ5	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Min, Service=Min, 2nd & 3rd positions derived"					
HBEJ6	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Min, Service=Min, 3rd & 4th positions derived"					
HBEJ7	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Min, Service=Min, 2nd & 4th positions derived"					
HBEJ8	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Min, Service=Min, all positions derived"					
HBEK1	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Min, Service=Low, all positions computed"					
HBEK2	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Min, Service=Low, 2nd position derived"					
HBEK3	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Min, Service=Low, 3rd position derived"					
HBEK4	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Min, Service=Low, 4th position derived"					
HBEK5	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Min, Service=Low, 2nd & 3rd positions derived"					
HBEK6	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Min, Service=Low, 3rd & 4th positions derived"					
HBEK7	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Min, Service=Low, 2nd & 4th positions derived"					
HBEK8	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Min, Service=Low, all positions derived"					
HBEL1	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Min, Service=Mod, all positions computed"					
HBEL2	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Min, Service=Mod, 2nd position derived"					
HBEL3	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Min, Service=Mod, 3rd position derived"					
HBEL4	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Min, Service=Mod, 4th position derived"					
HBEL5	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Min, Service=Mod, 2nd & 3rd positions derived"					
HBEL6	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Min, Service=Mod, 3rd & 4th positions derived"					
HBEL7	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Min, Service=Mod, 2nd & 4th positions derived"					
HBEL8	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Min, Service=Mod, all positions derived"					
HBEM1	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Min, Service=High, all positions computed"					
HBEM2	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Min, Service=High, 2nd position derived"					
HBEM3	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Min, Service=High, 3rd position derived"					
HBEM4	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Min, Service=High, 4th position derived"					
HBEM5	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Min, Service=High, 2nd & 3rd positions derived"					
HBEM6	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Min, Service=High, 3rd & 4th positions derived"					
HBEM7	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Min, Service=High, 2nd & 4th positions derived"					
HBEM8	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Min, Service=High, all positions derived"					
HBFJ1	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Low, Service=Min, all positions computed"					
HBFJ2	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Low, Service=Min, 2nd position derived"					
HBFJ3	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Low, Service=Min, 3rd position derived"					
HBFJ4	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Low, Service=Min, 4th position derived"					
HBFJ5	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Low, Service=Min, 2nd & 3rd positions derived"					
HBFJ6	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Low, Service=Min, 3rd & 4th positions derived"					
HBFJ7	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Low, Service=Min, 2nd & 4th positions derived"					
HBFJ8	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Low, Service=Min, all positions derived"					
HBFK1	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Low, Service=Low, all positions computed"					
HBFK2	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Low, Service=Low, 2nd position derived"					
HBFK3	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Low, Service=Low, 3rd position derived"					
HBFK4	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Low, Service=Low, 4th position derived"					
HBFK5	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Low, Service=Low, 2nd & 3rd positions derived"					
HBFK6	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Low, Service=Low, 3rd & 4th positions derived"					
HBFK7	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Low, Service=Low, 2nd & 4th positions derived"					
HBFK8	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Low, Service=Low, all positions derived"					
HBFL1	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Low, Service=Mod, all positions computed"					
HBFL2	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Low, Service=Mod, 2nd position derived"					
HBFL3	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Low, Service=Mod, 3rd position derived"					
HBFL4	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Low, Service=Mod, 4th position derived"					
HBFL5	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Low, Service=Mod, 2nd & 3rd positions derived"					
HBFL6	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Low, Service=Mod, 3rd & 4th positions derived"					
HBFL7	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Low, Service=Mod, 2nd & 4th positions derived"					
HBFL8	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Low, Service=Mod, all positions derived"					
HBFM1	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Low, Service=High, all positions computed"					
HBFM2	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Low, Service=High, 2nd position derived"					
HBFM3	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Low, Service=High, 3rd position derived"					
HBFM4	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Low, Service=High, 4th position derived"					
HBFM5	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Low, Service=High, 2nd & 3rd positions derived"					
HBFM6	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Low, Service=High, 3rd & 4th positions derived"					
HBFM7	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Low, Service=High, 2nd & 4th positions derived"					
HBFM8	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Low, Service=High, all positions derived"					
HBGJ1	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Mod, Service=Min, all positions computed"					
HBGJ2	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Mod, Service=Min, 2nd position derived"					
HBGJ3	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Mod, Service=Min, 3rd position derived"					
HBGJ4	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Mod, Service=Min, 4th position derived"					
HBGJ5	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Mod, Service=Min, 2nd & 3rd positions derived"					
HBGJ6	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Mod, Service=Min, 3rd & 4th positions derived"					
HBGJ7	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Mod, Service=Min, 2nd & 4th positions derived"					
HBGJ8	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Mod, Service=Min, all positions derived"					
HBGK1	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Mod, Service=Low, all positions computed"					
HBGK2	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Mod, Service=Low, 2nd position derived"					
HBGK3	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Mod, Service=Low, 3rd position derived"					
HBGK4	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Mod, Service=Low, 4th position derived"					
HBGK5	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Mod, Service=Low, 2nd & 3rd positions derived"					
HBGK6	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Mod, Service=Low, 3rd & 4th positions derived"					
HBGK7	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Mod, Service=Low, 2nd & 4th positions derived"					
HBGK8	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Mod, Service=Low, all positions derived"					
HBGL1	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Mod, Service=Mod, all positions computed"					
HBGL2	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Mod, Service=Mod, 2nd position derived"					
HBGL3	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Mod, Service=Mod, 3rd position derived"					
HBGL4	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Mod, Service=Mod, 4th position derived"					
HBGL5	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Mod, Service=Mod, 2nd & 3rd positions derived"					
HBGL6	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Mod, Service=Mod, 3rd & 4th positions derived"					
HBGL7	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Mod, Service=Mod, 2nd & 4th positions derived"					
HBGL8	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Mod, Service=Mod, all positions derived"					
HBGM1	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Mod, Service=High, all positions computed"					
HBGM2	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Mod, Service=High, 2nd position derived"					
HBGM3	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Mod, Service=High, 3rd position derived"					
HBGM4	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Mod, Service=High, 4th position derived"					
HBGM5	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Mod, Service=High, 2nd & 3rd positions derived"					
HBGM6	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Mod, Service=High, 3rd & 4th positions derived"					
HBGM7	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Mod, Service=High, 2nd & 4th positions derived"					
HBGM8	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Mod, Service=High, all positions derived"					
HBHJ1	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=High, Service=Min, all positions computed"					
HBHJ2	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=High, Service=Min, 2nd position derived"					
HBHJ3	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=High, Service=Min, 3rd position derived"					
HBHJ4	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=High, Service=Min, 4th position derived"					
HBHJ5	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=High, Service=Min, 2nd & 3rd positions derived"					
HBHJ6	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=High, Service=Min, 3rd & 4th positions derived"					
HBHJ7	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=High, Service=Min, 2nd & 4th positions derived"					
HBHJ8	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=High, Service=Min, all positions derived"					
HBHK1	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=High, Service=Low, all positions computed"					
HBHK2	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=High, Service=Low, 2nd position derived"					
HBHK3	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=High, Service=Low, 3rd position derived"					
HBHK4	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=High, Service=Low, 4th position derived"					
HBHK5	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=High, Service=Low, 2nd & 3rd positions derived"					
HBHK6	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=High, Service=Low, 3rd & 4th positions derived"					
HBHK7	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=High, Service=Low, 2nd & 4th positions derived"					
HBHK8	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=High, Service=Low, all positions derived"					
HBHL1	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=High, Service=Mod, all positions computed"					
HBHL2	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=High, Service=Mod, 2nd position derived"					
HBHL3	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=High, Service=Mod, 3rd position derived"					
HBHL4	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=High, Service=Mod, 4th position derived"					
HBHL5	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=High, Service=Mod, 2nd & 3rd positions derived"					
HBHL6	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=High, Service=Mod, 3rd & 4th positions derived"					
HBHL7	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=High, Service=Mod, 2nd & 4th positions derived"					
HBHL8	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=High, Service=Mod, all positions derived"					
HBHM1	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=High, Service=High, all positions computed"					
HBHM2	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=High, Service=High, 2nd position derived"					
HBHM3	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=High, Service=High, 3rd position derived"					
HBHM4	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=High, Service=High, 4th position derived"					
HBHM5	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=High, Service=High, 2nd & 3rd positions derived"					
HBHM6	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=High, Service=High, 3rd & 4th positions derived"					
HBHM7	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=High, Service=High, 2nd & 4th positions derived"					
HBHM8	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=High, Service=High, all positions derived"					
HBIJ1	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Max, Service=Min, all positions computed"					
HBIJ2	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Max, Service=Min, 2nd position derived"					
HBIJ3	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Max, Service=Min, 3rd position derived"					
HBIJ4	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Max, Service=Min, 4th position derived"					
HBIJ5	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Max, Service=Min, 2nd & 3rd positions derived"					
HBIJ6	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Max, Service=Min, 3rd & 4th positions derived"					
HBIJ7	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Max, Service=Min, 2nd & 4th positions derived"					
HBIJ8	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Max, Service=Min, all positions derived"					
HBIK1	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Max, Service=Low, all positions computed"					
HBIK2	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Max, Service=Low, 2nd position derived"					
HBIK3	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Max, Service=Low, 3rd position derived"					
HBIK4	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Max, Service=Low, 4th position derived"					
HBIK5	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Max, Service=Low, 2nd & 3rd positions derived"					
HBIK6	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Max, Service=Low, 3rd & 4th positions derived"					
HBIK7	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Max, Service=Low, 2nd & 4th positions derived"					
HBIK8	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Max, Service=Low, all positions derived"					
HBIL1	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Max, Service=Mod, all positions computed"					
HBIL2	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Max, Service=Mod, 2nd position derived"					
HBIL3	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Max, Service=Mod, 3rd position derived"					
HBIL4	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Max, Service=Mod, 4th position derived"					
HBIL5	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Max, Service=Mod, 2nd & 3rd positions derived"					
HBIL6	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Max, Service=Mod, 3rd & 4th positions derived"					
HBIL7	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Max, Service=Mod, 2nd & 4th positions derived"					
HBIL8	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Max, Service=Mod, all positions derived"					
HBIM1	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Max, Service=High, all positions computed"					
HBIM2	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Max, Service=High, 2nd position derived"					
HBIM3	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Max, Service=High, 3rd position derived"					
HBIM4	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Max, Service=High, 4th position derived"					
HBIM5	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Max, Service=High, 2nd & 3rd positions derived"					
HBIM6	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Max, Service=High, 3rd & 4th positions derived"					
HBIM7	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Max, Service=High, 2nd & 4th positions derived"					
HBIM8	10/01/00	12/31/07	HHA	"Clinical=Low, Functional=Max, Service=High, all positions derived"					
HCEJ1	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Min, Service=Min, all positions computed"					
HCEJ2	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Min, Service=Min, 2nd position derived"					
HCEJ3	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Min, Service=Min, 3rd position derived"					
HCEJ4	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Min, Service=Min, 4th position derived"					
HCEJ5	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Min, Service=Min, 2nd & 3rd positions derived"					
HCEJ6	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Min, Service=Min, 3rd & 4th positions derived"					
HCEJ7	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Min, Service=Min, 2nd & 4th positions derived"					
HCEJ8	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Min, Service=Min, all positions derived"					
HCEK1	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Min, Service=Low, all positions computed"					
HCEK2	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Min, Service=Low, 2nd position derived"					
HCEK3	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Min, Service=Low, 3rd position derived"					
HCEK4	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Min, Service=Low, 4th position derived"					
HCEK5	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Min, Service=Low, 2nd & 3rd positions derived"					
HCEK6	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Min, Service=Low, 3rd & 4th positions derived"					
HCEK7	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Min, Service=Low, 2nd & 4th positions derived"					
HCEK8	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Min, Service=Low, all positions derived"					
HCEL1	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Min, Service=Mod, all positions computed"					
HCEL2	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Min, Service=Mod, 2nd position derived"					
HCEL3	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Min, Service=Mod, 3rd position derived"					
HCEL4	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Min, Service=Mod, 4th position derived"					
HCEL5	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Min, Service=Mod, 2nd & 3rd positions derived"					
HCEL6	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Min, Service=Mod, 3rd & 4th positions derived"					
HCEL7	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Min, Service=Mod, 2nd & 4th positions derived"					
HCEL8	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Min, Service=Mod, all positions derived"					
HCEM1	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Min, Service=High, all positions computed"					
HCEM2	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Min, Service=High, 2nd position derived"					
HCEM3	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Min, Service=High, 3rd position derived"					
HCEM4	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Min, Service=High, 4th position derived"					
HCEM5	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Min, Service=High, 2nd & 3rd positions derived"					
HCEM6	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Min, Service=High, 3rd & 4th positions derived"					
HCEM7	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Min, Service=High, 2nd & 4th positions derived"					
HCEM8	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Min, Service=High, all positions derived"					
HCFJ1	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Low, Service=Min, all positions computed"					
HCFJ2	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Low, Service=Min, 2nd position derived"					
HCFJ3	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Low, Service=Min, 3rd position derived"					
HCFJ4	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Low, Service=Min, 4th position derived"					
HCFJ5	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Low, Service=Min, 2nd & 3rd positions derived"					
HCFJ6	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Low, Service=Min, 3rd & 4th positions derived"					
HCFJ7	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Low, Service=Min, 2nd & 4th positions derived"					
HCFJ8	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Low, Service=Min, all positions derived"					
HCFK1	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Low, Service=Low, all positions computed"					
HCFK2	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Low, Service=Low, 2nd position derived"					
HCFK3	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Low, Service=Low, 3rd position derived"					
HCFK4	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Low, Service=Low, 4th position derived"					
HCFK5	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Low, Service=Low, 2nd & 3rd positions derived"					
HCFK6	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Low, Service=Low, 3rd & 4th positions derived"					
HCFK7	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Low, Service=Low, 2nd & 4th positions derived"					
HCFK8	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Low, Service=Low, all positions derived"					
HCFL1	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Low, Service=Mod, all positions computed"					
HCFL2	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Low, Service=Mod, 2nd position derived"					
HCFL3	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Low, Service=Mod, 3rd position derived"					
HCFL4	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Low, Service=Mod, 4th position derived"					
HCFL5	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Low, Service=Mod, 2nd & 3rd positions derived"					
HCFL6	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Low, Service=Mod, 3rd & 4th positions derived"					
HCFL7	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Low, Service=Mod, 2nd & 4th positions derived"					
HCFL8	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Low, Service=Mod, all positions derived"					
HCFM1	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Low, Service=High, all positions computed"					
HCFM2	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Low, Service=High, 2nd position derived"					
HCFM3	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Low, Service=High, 3rd position derived"					
HCFM4	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Low, Service=High, 4th position derived"					
HCFM5	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Low, Service=High, 2nd & 3rd positions derived"					
HCFM6	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Low, Service=High, 3rd & 4th positions derived"					
HCFM7	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Low, Service=High, 2nd & 4th positions derived"					
HCFM8	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Low, Service=High, all positions derived"					
HCGJ1	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Mod, Service=Min, all positions computed"					
HCGJ2	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Mod, Service=Min, 2nd position derived"					
HCGJ3	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Mod, Service=Min, 3rd position derived"					
HCGJ4	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Mod, Service=Min, 4th position derived"					
HCGJ5	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Mod, Service=Min, 2nd & 3rd positions derived"					
HCGJ6	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Mod, Service=Min, 3rd & 4th positions derived"					
HCGJ7	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Mod, Service=Min, 2nd & 4th positions derived"					
HCGJ8	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Mod, Service=Min, all positions derived"					
HCGK1	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Mod, Service=Low, all positions computed"					
HCGK2	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Mod, Service=Low, 2nd position derived"					
HCGK3	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Mod, Service=Low, 3rd position derived"					
HCGK4	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Mod, Service=Low, 4th position derived"					
HCGK5	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Mod, Service=Low, 2nd & 3rd positions derived"					
HCGK6	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Mod, Service=Low, 3rd & 4th positions derived"					
HCGK7	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Mod, Service=Low, 2nd & 4th positions derived"					
HCGK8	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Mod, Service=Low, all positions derived"					
HCGL1	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Mod, Service=Mod, all positions computed"					
HCGL2	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Mod, Service=Mod, 2nd position derived"					
HCGL3	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Mod, Service=Mod, 3rd position derived"					
HCGL4	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Mod, Service=Mod, 4th position derived"					
HCGL5	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Mod, Service=Mod, 2nd & 3rd positions derived"					
HCGL6	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Mod, Service=Mod, 3rd & 4th positions derived"					
HCGL7	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Mod, Service=Mod, 2nd & 4th positions derived"					
HCGL8	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Mod, Service=Mod, all positions derived"					
HCGM1	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Mod, Service=High, all positions computed"					
HCGM2	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Mod, Service=High, 2nd position derived"					
HCGM3	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Mod, Service=High, 3rd position derived"					
HCGM4	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Mod, Service=High, 4th position derived"					
HCGM5	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Mod, Service=High, 2nd & 3rd positions derived"					
HCGM6	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Mod, Service=High, 3rd & 4th positions derived"					
HCGM7	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Mod, Service=High, 2nd & 4th positions derived"					
HCGM8	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Mod, Service=High, all positions derived"					
HCHJ1	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=High, Service=Min, all positions computed"					
HCHJ2	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=High, Service=Min, 2nd position derived"					
HCHJ3	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=High, Service=Min, 3rd position derived"					
HCHJ4	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=High, Service=Min, 4th position derived"					
HCHJ5	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=High, Service=Min, 2nd & 3rd positions derived"					
HCHJ6	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=High, Service=Min, 3rd & 4th positions derived"					
HCHJ7	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=High, Service=Min, 2nd & 4th positions derived"					
HCHJ8	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=High, Service=Min, all positions derived"					
HCHK1	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=High, Service=Low, all positions computed"					
HCHK2	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=High, Service=Low, 2nd position derived"					
HCHK3	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=High, Service=Low, 3rd position derived"					
HCHK4	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=High, Service=Low, 4th position derived"					
HCHK5	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=High, Service=Low, 2nd & 3rd positions derived"					
HCHK6	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=High, Service=Low, 3rd & 4th positions derived"					
HCHK7	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=High, Service=Low, 2nd & 4th positions derived"					
HCHK8	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=High, Service=Low, all positions derived"					
HCHL1	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=High, Service=Mod, all positions computed"					
HCHL2	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=High, Service=Mod, 2nd position derived"					
HCHL3	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=High, Service=Mod, 3rd position derived"					
HCHL4	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=High, Service=Mod, 4th position derived"					
HCHL5	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=High, Service=Mod, 2nd & 3rd positions derived"					
HCHL6	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=High, Service=Mod, 3rd & 4th positions derived"					
HCHL7	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=High, Service=Mod, 2nd & 4th positions derived"					
HCHL8	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=High, Service=Mod, all positions derived"					
HCHM1	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=High, Service=High, all positions computed"					
HCHM2	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=High, Service=High, 2nd position derived"					
HCHM3	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=High, Service=High, 3rd position derived"					
HCHM4	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=High, Service=High, 4th position derived"					
HCHM5	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=High, Service=High, 2nd & 3rd positions derived"					
HCHM6	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=High, Service=High, 3rd & 4th positions derived"					
HCHM7	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=High, Service=High, 2nd & 4th positions derived"					
HCHM8	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=High, Service=High, all positions derived"					
HCIJ1	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Max, Service=Min, all positions computed"					
HCIJ2	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Max, Service=Min, 2nd position derived"					
HCIJ3	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Max, Service=Min, 3rd position derived"					
HCIJ4	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Max, Service=Min, 4th position derived"					
HCIJ5	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Max, Service=Min, 2nd & 3rd positions derived"					
HCIJ6	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Max, Service=Min, 3rd & 4th positions derived"					
HCIJ7	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Max, Service=Min, 2nd & 4th positions derived"					
HCIJ8	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Max, Service=Min, all positions derived"					
HCIK1	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Max, Service=Low, all positions computed"					
HCIK2	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Max, Service=Low, 2nd position derived"					
HCIK3	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Max, Service=Low, 3rd position derived"					
HCIK4	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Max, Service=Low, 4th position derived"					
HCIK5	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Max, Service=Low, 2nd & 3rd positions derived"					
HCIK6	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Max, Service=Low, 3rd & 4th positions derived"					
HCIK7	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Max, Service=Low, 2nd & 4th positions derived"					
HCIK8	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Max, Service=Low, all positions derived"					
HCIL1	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Max, Service=Mod, all positions computed"					
HCIL2	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Max, Service=Mod, 2nd position derived"					
HCIL3	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Max, Service=Mod, 3rd position derived"					
HCIL4	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Max, Service=Mod, 4th position derived"					
HCIL5	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Max, Service=Mod, 2nd & 3rd positions derived"					
HCIL6	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Max, Service=Mod, 3rd & 4th positions derived"					
HCIL7	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Max, Service=Mod, 2nd & 4th positions derived"					
HCIL8	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Max, Service=Mod, all positions derived"					
HCIM1	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Max, Service=High, all positions computed"					
HCIM2	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Max, Service=High, 2nd position derived"					
HCIM3	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Max, Service=High, 3rd position derived"					
HCIM4	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Max, Service=High, 4th position derived"					
HCIM5	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Max, Service=High, 2nd & 3rd positions derived"					
HCIM6	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Max, Service=High, 3rd & 4th positions derived"					
HCIM7	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Max, Service=High, 2nd & 4th positions derived"					
HCIM8	10/01/00	12/31/07	HHA	"Clinical=Mod, Functional=Max, Service=High, all positions derived"					
HDEJ1	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Min, Service=Min, all positions computed"					
HDEJ2	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Min, Service=Min, 2nd position derived"					
HDEJ3	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Min, Service=Min, 3rd position derived"					
HDEJ4	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Min, Service=Min, 4th position derived"					
HDEJ5	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Min, Service=Min, 2nd & 3rd positions derived"					
HDEJ6	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Min, Service=Min, 3rd & 4th positions derived"					
HDEJ7	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Min, Service=Min, 2nd & 4th positions derived"					
HDEJ8	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Min, Service=Min, all positions derived"					
HDEK1	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Min, Service=Low, all positions computed"					
HDEK2	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Min, Service=Low, 2nd position derived"					
HDEK3	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Min, Service=Low, 3rd position derived"					
HDEK4	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Min, Service=Low, 4th position derived"					
HDEK5	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Min, Service=Low, 2nd & 3rd positions derived"					
HDEK6	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Min, Service=Low, 3rd & 4th positions derived"					
HDEK7	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Min, Service=Low, 2nd & 4th positions derived"					
HDEK8	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Min, Service=Low, all positions derived"					
HDEL1	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Min, Service=Mod, all positions computed"					
HDEL2	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Min, Service=Mod, 2nd position derived"					
HDEL3	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Min, Service=Mod, 3rd position derived"					
HDEL4	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Min, Service=Mod, 4th position derived"					
HDEL5	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Min, Service=Mod, 2nd & 3rd positions derived"					
HDEL6	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Min, Service=Mod, 3rd & 4th positions derived"					
HDEL7	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Min, Service=Mod, 2nd & 4th positions derived"					
HDEL8	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Min, Service=Mod, all positions derived"					
HDEM1	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Min, Service=High, all positions computed"					
HDEM2	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Min, Service=High, 2nd position derived"					
HDEM3	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Min, Service=High, 3rd position derived"					
HDEM4	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Min, Service=High, 4th position derived"					
HDEM5	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Min, Service=High, 2nd & 3rd positions derived"					
HDEM6	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Min, Service=High, 3rd & 4th positions derived"					
HDEM7	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Min, Service=High, 2nd & 4th positions derived"					
HDEM8	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Min, Service=High, all positions derived"					
HDFJ1	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Low, Service=Min, all positions computed"					
HDFJ2	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Low, Service=Min, 2nd position derived"					
HDFJ3	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Low, Service=Min, 3rd position derived"					
HDFJ4	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Low, Service=Min, 4th position derived"					
HDFJ5	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Low, Service=Min, 2nd & 3rd positions derived"					
HDFJ6	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Low, Service=Min, 3rd & 4th positions derived"					
HDFJ7	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Low, Service=Min, 2nd & 4th positions derived"					
HDFJ8	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Low, Service=Min, all positions derived"					
HDFK1	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Low, Service=Low, all positions computed"					
HDFK2	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Low, Service=Low, 2nd position derived"					
HDFK3	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Low, Service=Low, 3rd position derived"					
HDFK4	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Low, Service=Low, 4th position derived"					
HDFK5	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Low, Service=Low, 2nd & 3rd positions derived"					
HDFK6	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Low, Service=Low, 3rd & 4th positions derived"					
HDFK7	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Low, Service=Low, 2nd & 4th positions derived"					
HDFK8	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Low, Service=Low, all positions derived"					
HDFL1	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Low, Service=Mod, all positions computed"					
HDFL2	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Low, Service=Mod, 2nd position derived"					
HDFL3	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Low, Service=Mod, 3rd position derived"					
HDFL4	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Low, Service=Mod, 4th position derived"					
HDFL5	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Low, Service=Mod, 2nd & 3rd positions derived"					
HDFL6	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Low, Service=Mod, 3rd & 4th positions derived"					
HDFL7	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Low, Service=Mod, 2nd & 4th positions derived"					
HDFL8	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Low, Service=Mod, all positions derived"					
HDFM1	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Low, Service=High, all positions computed"					
HDFM2	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Low, Service=High, 2nd position derived"					
HDFM3	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Low, Service=High, 3rd position derived"					
HDFM4	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Low, Service=High, 4th position derived"					
HDFM5	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Low, Service=High, 2nd & 3rd positions derived"					
HDFM6	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Low, Service=High, 3rd & 4th positions derived"					
HDFM7	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Low, Service=High, 2nd & 4th positions derived"					
HDFM8	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Low, Service=High, all positions derived"					
HDGJ1	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Mod, Service=Min, all positions computed"					
HDGJ2	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Mod, Service=Min, 2nd position derived"					
HDGJ3	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Mod, Service=Min, 3rd position derived"					
HDGJ4	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Mod, Service=Min, 4th position derived"					
HDGJ5	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Mod, Service=Min, 2nd & 3rd positions derived"					
HDGJ6	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Mod, Service=Min, 3rd & 4th positions derived"					
HDGJ7	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Mod, Service=Min, 2nd & 4th positions derived"					
HDGJ8	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Mod, Service=Min, all positions derived"					
HDGK1	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Mod, Service=Low, all positions computed"					
HDGK2	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Mod, Service=Low, 2nd position derived"					
HDGK3	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Mod, Service=Low, 3rd position derived"					
HDGK4	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Mod, Service=Low, 4th position derived"					
HDGK5	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Mod, Service=Low, 2nd & 3rd positions derived"					
HDGK6	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Mod, Service=Low, 3rd & 4th positions derived"					
HDGK7	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Mod, Service=Low, 2nd & 4th positions derived"					
HDGK8	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Mod, Service=Low, all positions derived"					
HDGL1	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Mod, Service=Mod, all positions computed"					
HDGL2	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Mod, Service=Mod, 2nd position derived"					
HDGL3	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Mod, Service=Mod, 3rd position derived"					
HDGL4	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Mod, Service=Mod, 4th position derived"					
HDGL5	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Mod, Service=Mod, 2nd & 3rd positions derived"					
HDGL6	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Mod, Service=Mod, 3rd & 4th positions derived"					
HDGL7	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Mod, Service=Mod, 2nd & 4th positions derived"					
HDGL8	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Mod, Service=Mod, all positions derived"					
HDGM1	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Mod, Service=High, all positions computed"					
HDGM2	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Mod, Service=High, 2nd position derived"					
HDGM3	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Mod, Service=High, 3rd position derived"					
HDGM4	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Mod, Service=High, 4th position derived"					
HDGM5	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Mod, Service=High, 2nd & 3rd positions derived"					
HDGM6	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Mod, Service=High, 3rd & 4th positions derived"					
HDGM7	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Mod, Service=High, 2nd & 4th positions derived"					
HDGM8	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Mod, Service=High, all positions derived"					
HDHJ1	10/01/00	12/31/07	HHA	"Clinical=High, Functional=High, Service=Min, all positions computed"					
HDHJ2	10/01/00	12/31/07	HHA	"Clinical=High, Functional=High, Service=Min, 2nd position derived"					
HDHJ3	10/01/00	12/31/07	HHA	"Clinical=High, Functional=High, Service=Min, 3rd position derived"					
HDHJ4	10/01/00	12/31/07	HHA	"Clinical=High, Functional=High, Service=Min, 4th position derived"					
HDHJ5	10/01/00	12/31/07	HHA	"Clinical=High, Functional=High, Service=Min, 2nd & 3rd positions derived"					
HDHJ6	10/01/00	12/31/07	HHA	"Clinical=High, Functional=High, Service=Min, 3rd & 4th positions derived"					
HDHJ7	10/01/00	12/31/07	HHA	"Clinical=High, Functional=High, Service=Min, 2nd & 4th positions derived"					
HDHJ8	10/01/00	12/31/07	HHA	"Clinical=High, Functional=High, Service=Min, all positions derived"					
HDHK1	10/01/00	12/31/07	HHA	"Clinical=High, Functional=High, Service=Low, all positions computed"					
HDHK2	10/01/00	12/31/07	HHA	"Clinical=High, Functional=High, Service=Low, 2nd position derived"					
HDHK3	10/01/00	12/31/07	HHA	"Clinical=High, Functional=High, Service=Low, 3rd position derived"					
HDHK4	10/01/00	12/31/07	HHA	"Clinical=High, Functional=High, Service=Low, 4th position derived"					
HDHK5	10/01/00	12/31/07	HHA	"Clinical=High, Functional=High, Service=Low, 2nd & 3rd positions derived"					
HDHK6	10/01/00	12/31/07	HHA	"Clinical=High, Functional=High, Service=Low, 3rd & 4th positions derived"					
HDHK7	10/01/00	12/31/07	HHA	"Clinical=High, Functional=High, Service=Low, 2nd & 4th positions derived"					
HDHK8	10/01/00	12/31/07	HHA	"Clinical=High, Functional=High, Service=Low, all positions derived"					
HDHL1	10/01/00	12/31/07	HHA	"Clinical=High, Functional=High, Service=Mod, all positions computed"					
HDHL2	10/01/00	12/31/07	HHA	"Clinical=High, Functional=High, Service=Mod, 2nd position derived"					
HDHL3	10/01/00	12/31/07	HHA	"Clinical=High, Functional=High, Service=Mod, 3rd position derived"					
HDHL4	10/01/00	12/31/07	HHA	"Clinical=High, Functional=High, Service=Mod, 4th position derived"					
HDHL5	10/01/00	12/31/07	HHA	"Clinical=High, Functional=High, Service=Mod, 2nd & 3rd positions derived"					
HDHL6	10/01/00	12/31/07	HHA	"Clinical=High, Functional=High, Service=Mod, 3rd & 4th positions derived"					
HDHL7	10/01/00	12/31/07	HHA	"Clinical=High, Functional=High, Service=Mod, 2nd & 4th positions derived"					
HDHL8	10/01/00	12/31/07	HHA	"Clinical=High, Functional=High, Service=Mod, all positions derived"					
HDHM1	10/01/00	12/31/07	HHA	"Clinical=High, Functional=High, Service=High, all positions computed"					
HDHM2	10/01/00	12/31/07	HHA	"Clinical=High, Functional=High, Service=High, 2nd position derived"					
HDHM3	10/01/00	12/31/07	HHA	"Clinical=High, Functional=High, Service=High, 3rd position derived"					
HDHM4	10/01/00	12/31/07	HHA	"Clinical=High, Functional=High, Service=High, 4th position derived"					
HDHM5	10/01/00	12/31/07	HHA	"Clinical=High, Functional=High, Service=High, 2nd & 3rd positions derived"					
HDHM6	10/01/00	12/31/07	HHA	"Clinical=High, Functional=High, Service=High, 3rd & 4th positions derived"					
HDHM7	10/01/00	12/31/07	HHA	"Clinical=High, Functional=High, Service=High, 2nd & 4th positions derived"					
HDHM8	10/01/00	12/31/07	HHA	"Clinical=High, Functional=High, Service=High, all positions derived"					
HDIJ1	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Max, Service=Min, all positions computed"					
HDIJ2	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Max, Service=Min, 2nd position derived"					
HDIJ3	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Max, Service=Min, 3rd position derived"					
HDIJ4	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Max, Service=Min, 4th position derived"					
HDIJ5	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Max, Service=Min, 2nd & 3rd positions derived"					
HDIJ6	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Max, Service=Min, 3rd & 4th positions derived"					
HDIJ7	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Max, Service=Min, 2nd & 4th positions derived"					
HDIJ8	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Max, Service=Min, all positions derived"					
HDIK1	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Max, Service=Low, all positions computed"					
HDIK2	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Max, Service=Low, 2nd position derived"					
HDIK3	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Max, Service=Low, 3rd position derived"					
HDIK4	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Max, Service=Low, 4th position derived"					
HDIK5	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Max, Service=Low, 2nd & 3rd positions derived"					
HDIK6	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Max, Service=Low, 3rd & 4th positions derived"					
HDIK7	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Max, Service=Low, 2nd & 4th positions derived"					
HDIK8	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Max, Service=Low, all positions derived"					
HDIL1	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Max, Service=Mod, all positions computed"					
HDIL2	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Max, Service=Mod, 2nd position derived"					
HDIL3	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Max, Service=Mod, 3rd position derived"					
HDIL4	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Max, Service=Mod, 4th position derived"					
HDIL5	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Max, Service=Mod, 2nd & 3rd positions derived"					
HDIL6	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Max, Service=Mod, 3rd & 4th positions derived"					
HDIL7	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Max, Service=Mod, 2nd & 4th positions derived"					
HDIL8	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Max, Service=Mod, all positions derived"					
HDIM1	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Max, Service=High, all positions computed"					
HDIM2	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Max, Service=High, 2nd position derived"					
HDIM3	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Max, Service=High, 3rd position derived"					
HDIM4	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Max, Service=High, 4th position derived"					
HDIM5	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Max, Service=High, 2nd & 3rd positions derived"					
HDIM6	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Max, Service=High, 3rd & 4th positions derived"					
HDIM7	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Max, Service=High, 2nd & 4th positions derived"					
HDIM8	10/01/00	12/31/07	HHA	"Clinical=High, Functional=Max, Service=High, all positions derived"					
A0101	01/01/02		IRF	"Stroke with Motor >51.05.,without comorbidities"					
B0101	01/01/02		IRF	"Stroke with Motor >51.05.,comorbidity in tier 1"					
C0101	01/01/02		IRF	"Stroke with Motor >51.05.,comorbidity in tier 2"					
D0101	01/01/02		IRF	"Stroke with Motor >51.05.,comorbidity in tier 3"					
A0102	01/01/02		IRF	"Stroke with Motor >44.45 & Motor <51.05 & Cognitive >18.5.,without comorbidities"					
B0102	01/01/02		IRF	"Stroke with Motor >44.45 & Motor <51.05 & Cognitive >18.5.,comorbidity in tier 1"					
C0102	01/01/02		IRF	"Stroke with Motor >44.45 & Motor <51.05 & Cognitive >18.5.,comorbidity in tier 2"					
D0102	01/01/02		IRF	"Stroke with Motor >44.45 & Motor <51.05 & Cognitive >18.5.,comorbidity in tier 3"					
A0103	01/01/02		IRF	"Stroke with Motor >44.45 & Motor <51.05 & Cognitive <18.5.,without comorbidities"					
B0103	01/01/02		IRF	"Stroke with Motor >44.45 & Motor <51.05 & Cognitive <18.5.,comorbidity in tier 1"					
C0103	01/01/02		IRF	"Stroke with Motor >44.45 & Motor <51.05 & Cognitive <18.5.,comorbidity in tier 2"					
D0103	01/01/02		IRF	"Stroke with Motor >44.45 & Motor <51.05 & Cognitive <18.5.,comorbidity in tier 3"					
A0104	01/01/02		IRF	"Stroke with Motor >38.85 & Motor <44.45.,without comorbidities"					
B0104	01/01/02		IRF	"Stroke with Motor >38.85 & Motor <44.45.,comorbidity in tier 1"					
C0104	01/01/02		IRF	"Stroke with Motor >38.85 & Motor <44.45.,comorbidity in tier 2"					
D0104	01/01/02		IRF	"Stroke with Motor >38.85 & Motor <44.45.,comorbidity in tier 3"					
A0105	01/01/02		IRF	"Stroke with Motor >34.25 & Motor <38.85.,without comorbidities"					
B0105	01/01/02		IRF	"Stroke with Motor >34.25 & Motor <38.85.,comorbidity in tier 1"					
C0105	01/01/02		IRF	"Stroke with Motor >34.25 & Motor <38.85.,comorbidity in tier 2"					
D0105	01/01/02		IRF	"Stroke with Motor >34.25 & Motor <38.85.,comorbidity in tier 3"					
A0106	01/01/02		IRF	"Stroke with Motor >30.05 & Motor <34.25.,without comorbidities"					
B0106	01/01/02		IRF	"Stroke with Motor >30.05 & Motor <34.25.,comorbidity in tier 1"					
C0106	01/01/02		IRF	"Stroke with Motor >30.05 & Motor <34.25.,comorbidity in tier 2"					
D0106	01/01/02		IRF	"Stroke with Motor >30.05 & Motor <34.25.,comorbidity in tier 3"					
A0107	01/01/02		IRF	"Stroke with Motor >26.15 & Motor <30.05.,without comorbidities"					
B0107	01/01/02		IRF	"Stroke with Motor >26.15 & Motor <30.05.,comorbidity in tier 1"					
C0107	01/01/02		IRF	"Stroke with Motor >26.15 & Motor <30.05.,comorbidity in tier 2"					
D0107	01/01/02		IRF	"Stroke with Motor >26.15 & Motor <30.05.,comorbidity in tier 3"					
A0108	01/01/02		IRF	"Stroke with Motor <26.15 & Age >84.5, without comorbidities"					
B0108	01/01/02		IRF	"Stroke with Motor <26.15 & Age >84.5, comorbidity in tier 1"					
C0108	01/01/02		IRF	"Stroke with Motor <26.15 & Age >84.5, comorbidity in tier 2"					
D0108	01/01/02		IRF	"Stroke with Motor <26.15 & Age >84.5, comorbidity in tier 3"					
A0109	01/01/02		IRF	"Stroke with Motor >22.35 & Motor <26.15 & Age <84.5, without comorbidities"					
B0109	01/01/02		IRF	"Stroke with Motor >22.35 & Motor <26.15 & Age <84.5,comorbidity in tier 1"					
C0109	01/01/02		IRF	"Stroke with Motor >22.35 & Motor <26.15 & Age <84.5,comorbidity in tier 2"					
D0109	01/01/02		IRF	"Stroke with Motor >22.35 & Motor <26.15 & Age <84.5,comorbidity in tier 3"					
A0110	01/01/02		IRF	"Stroke with Motor <22.35 & Age <84.5, without comorbidities"					
B0110	01/01/02		IRF	"Stroke with Motor <22.35 & Age <84.5, comorbidity in tier 1"					
C0110	01/01/02		IRF	"Stroke with Motor <22.35 & Age <84.5, comorbidity in tier 2"					
D0110	01/01/02		IRF	"Stroke with Motor <22.35 & Age <84.5, comorbidity in tier 3"					
A0111	01/01/02	09/30/05	IRF	"Stroke with motor score from 27 33 and patient is between 82 and 88 years old, without comorbidities"					
B0111	01/01/02	09/30/05	IRF	"Stroke with motor score from 27 33 and patient is between 82 and 88 years old, comorbidity in tier 1"					
C0111	01/01/02	09/30/05	IRF	"Stroke with motor score from 27 33 and patient is between 82 and 88 years old, comorbidity in tier 2"					
D0111	01/01/02	09/30/05	IRF	"Stroke with motor score from 27 33 and patient is between 82 and 88 years old, comorbidity in tier 3"					
A0112	01/01/02	09/30/05	IRF	"Stroke with motor score from 12 26 and patient is between 82 and 88 years old, without comorbidities"					
B0112	01/01/02	09/30/05	IRF	"Stroke with motor score from 12 26 and patient is between 82 and 88 years old, comorbidity in tier 1"					
C0112	01/01/02	09/30/05	IRF	"Stroke with motor score from 12 26 and patient is between 82 and 88 years old, comorbidity in tier 2"					
D0112	01/01/02	09/30/05	IRF	"Stroke with motor score from 12 26 and patient is between 82 and 88 years old, comorbidity in tier 3"					
A0113	01/01/02	09/30/05	IRF	"Stroke with motor score from 27 33 and patient is 81 years old or younger, without comorbidities"					
B0113	01/01/02	09/30/05	IRF	"Stroke with motor score from 27 33 and patient is 81 years old or younger,comorbidity in tier 1"					
C0113	01/01/02	09/30/05	IRF	"Stroke with motor score from 27 33 and patient is 81 years old or younger,comorbidity in tier 2"					
D0113	01/01/02	09/30/05	IRF	"Stroke with motor score from 27 33 and patient is 81 years old or younger,comorbidity in tier 3"					
A0114	01/01/02	09/30/05	IRF	"Stroke with motor score from 12 26 and patient is 81 years old or younger, without comorbidities"					
B0114	01/01/02	09/30/05	IRF	"Stroke with motor score from 12 26 and patient is 81 years old or younger,comorbidity in tier 1"					
C0114	01/01/02	09/30/05	IRF	"Stroke with motor score from 12 26 and patient is 81 years old or younger,comorbidity in tier 2"					
D0114	01/01/02	09/30/05	IRF	"Stroke with motor score from 12 26 and patient is 81 years old or younger,comorbidity in tier 3"					
A0201	01/01/02		IRF	"Traumatic brain injury with Motor >53.35 & Cognitive >23.5.,without comorbidities"					
B0201	01/01/02		IRF	"Traumatic brain injury with Motor >53.35 & Cognitive >23.5.,comorbidity in tier 1"					
C0201	01/01/02		IRF	"Traumatic brain injury with Motor >53.35 & Cognitive >23.5.,comorbidity in tier 2"					
D0201	01/01/02		IRF	"Traumatic brain injury with Motor >53.35 & Cognitive >23.5.,comorbidity in tier 3"					
A0202	01/01/02		IRF	"Traumatic brain injury with Motor >44.25 & Motor <53.35 & Cognitive >23.5.,without comorbidities"					
B0202	01/01/02		IRF	"Traumatic brain injury with Motor >44.25 & Motor <53.35 & Cognitive >23.5.,comorbidity in tier 1"					
C0202	01/01/02		IRF	"Traumatic brain injury with Motor >44.25 & Motor <53.35 & Cognitive >23.5.,comorbidity in tier 2"					
D0202	01/01/02		IRF	"Traumatic brain injury with Motor >44.25 & Motor <53.35 & Cognitive >23.5.,comorbidity in tier 3"					
A0203	01/01/02		IRF	"Traumatic brain injury with Motor >44.25 & Cognitive <23.5.,without comorbidities"					
B0203	01/01/02		IRF	"Traumatic brain injury with Motor >44.25 & Cognitive <23.5.,comorbidity in tier 1"					
C0203	01/01/02		IRF	"Traumatic brain injury with Motor >44.25 & Cognitive <23.5.,comorbidity in tier 2"					
D0203	01/01/02		IRF	"Traumatic brain injury with Motor >44.25 & Cognitive <23.5.,comorbidity in tier 3"					
A0204	01/01/02		IRF	"Traumatic brain injury with Motor >40.65 & Motor <44.25.,without comorbidities"					
B0204	01/01/02		IRF	"Traumatic brain injury with Motor >40.65 & Motor <44.25.,comorbidity in tier 1"					
C0204	01/01/02		IRF	"Traumatic brain injury with Motor >40.65 & Motor <44.25.,comorbidity in tier 2"					
D0204	01/01/02		IRF	"Traumatic brain injury with Motor >40.65 & Motor <44.25.,comorbidity in tier 3"					
A0205	01/01/02		IRF	"Traumatic brain injury with Motor >28.75 & Motor <40.65.,without comorbidities"					
B0205	01/01/02		IRF	"Traumatic brain injury with Motor >28.75 & Motor <40.65.,comorbidity in tier 1"					
C0205	01/01/02		IRF	"Traumatic brain injury with Motor >28.75 & Motor <40.65.,comorbidity in tier 2"					
D0205	01/01/02		IRF	"Traumatic brain injury with Motor >28.75 & Motor <40.65.,comorbidity in tier 3"					
A0206	10/01/05		IRF	"Traumatic brain injury with Motor >22.05 & Motor <28.75.,without comorbidities"					
B0206	10/01/05		IRF	"Traumatic brain injury with Motor >22.05 & Motor <28.75.,comorbidity in tier 1"					
C0206	10/01/05		IRF	"Traumatic brain injury with Motor >22.05 & Motor <28.75.,comorbidity in tier 2"					
D0206	10/01/05		IRF	"Traumatic brain injury with Motor >22.05 & Motor <28.75.,comorbidity in tier 3"					
A0207	10/01/05		IRF	"Traumatic brain injury with Motor <22.05.,without comorbidities"					
B0207	10/01/05		IRF	"Traumatic brain injury with Motor <22.05.,comorbidity in tier 1"					
C0207	10/01/05		IRF	"Traumatic brain injury with Motor <22.05.,comorbidity in tier 2"					
D0207	10/01/05		IRF	"Traumatic brain injury with Motor <22.05.,comorbidity in tier 3"					
A0301	01/01/02		IRF	"Non-traumatic brain injury with Motor >41.05.,without comorbidities"					
B0301	01/01/02		IRF	"Non-traumatic brain injury with Motor >41.05.,comorbidity in tier 1"					
C0301	01/01/02		IRF	"Non-traumatic brain injury with Motor >41.05.,comorbidity in tier 2"					
D0301	01/01/02		IRF	"Non-traumatic brain injury with Motor >41.05.,comorbidity in tier 3"					
A0302	01/01/02		IRF	"Non-traumatic brain injury with Motor >35.05 & Motor <41.05.,without comorbidities"					
B0302	01/01/02		IRF	"Non-traumatic brain injury with Motor >35.05 & Motor <41.05.,comorbidity in tier 1"					
C0302	01/01/02		IRF	"Non-traumatic brain injury with Motor >35.05 & Motor <41.05.,comorbidity in tier 2"					
D0302	01/01/02		IRF	"Non-traumatic brain injury with Motor >35.05 & Motor <41.05.,comorbidity in tier 3"					
A0303	01/01/02		IRF	"Non-traumatic brain injury with Motor >26.15 & Motor <35.05.,without comorbidities"					
B0303	01/01/02		IRF	"Non-traumatic brain injury with Motor >26.15 & Motor <35.05.,comorbidity in tier 1"					
C0303	01/01/02		IRF	"Non-traumatic brain injury with Motor >26.15 & Motor <35.050.,comorbidity in tier 2"					
D0303	01/01/02		IRF	"Non-traumatic brain injury with Motor >26.15 & Motor <35.05.,comorbidity in tier 3"					
A0304	01/01/02		IRF	"Non-traumatic brain injury with Motor <26.15.,without comorbidities"					
B0304	01/01/02		IRF	"Non-traumatic brain injury with Motor <26.15.,comorbidity in tier 1"					
C0304	01/01/02		IRF	"Non-traumatic brain injury with Motor <26.15.,comorbidity in tier 2"					
D0304	01/01/02		IRF	"Non-traumatic brain injury with Motor <26.15.,comorbidity in tier 3"					
A0401	01/01/02		IRF	"Traumatic spinal cord injury with Motor >48.45.,without comorbidities"					
B0401	01/01/02		IRF	"Traumatic spinal cord injury with Motor >48.45.,comorbidity in tier 1"					
C0401	01/01/02		IRF	"Traumatic spinal cord injury with Motor >48.45.,comorbidity in tier 2"					
D0401	01/01/02		IRF	"Traumatic spinal cord injury with Motor >48.45.,comorbidity in tier 3"					
A0402	01/01/02		IRF	"Traumatic spinal cord injury with Motor >30.35 & Motor <48.45.,without comorbidities"					
B0402	01/01/02		IRF	"Traumatic spinal cord injury with Motor >30.35 & Motor <48.45.,comorbidity in tier 1"					
C0402	01/01/02		IRF	"Traumatic spinal cord injury with Motor >30.35 & Motor <48.45.,comorbidity in tier 2"					
D0402	01/01/02		IRF	"Traumatic spinal cord injury with Motor >30.35 & Motor <48.45.,comorbidity in tier 3"					
A0403	01/01/02		IRF	"Traumatic spinal cord injury with Motor >16.05 & Motor <30.35.,without comorbidities"					
B0403	01/01/02		IRF	"Traumatic spinal cord injury with Motor >16.05 & Motor <30.35.,comorbidity in tier 1"					
C0403	01/01/02		IRF	"Traumatic spinal cord injury with Motor >16.05 & Motor <30.35.,comorbidity in tier 2"					
D0403	01/01/02		IRF	"Traumatic spinal cord injury with Motor >16.05 & Motor <30.35.,comorbidity in tier 3"					
A0404	01/01/02		IRF	"Traumatic spinal cord injury with Motor <16.05 & Age >63.5.,without comorbidities"					
B0404	01/01/02		IRF	"Traumatic spinal cord injury with Motor <16.05 & Age >63.5.,comorbidity in tier 1"					
C0404	01/01/02		IRF	"Traumatic spinal cord injury with Motor <16.05 & Age >63.5.,comorbidity in tier 2"					
D0404	01/01/02		IRF	"Traumatic spinal cord injury with Motor <16.05 & Age >63.5.,comorbidity in tier 3"					
A0405	10/01/05		IRF	"Traumatic spinal cord injury with Motor <16.05 & Age <63.5.,without comorbidities"					
B0405	10/01/05		IRF	"Traumatic spinal cord injury with Motor <16.05 & Age <63.5.,comorbidity in tier 1"					
C0405	10/01/05		IRF	"Traumatic spinal cord injury with Motor <16.05 & Age <63.5.,comorbidity in tier 2"					
D0405	10/01/05		IRF	"Traumatic spinal cord injury with Motor <16.05 & Age <63.5.,comorbidity in tier 3"					
A0501	01/01/02		IRF	"Non-traumatic spinal cord injury with Motor >51.35.,without comorbidities"					
B0501	01/01/02		IRF	"Non-traumatic spinal cord injury with Motor >51.35.,comorbidity in tier 1"					
C0501	01/01/02		IRF	"Non-traumatic spinal cord injury with Motor >51.35.,comorbidity in tier 2"					
D0501	01/01/02		IRF	"Non-traumatic spinal cord injury with Motor >51.35.,comorbidity in tier 3"					
A0502	01/01/02		IRF	"Non-traumatic spinal cord injury with Motor >40.15 & Motor <51.35.,without comorbidities"					
B0502	01/01/02		IRF	"Non-traumatic spinal cord injury with Motor >40.15 & Motor <51.35.,comorbidity in tier 1"					
C0502	01/01/02		IRF	"Non-traumatic spinal cord injury with Motor >40.15 & Motor <51.35.,comorbidity in tier 2"					
D0502	01/01/02		IRF	"Non-traumatic spinal cord injury with Motor >40.15 & Motor <51.35.,comorbidity in tier 3"					
A0503	01/01/02		IRF	"Non-traumatic spinal cord injury with Motor >31.25 & Motor <40.15.,without comorbidities"					
B0503	01/01/02		IRF	"Non-traumatic spinal cord injury with Motor >31.25 & Motor <40.15.,comorbidity in tier 1"					
C0503	01/01/02		IRF	"Non-traumatic spinal cord injury with Motor >31.25 & Motor <40.15.,comorbidity in tier 2"					
D0503	01/01/02		IRF	"Non-traumatic spinal cord injury with Motor >31.25 & Motor <40.15.,comorbidity in tier 3"					
A0504	01/01/02		IRF	"Non-traumatic spinal cord injury with Motor >29.25 & Motor <31.25.,without comorbidities"					
B0504	01/01/02		IRF	"Non-traumatic spinal cord injury with Motor >29.25 & Motor <31.25.,comorbidity in tier 1"					
C0504	01/01/02		IRF	"Non-traumatic spinal cord injury with Motor >29.25 & Motor <31.25.,comorbidity in tier 2"					
D0504	01/01/02		IRF	"Non-traumatic spinal cord injury with Motor >29.25 & Motor <31.25.,comorbidity in tier 3"					
A0505	01/01/02		IRF	"Non-traumatic spinal cord injury with Motor >23.75 & Motor <29.25.,without comorbidities"					
B0505	01/01/02		IRF	"Non-traumatic spinal cord injury with Motor >23.75 & Motor <29.25.,comorbidity in tier 1"					
C0505	01/01/02		IRF	"Non-traumatic spinal cord injury with Motor >23.75 & Motor <29.25.,comorbidity in tier 2"					
D0505	01/01/02		IRF	"Non-traumatic spinal cord injury with Motor >23.75 & Motor <29.25.,comorbidity in tier 3"					
A0506	10/01/05		IRF	"Non-traumatic spinal cord injury with Motor <23.75.,without comorbidities"					
B0506	10/01/05		IRF	"Non-traumatic spinal cord injury with Motor <23.75.,comorbidity in tier 1"					
C0506	10/01/05		IRF	"Non-traumatic spinal cord injury with Motor <23.75.,comorbidity in tier 2"					
D0506	10/01/05		IRF	"Non-traumatic spinal cord injury with Motor <23.75.,comorbidity in tier 3"					
A0601	01/01/02		IRF	"Neurological with Motor >47.75.,without comorbidities"					
B0601	01/01/02		IRF	"Neurological with Motor >47.75.,comorbidity in tier 1"					
C0601	01/01/02		IRF	"Neurological with Motor >47.75.,comorbidity in tier 2"					
D0601	01/01/02		IRF	"Neurological with Motor >47.75.,comorbidity in tier 3"					
A0602	01/01/02		IRF	"Neurological with Motor >37.35 & Motor <47.75.,without comorbidities"					
B0602	01/01/02		IRF	"Neurological with Motor >37.35 & Motor <47.75.,comorbidity in tier 1"					
C0602	01/01/02		IRF	"Neurological with Motor >37.35 & Motor <47.75.,comorbidity in tier 2"					
D0602	01/01/02		IRF	"Neurological with Motor >37.35 & Motor <47.75.,comorbidity in tier 3"					
A0603	01/01/02		IRF	"Neurological with Motor >25.85 & Motor <37.35.,without comorbidities"					
B0603	01/01/02		IRF	"Neurological with Motor >25.85 & Motor <37.35.,comorbidity in tier 1"					
C0603	01/01/02		IRF	"Neurological with Motor >25.85 & Motor <37.35.,comorbidity in tier 2"					
D0603	01/01/02		IRF	"Neurological with Motor >25.85 & Motor <37.35.,comorbidity in tier 3"					
A0604	01/01/02		IRF	"Neurological with Motor <25.85.,without comorbidities"					
B0604	01/01/02		IRF	"Neurological with Motor <25.85.,comorbidity in tier 1"					
C0604	01/01/02		IRF	"Neurological with Motor <25.85.,comorbidity in tier 2"					
D0604	01/01/02		IRF	"Neurological with Motor <25.85.,comorbidity in tier 3"					
A0701	01/01/02		IRF	"Fracture of lower extremity with Motor >42.15.,without comorbidities"					
B0701	01/01/02		IRF	"Fracture of lower extremity with Motor >42.15.,comorbidity in tier 1"					
C0701	01/01/02		IRF	"Fracture of lower extremity with Motor >42.15.,comorbidity in tier 2"					
D0701	01/01/02		IRF	"Fracture of lower extremity with Motor >42.15.,comorbidity in tier 3"					
A0702	01/01/02		IRF	"Fracture of lower extremity with Motor >34.15 & Motor <42.15.,without comorbidities"					
B0702	01/01/02		IRF	"Fracture of lower extremity with Motor >34.15 & Motor <42.15.,comorbidity in tier 1"					
C0702	01/01/02		IRF	"Fracture of lower extremity with Motor >34.15 & Motor <42.15.,comorbidity in tier 2"					
D0702	01/01/02		IRF	"Fracture of lower extremity with Motor >34.15 & Motor <42.15.,comorbidity in tier 3"					
A0703	01/01/02		IRF	"Fracture of lower extremity with Motor >28.15 & Motor <34.15.,without comorbidities"					
B0703	01/01/02		IRF	"Fracture of lower extremity with Motor >28.15 & Motor <34.15.,comorbidity in tier 1"					
C0703	01/01/02		IRF	"Fracture of lower extremity with Motor >28.15 & Motor <34.15.,comorbidity in tier 2"					
D0703	01/01/02		IRF	"Fracture of lower extremity with Motor >28.15 & Motor <34.15.,comorbidity in tier 3"					
A0704	01/01/02		IRF	"Fracture of lower extremity with Motor <28.15.,without comorbidities"					
B0704	01/01/02		IRF	"Fracture of lower extremity with Motor <28.15.,comorbidity in tier 1"					
C0704	01/01/02		IRF	"Fracture of lower extremity with Motor <28.15.,comorbidity in tier 2"					
D0704	01/01/02		IRF	"Fracture of lower extremity with Motor <28.15.,comorbidity in tier 3"					
A0705	01/01/02	09/30/05	IRF	"Fracture of lower extremity with motor score from 12 37.,without comorbidities"					
B0705	01/01/02	09/30/05	IRF	"Fracture of lower extremity with motor score from 12 37.,comorbidity in tier 1"					
C0705	01/01/02	09/30/05	IRF	"Fracture of lower extremity with motor score from 12 37.,comorbidity in tier 2"					
D0705	01/01/02	09/30/05	IRF	"Fracture of lower extremity with motor score from 12 37.,comorbidity in tier 3"					
A0801	01/01/02		IRF	"Replacement of lower extremity joint with Motor >49.55.,without comorbidities"					
B0801	01/01/02		IRF	"Replacement of lower extremity joint with Motor >49.55.,comorbidity in tier 1"					
C0801	01/01/02		IRF	"Replacement of lower extremity joint with Motor >49.55.,comorbidity in tier 2"					
D0801	01/01/02		IRF	"Replacement of lower extremity joint with Motor >49.55.,comorbidity in tier 3"					
A0802	01/01/02		IRF	"Replacement of lower extremity joint with Motor >37.05 & Motor <49.55.,without comorbidities"					
B0802	01/01/02		IRF	"Replacement of lower extremity joint with Motor >37.05 & Motor <49.55.,comorbidity in tier 1"					
C0802	01/01/02		IRF	"Replacement of lower extremity joint with Motor >37.05 & Motor <49.55.,comorbidity in tier 2"					
D0802	01/01/02		IRF	"Replacement of lower extremity joint with Motor >37.05 & Motor <49.55.,comorbidity in tier 3"					
A0803	01/01/02		IRF	"Replacement of lower extremity joint with Motor >28.65 & Motor <37.05 & Age >83.5.,without comorbidities"					
B0803	01/01/02		IRF	"Replacement of lower extremity joint with Motor >28.65 & Motor <37.05 & Age >83.5.,comorbidity in tier 1"					
C0803	01/01/02		IRF	"Replacement of lower extremity joint with Motor >28.65 & Motor <37.05 & Age >83.5.,comorbidity in tier 2"					
D0803	01/01/02		IRF	"Replacement of lower extremity joint with Motor >28.65 & Motor <37.05 & Age >83.5.,comorbidity in tier 3"					
A0804	01/01/02		IRF	"Replacement of lower extremity joint with Motor >28.65 & Motor <37.05 & Age <83.5.,without comorbidities"					
B0804	01/01/02		IRF	"Replacement of lower extremity joint with Motor >28.65 & Motor <37.05 & Age <83.5.,comorbidity in tier 1"					
C0804	01/01/02		IRF	"Replacement of lower extremity joint with Motor >28.65 & Motor <37.05 & Age <83.5.,comorbidity in tier 2"					
D0804	01/01/02		IRF	"Replacement of lower extremity joint with Motor >28.65 & Motor <37.05 & Age <83.5.,comorbidity in tier 3"					
A0805	01/01/02		IRF	"Replacement of lower extremity joint with Motor >22.05 & Motor <28.65.,without comorbidities"					
B0805	01/01/02		IRF	"Replacement of lower extremity joint with Motor >22.05 & Motor <28.65.,comorbidity in tier 1"					
C0805	01/01/02		IRF	"Replacement of lower extremity joint with Motor >22.05 & Motor <28.65.,comorbidity in tier 2"					
D0805	01/01/02		IRF	"Replacement of lower extremity joint with Motor >22.05 & Motor <28.65.,comorbidity in tier 3"					
A0806	01/01/02		IRF	"Replacement of lower extremity joint with Motor <22.05.,without comorbidities"					
B0806	01/01/02		IRF	"Replacement of lower extremity joint with Motor <22.05.,comorbidity in tier 1"					
C0806	01/01/02		IRF	"Replacement of lower extremity joint with Motor <22.05.,comorbidity in tier 2"					
D0806	01/01/02		IRF	"Replacement of lower extremity joint with Motor <22.05.,comorbidity in tier 3"					
A0901	01/01/02		IRF	"Other orthopedic with Motor >44.75.,without comorbidities"					
B0901	01/01/02		IRF	"Other orthopedic with Motor >44.75.,comorbidity in tier 1"					
C0901	01/01/02		IRF	"Other orthopedic with Motor >44.75.,comorbidity in tier 2"					
D0901	01/01/02		IRF	"Other orthopedic with Motor >44.75.,comorbidity in tier 3"					
A0902	01/01/02		IRF	"Other orthopedic with Motor >34.35 & Motor <44.75.,without comorbidities"					
B0902	01/01/02		IRF	"Other orthopedic with Motor >34.35 & Motor <44.75.,comorbidity in tier 1"					
C0902	01/01/02		IRF	"Other orthopedic with Motor >34.35 & Motor <44.75.,comorbidity in tier 2"					
D0902	01/01/02		IRF	"Other orthopedic with Motor >34.35 & Motor <44.75.,comorbidity in tier 3"					
A0903	01/01/02		IRF	"Other orthopedic with Motor >24.15 & Motor <34.35.,without comorbidities"					
B0903	01/01/02		IRF	"Other orthopedic with Motor >24.15 & Motor <34.35.,comorbidity in tier 1"					
C0903	01/01/02		IRF	"Other orthopedic with Motor >24.15 & Motor <34.35.,comorbidity in tier 2"					
D0903	01/01/02		IRF	"Other orthopedic with Motor >24.15 & Motor <34.35.,comorbidity in tier 3"					
A0904	01/01/02		IRF	"Other orthopedic with Motor <24.15.,without comorbidities"					
B0904	01/01/02		IRF	"Other orthopedic with Motor <24.15.,comorbidity in tier 1"					
C0904	01/01/02		IRF	"Other orthopedic with Motor <24.15.,comorbidity in tier 2"					
D0904	01/01/02		IRF	"Other orthopedic with Motor <24.15.,comorbidity in tier 3"					
A1001	01/01/02		IRF	"Amputation, lower extremity with Motor >47.65.,without comorbidities"					
B1001	01/01/02		IRF	"Amputation, lower extremity with Motor >47.65.,comorbidity in tier 1"					
C1001	01/01/02		IRF	"Amputation, lower extremity with Motor >47.65.,comorbidity in tier 2"					
D1001	01/01/02		IRF	"Amputation, lower extremity with Motor >47.65.,comorbidity in tier 3"					
A1002	01/01/02		IRF	"Amputation, lower extremity with Motor >36.25 & Motor <47.65.,without comorbidities"					
B1002	01/01/02		IRF	"Amputation, lower extremity with Motor >36.25 & Motor <47.65.,comorbidity in tier 1"					
C1002	01/01/02		IRF	"Amputation, lower extremity with Motor >36.25 & Motor <47.65.,comorbidity in tier 2"					
D1002	01/01/02		IRF	"Amputation, lower extremity with Motor >36.25 & Motor <47.65.,comorbidity in tier 3"					
A1003	01/01/02		IRF	"Amputation, lower extremity with Motor <36.25.,without comorbidities"					
B1003	01/01/02		IRF	"Amputation, lower extremity with Motor <36.25.,comorbidity in tier 1"					
C1003	01/01/02		IRF	"Amputation, lower extremity with Motor <36.25.,comorbidity in tier 2"					
D1003	01/01/02		IRF	"Amputation, lower extremity with Motor <36.25.,comorbidity in tier 3"					
A1004	01/01/02	09/30/05	IRF	"Amputation, lower extremity with motor score from 39 45.,without comorbidities"					
B1004	01/01/02	09/30/05	IRF	"Amputation, lower extremity with motor score from 39 45.,comorbidity in tier 1"					
C1004	01/01/02	09/30/05	IRF	"Amputation, lower extremity with motor score from 39 45.,comorbidity in tier 2"					
D1004	01/01/02	09/30/05	IRF	"Amputation, lower extremity with motor score from 39 45.,comorbidity in tier 3"					
A1005	01/01/02	09/30/05	IRF	"Amputation, lower extremity with motor score from 12 38.,without comorbidities"					
B1005	01/01/02	09/30/05	IRF	"Amputation, lower extremity with motor score from 12 38.,comorbidity in tier 1"					
C1005	01/01/02	09/30/05	IRF	"Amputation, lower extremity with motor score from 12 38.,comorbidity in tier 2"					
D1005	01/01/02	09/30/05	IRF	"Amputation, lower extremity with motor score from 12 38.,comorbidity in tier 3"					
A1101	01/01/02		IRF	"Amputation, other extremity with Motor >36.35.,without comorbidities"					
B1101	01/01/02		IRF	"Amputation, other extremity with Motor >36.35.,comorbidity in tier 1"					
C1101	01/01/02		IRF	"Amputation, other extremity with Motor >36.35.,comorbidity in tier 2"					
D1101	01/01/02		IRF	"Amputation, other extremity with Motor >36.35.,comorbidity in tier 3"					
A1102	01/01/02		IRF	"Amputation, other extremity with Motor <36.35.,without comorbidities"					
B1102	01/01/02		IRF	"Amputation, other extremity with Motor <36.35.,comorbidity in tier 1"					
C1102	01/01/02		IRF	"Amputation, other extremity with Motor <36.35.,comorbidity in tier 2"					
D1102	01/01/02		IRF	"Amputation, other extremity with Motor <36.35.,comorbidity in tier 3"					
A1103	01/01/02	09/30/05	IRF	"Lower-lower extremity with motor score from 12 37.,without comorbidities"					
B1103	01/01/02	09/30/05	IRF	"Lower-lower extremity with motor score from 12 37.,comorbidity in tier 1"					
C1103	01/01/02	09/30/05	IRF	"Lower-lower extremity with motor score from 12 37.,comorbidity in tier 2"					
D1103	01/01/02	09/30/05	IRF	"Lower-lower extremity with motor score from 12 37.,comorbidity in tier 3"					
A1201	01/01/02		IRF	"Osteoarthritis with Motor >37.65.,without comorbidities"					
B1201	01/01/02		IRF	"Osteoarthritis with Motor >37.65.,comorbidity in tier 1"					
C1201	01/01/02		IRF	"Osteoarthritis with Motor >37.65.,comorbidity in tier 2"					
D1201	01/01/02		IRF	"Osteoarthritis with Motor >37.65.,comorbidity in tier 3"					
A1202	01/01/02		IRF	"Osteoarthritis with Motor >30.75 & Motor <37.65.,without comorbidities"					
B1202	01/01/02		IRF	"Osteoarthritis with Motor >30.75 & Motor <37.65.,comorbidity in tier 1"					
C1202	01/01/02		IRF	"Osteoarthritis with Motor >30.75 & Motor <37.65.,comorbidity in tier 2"					
D1202	01/01/02		IRF	"Osteoarthritis with Motor >30.75 & Motor <37.65.,comorbidity in tier 3"					
A1203	01/01/02		IRF	"Osteoarthritis with Motor <30.75.,without comorbidities"					
B1203	01/01/02		IRF	"Osteoarthritis with Motor <30.75.,comorbidity in tier 1"					
C1203	01/01/02		IRF	"Osteoarthritis with Motor <30.75.,comorbidity in tier 2"					
D1203	01/01/02		IRF	"Osteoarthritis with Motor <30.75.,comorbidity in tier 3"					
A1204	01/01/02	09/30/05	IRF	"Osteoarthritis with motor score from 39 47.,without comorbidities"					
B1204	01/01/02	09/30/05	IRF	"Osteoarthritis with motor score from 39 47.,comorbidity in tier 1"					
C1204	01/01/02	09/30/05	IRF	"Osteoarthritis with motor score from 39 47.,comorbidity in tier 2"					
D1204	01/01/02	09/30/05	IRF	"Osteoarthritis with motor score from 39 47.,comorbidity in tier 3"					
A1205	01/01/02	09/30/05	IRF	"Osteoarthritis with motor score from 12 38.,without comorbidities"					
B1205	01/01/02	09/30/05	IRF	"Osteoarthritis with motor score from 12 38.,comorbidity in tier 1"					
C1205	01/01/02	09/30/05	IRF	"Osteoarthritis with motor score from 12 38.,comorbidity in tier 2"					
D1205	01/01/02	09/30/05	IRF	"Osteoarthritis with motor score from 12 38.,comorbidity in tier 3"					
A1301	01/01/02		IRF	"Rheumatoid, other arthritis with Motor >36.35.,without comorbidities"					
B1301	01/01/02		IRF	"Rheumatoid, other arthritis with Motor >36.35.,comorbidity in tier 1"					
C1301	01/01/02		IRF	"Rheumatoid, other arthritis with Motor >36.35.,comorbidity in tier 2"					
D1301	01/01/02		IRF	"Rheumatoid, other arthritis with Motor >36.35.,comorbidity in tier 3"					
A1302	01/01/02		IRF	"Rheumatoid, other arthritis with Motor >26.15 & Motor <36.35.,without comorbidities"					
B1302	01/01/02		IRF	"Rheumatoid, other arthritis with Motor >26.15 & Motor <36.35.,comorbidity in tier 1"					
C1302	01/01/02		IRF	"Rheumatoid, other arthritis with Motor >26.15 & Motor <36.35.,comorbidity in tier 2"					
D1302	01/01/02		IRF	"Rheumatoid, other arthritis with Motor >26.15 & Motor <36.35.,comorbidity in tier 3"					
A1303	01/01/02		IRF	"Rheumatoid, other arthritis with Motor <26.15.,without comorbidities"					
B1303	01/01/02		IRF	"Rheumatoid, other arthritis with Motor <26.15.,comorbidity in tier 1"					
C1303	01/01/02		IRF	"Rheumatoid, other arthritis with Motor <26.15.,comorbidity in tier 2"					
D1303	01/01/02		IRF	"Rheumatoid, other arthritis with Motor <26.15.,comorbidity in tier 3"					
A1304	01/01/02	09/30/05	IRF	"Rheumatoid, other arthritis with motor score from 12 35.,without comorbidities"					
B1304	01/01/02	09/30/05	IRF	"Rheumatoid, other arthritis with motor score from 12 35.,comorbidity in tier 1"					
C1304	01/01/02	09/30/05	IRF	"Rheumatoid, other arthritis with motor score from 12 35.,comorbidity in tier 2"					
D1304	01/01/02	09/30/05	IRF	"Rheumatoid, other arthritis with motor score from 12 35.,comorbidity in tier 3"					
A1401	01/01/02		IRF	"Cardiac with Motor >48.85.,without comorbidities"					
B1401	01/01/02		IRF	"Cardiac with Motor >48.85.,comorbidity in tier 1"					
C1401	01/01/02		IRF	"Cardiac with Motor >48.85.,comorbidity in tier 2"					
D1401	01/01/02		IRF	"Cardiac with Motor >48.85.,comorbidity in tier 3"					
A1402	01/01/02		IRF	"Cardiac with Motor >38.55 & Motor <48.85.,without comorbidities"					
B1402	01/01/02		IRF	"Cardiac with Motor >38.55 & Motor <48.85.,comorbidity in tier 1"					
C1402	01/01/02		IRF	"Cardiac with Motor >38.55 & Motor <48.85.,comorbidity in tier 2"					
D1402	01/01/02		IRF	"Cardiac with Motor >38.55 & Motor <48.85.,comorbidity in tier 3"					
A1403	01/01/02		IRF	"Cardiac with Motor >31.15 & Motor <38.55.,without comorbidities"					
B1403	01/01/02		IRF	"Cardiac with Motor >31.15 & Motor <38.55.,comorbidity in tier 1"					
C1403	01/01/02		IRF	"Cardiac with Motor >31.15 & Motor <38.55.,comorbidity in tier 2"					
D1403	01/01/02		IRF	"Cardiac with Motor >31.15 & Motor <38.55.,comorbidity in tier 3"					
A1404	01/01/02		IRF	"Cardiac with Motor <31.15.,without comorbidities"					
B1404	01/01/02		IRF	"Cardiac with Motor <31.15.,comorbidity in tier 1"					
C1404	01/01/02		IRF	"Cardiac with Motor <31.15.,comorbidity in tier 2"					
D1404	01/01/02		IRF	"Cardiac with Motor <31.15.,comorbidity in tier 3"					
A1501	01/01/02		IRF	"Pulmonary with Motor >49.25.,without comorbidities"					
B1501	01/01/02		IRF	"Pulmonary with Motor >49.25.,comorbidity in tier 1"					
C1501	01/01/02		IRF	"Pulmonary with Motor >49.25.,comorbidity in tier 2"					
D1501	01/01/02		IRF	"Pulmonary with Motor >49.25.,comorbidity in tier 3"					
A1502	01/01/02		IRF	"Pulmonary with Motor >39.05 & Motor <49.25.,without comorbidities"					
B1502	01/01/02		IRF	"Pulmonary with Motor >39.05 & Motor <49.25.,comorbidity in tier 1"					
C1502	01/01/02		IRF	"Pulmonary with Motor >39.05 & Motor <49.25.,comorbidity in tier 2"					
D1502	01/01/02		IRF	"Pulmonary with Motor >39.05 & Motor <49.25.,comorbidity in tier 3"					
A1503	01/01/02		IRF	"Pulmonary with Motor >29.15 & Motor <39.05.,without comorbidities"					
B1503	01/01/02		IRF	"Pulmonary with Motor >29.15 & Motor <39.05.,comorbidity in tier 1"					
C1503	01/01/02		IRF	"Pulmonary with Motor >29.15 & Motor <39.05.,comorbidity in tier 2"					
D1503	01/01/02		IRF	"Pulmonary with Motor >29.15 & Motor <39.05.,comorbidity in tier 3"					
A1504	01/01/02		IRF	"Pulmonary with Motor <29.15.,without comorbidities"					
B1504	01/01/02		IRF	"Pulmonary with Motor <29.15.,comorbidity in tier 1"					
C1504	01/01/02		IRF	"Pulmonary with Motor <29.15.,comorbidity in tier 2"					
D1504	01/01/02		IRF	"Pulmonary with Motor <29.15.,comorbidity in tier 3"					
A1601	01/01/02		IRF	"Pain syndrome with Motor >37.15.,without comorbidities"					
B1601	01/01/02		IRF	"Pain syndrome with Motor >37.15.,comorbidity in tier 1"					
C1601	01/01/02		IRF	"Pain syndrome with Motor >37.15.,comorbidity in tier 2"					
D1601	01/01/02		IRF	"Pain syndrome with Motor >37.15.,comorbidity in tier 3"					
A1602	01/01/02		IRF	"Pain syndrome with Motor >26.75 & Motor <37.15.,without comorbidities"					
B1602	01/01/02		IRF	"Pain syndrome with Motor >26.75 & Motor <37.15.,comorbidity in tier 1"					
C1602	01/01/02		IRF	"Pain syndrome with Motor >26.75 & Motor <37.15.,comorbidity in tier 2"					
D1602	01/01/02		IRF	"Pain syndrome with Motor >26.75 & Motor <37.15.,comorbidity in tier 3"					
A1603	10/01/05		IRF	"Pain syndrome with Motor <26.75.,without comorbidities"					
B1603	10/01/05		IRF	"Pain syndrome with Motor <26.75.,comorbidity in tier 1"					
C1603	10/01/05		IRF	"Pain syndrome with Motor <26.75.,comorbidity in tier 2"					
D1603	10/01/05		IRF	"Pain syndrome with Motor <26.75.,comorbidity in tier 3"					
A1701	01/01/02		IRF	"Major multiple trauma without brain or spinal cord injury with Motor >39.25.,without comorbidities"					
B1701	01/01/02		IRF	"Major multiple trauma without brain or spinal cord injury with Motor >39.25.,comorbidity in tier 1"					
C1701	01/01/02		IRF	"Major multiple trauma without brain or spinal cord injury with Motor >39.25.,comorbidity in tier 2"					
D1701	01/01/02		IRF	"Major multiple trauma without brain or spinal cord injury with Motor >39.25.,comorbidity in tier 3"					
A1702	01/01/02		IRF	"Major multiple trauma without brain or spinal cord injury with Motor >31.05 & Motor <39.25.,without comorbidities"					
B1702	01/01/02		IRF	"Major multiple trauma without brain or spinal cord injury with Motor >31.05 & Motor <39.25., comorbidity in tier 1"					
C1702	01/01/02		IRF	"Major multiple trauma without brain or spinal cord injury with Motor >31.05 & Motor <39.25., comorbidity in tier 2"					
D1702	01/01/02		IRF	"Major multiple trauma without brain or spinal cord injury with Motor >31.05 & Motor <39.25., comorbidity in tier 3"					
A1703	01/01/02		IRF	"Major multiple trauma without brain or spinal cord injury with Motor >25.55 & Motor <31.05.,       without comorbidities"					
B1703	01/01/02		IRF	"Major multiple trauma without brain or spinal cord injury with Motor >25.55 & Motor <31.05., comorbidity in tier 1"					
C1703	01/01/02		IRF	"Major multiple trauma without brain or spinal cord injury with Motor >25.55 & Motor <31.05., comorbidity in tier 2"					
D1703	01/01/02		IRF	"Major multiple trauma without brain or spinal cord injury with Motor >25.55 & Motor <31.05., comorbidity in tier 3"					
A1704	10/01/05		IRF	"Major multiple trauma without brain or spinal cord injury with Motor <25.55.,without comorbidities"					
B1704	10/01/05		IRF	"Major multiple trauma without brain or spinal cord injury with Motor <25.55.,comorbidity in tier 1"					
C1704	10/01/05		IRF	"Major multiple trauma without brain or spinal cord injury with Motor <25.55.,comorbidity in tier 2"					
D1704	10/01/05		IRF	"Major multiple trauma without brain or spinal cord injury with Motor <25.55.,comorbidity in tier 3"					
A1801	01/01/02		IRF	"Major multiple trauma with brain or spinal cord injury with Motor >40.85.,without comorbidities"					
B1801	01/01/02		IRF	"Major multiple trauma with brain or spinal cord injury with Motor >40.85.,comorbidity in tier 1"					
C1801	01/01/02		IRF	"Major multiple trauma with brain or spinal cord injury with Motor >40.85.,comorbidity in tier 2"					
D1801	01/01/02		IRF	"Major multiple trauma with brain or spinal cord injury with Motor >40.85.,comorbidity in tier 3"					
A1802	01/01/02		IRF	"Major multiple trauma with brain or spinal cord injury with Motor >23.05 & Motor <40.85.,without comorbidities"					
B1802	01/01/02		IRF	"Major multiple trauma with brain or spinal cord injury with Motor >23.05 & Motor <40.85.,comorbidity in tier 1"					
C1802	01/01/02		IRF	"Major multiple trauma with brain or spinal cord injury with Motor >23.05 & Motor <40.85.,comorbidity in tier 2"					
D1802	01/01/02		IRF	"Major multiple trauma with brain or spinal cord injury with Motor >23.05 & Motor <40.85.,comorbidity in tier 3"					
A1803	01/01/02		IRF	"Major multiple trauma with brain or spinal cord injury with Motor <23.05.,without comorbidities"					
B1803	01/01/02		IRF	"Major multiple trauma with brain or spinal cord injury with Motor <23.05.,comorbidity in tier 1"					
C1803	01/01/02		IRF	"Major multiple trauma with brain or spinal cord injury with Motor <23.05.,comorbidity in tier 2"					
D1803	01/01/02		IRF	"Major multiple trauma with brain or spinal cord injury with Motor <23.05.,comorbidity in tier 3"					
A1804	01/01/02	09/30/05	IRF	"Major multiple trauma with brain or spinal cord injury with motor score from 12 25.,without comorbidities"					
B1804	01/01/02	09/30/05	IRF	"Major multiple trauma with brain or spinal cord injury with motor score from 12 25.,comorbidity in tier 1"					
C1804	01/01/02	09/30/05	IRF	"Major multiple trauma with brain or spinal cord injury with motor score from 12 25.,comorbidity in tier 2"					
D1804	01/01/02	09/30/05	IRF	"Major multiple trauma with brain or spinal cord injury with motor score from 12 25.,comorbidity in tier 3"					
A1901	01/01/02		IRF	"Guillian Barre with Motor >35.95.,without comorbidities"					
B1901	01/01/02		IRF	"Guillian Barre with Motor >35.95.,comorbidity in tier 1"					
C1901	01/01/02		IRF	"Guillian Barre with Motor >35.95.,comorbidity in tier 2"					
D1901	01/01/02		IRF	"Guillian Barre with Motor >35.95.,comorbidity in tier 3"					
A1902	01/01/02		IRF	"Guillian Barre with Motor >18.05 & Motor <35.95.,without comorbidities"					
B1902	01/01/02		IRF	"Guillian Barre with Motor >18.05 & Motor <35.95.,comorbidity in tier 1"					
C1902	01/01/02		IRF	"Guillian Barre with Motor >18.05 & Motor <35.95.,comorbidity in tier 2"					
D1902	01/01/02		IRF	"Guillian Barre with Motor >18.05 & Motor <35.95.,comorbidity in tier 3"					
A1903	01/01/02		IRF	"Guillian Barre with Motor <18.05.,without comorbidities"					
B1903	01/01/02		IRF	"Guillian Barre with Motor <18.05.,comorbidity in tier 1"					
C1903	01/01/02		IRF	"Guillian Barre with Motor <18.05.,comorbidity in tier 2"					
D1903	01/01/02		IRF	"Guillian Barre with Motor <18.05.,comorbidity in tier 3"					
A2001	01/01/02		IRF	"Miscellaneous with Motor >49.15.,without comorbidities"					
B2001	01/01/02		IRF	"Miscellaneous with Motor >49.15.,comorbidity in tier 1"					
C2001	01/01/02		IRF	"Miscellaneous with Motor >49.15.,comorbidity in tier 2"					
D2001	01/01/02		IRF	"Miscellaneous with Motor >49.15.,comorbidity in tier 3"					
A2002	01/01/02		IRF	"Miscellaneous with Motor >38.75 & Motor <49.15.,without comorbidities"					
B2002	01/01/02		IRF	"Miscellaneous with Motor >38.75 & Motor <49.15.,comorbidity in tier 1"					
C2002	01/01/02		IRF	"Miscellaneous with Motor >38.75 & Motor <49.15.,comorbidity in tier 2"					
D2002	01/01/02		IRF	"Miscellaneous with Motor >38.75 & Motor <49.15.,comorbidity in tier 3"					
A2003	01/01/02		IRF	"Miscellaneous with Motor >27.85 & Motor <38.75.,without comorbidities"					
B2003	01/01/02		IRF	"Miscellaneous with Motor >27.85 & Motor <38.75.,comorbidity in tier 1"					
C2003	01/01/02		IRF	"Miscellaneous with Motor >27.85 & Motor <38.75.,comorbidity in tier 2"					
D2003	01/01/02		IRF	"Miscellaneous with Motor >27.85 & Motor <38.75.,comorbidity in tier 3"					
A2004	01/01/02		IRF	"Miscellaneous with Motor <27.85, without comorbidities"					
B2004	01/01/02		IRF	"Miscellaneous with Motor <27.85, comorbidity in tier 1"					
C2004	01/01/02		IRF	"Miscellaneous with Motor <27.85, comorbidity in tier 2"					
D2004	01/01/02		IRF	"Miscellaneous with Motor <27.85, comorbidity in tier 3"					
A2005	01/01/02	09/30/05	IRF	"Miscellaneous with motor score from 12 32 and patient is 81 years old or younger, without comorbidities"					
B2005	01/01/02	09/30/05	IRF	"Miscellaneous with motor score from 12 32 and patient is 81 years old or younger,comorbidity in tier 1"					
C2005	01/01/02	09/30/05	IRF	"Miscellaneous with motor score from 12 32 and patient is 81 years old or younger,comorbidity in tier 2"					
D2005	01/01/02	09/30/05	IRF	"Miscellaneous with motor score from 12 32 and patient is 81 years old or younger,comorbidity in tier 3"					
A2101	01/01/02		IRF	"Burns with Motor >0.,without comorbidities"					
B2101	01/01/02		IRF	"Burns with Motor >0.,comorbidity in tier 1"					
C2101	01/01/02		IRF	"Burns with Motor >0.,comorbidity in tier 2"					
D2101	01/01/02		IRF	"Burns with Motor >0.,comorbidity in tier 3"					
A2102	01/01/02	09/30/05	IRF	"Burns with motor score from 12 45.,without comorbidities"					
B2102	01/01/02	09/30/05	IRF	"Burns with motor score from 12 45.,comorbidity in tier 1"					
C2102	01/01/02	09/30/05	IRF	"Burns with motor score from 12 45.,comorbidity in tier 2"					
D2102	01/01/02	09/30/05	IRF	"Burns with motor score from 12 45.,comorbidity in tier 3"					
A5001	01/01/02		IRF	"Short-stay cases, length of stay is 3 days or fewer."					
A5101	01/01/02		IRF	"Expired, orthopedic, length of stay is 13 days or fewer."					
A5102	01/01/02		IRF	"Expired, orthopedic, length of stay is 14 days or more."					
A5103	01/01/02		IRF	"Expired, not orthopedic, length of stay is 15 days or fewer."					
A5104	01/01/02		IRF	"Expired, not orthopedic, length of stay is 16 days or more."					
A9999	10/01/05		IRF	Default Code - used for informational-only Managed Care claims.					
AAA00	07/01/98		SNF	"Default, /No PPS (or OBRA) assessment due to one of the following: Stay is less than 8 days, or SNF notified untimely of MSP denial, or SNF notified untimely of revocation of payment ban, beneficiary requested demand bill, SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
AAA01	10/01/10		SNF	"Default, /Stand-alone OBRA SCSA OR SCPA OR CCA."					
AAA02	10/01/10		SNF	"Default, /Stand-alone SOT OMRA (not Medicare short stay)."					
AAA03	10/01/10		SNF	"Default, /SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA."					
AAA04	10/01/10		SNF	"Default, /EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA."					
AAA05	10/01/10		SNF	"Default, /SOT OMRA (not Medicare short stay) AND EOT OMRA."					
AAA06	10/01/10		SNF	"Default, /SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
AAA07	10/01/10		SNF	"Default, /Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA. "					
AAA0A	10/01/11		SNF	"Default, /Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
AAA0B	10/01/11		SNF	"Default, /SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
AAA0C	10/01/11		SNF	"Default, /SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
AAA0D	10/01/11		SNF	"Default, /Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
AAA10	10/01/10		SNF	"Default, /5-day or readmission return. "					
AAA11	10/01/10		SNF	"Default, /5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
AAA12	10/01/10		SNF	"Default, /5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
AAA13	10/01/10		SNF	"Default, /5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
AAA14	10/01/10		SNF	"Default, /5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
AAA15	10/01/10		SNF	"Default, /5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
AAA16	10/01/10		SNF	"Default, /5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
AAA17	10/01/10		SNF	"Default, /5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
AAA1A	10/01/11		SNF	"Default, /PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
AAA1B	10/01/11		SNF	"Default, /PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
AAA1C	10/01/11		SNF	"Default, /PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
AAA20	10/01/10		SNF	"Default, /14-day. "					
AAA21	10/01/10		SNF	"Default, /14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
AAA22	10/01/10		SNF	"Default, /14-day AND SOT OMRA (not Medicare short stay)."					
AAA23	10/01/10		SNF	"Default, /14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND CCA. "					
AAA24	10/01/10		SNF	"Default, /14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
AAA25	10/01/10		SNF	"Default, /14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
AAA26	10/01/10		SNF	"Default, /14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
AAA2A	10/01/11		SNF	"Default, /PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
AAA2B	10/01/11		SNF	"Default, /PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
AAA2C	10/01/11		SNF	"Default, /PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
AAA2D	10/01/11		SNF	"Default, /PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
AAA30	10/01/10		SNF	"Default, /30-day. "					
AAA31	10/01/10		SNF	"Default, /30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
AAA32	10/01/10		SNF	"Default, /30-day AND SOT OMRA (not Medicare short stay)."					
AAA33	10/01/10		SNF	"Default, /30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND CCA."					
AAA34	10/01/10		SNF	"Default, /30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
AAA35	10/01/10		SNF	"Default, /30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
AAA36	10/01/10		SNF	"Default, /30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
AAA3A	10/01/11		SNF	"Default, /PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
AAA3B	10/01/11		SNF	"Default, /PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
AAA3C	10/01/11		SNF	"Default, /PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
AAA3D	10/01/11		SNF	"Default, /PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
AAA40	10/01/10		SNF	"Default, /60-day. "					
AAA41	10/01/10		SNF	"Default, /60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
AAA42	10/01/10		SNF	"Default, /60-day AND SOT OMRA (not Medicare short stay)."					
AAA43	10/01/10		SNF	"Default, /60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) AND CCA."					
AAA44	10/01/10		SNF	"Default, /60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
AAA45	10/01/10		SNF	"Default, /60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
AAA46	10/01/10		SNF	"Default, /60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
AAA4A	10/01/11		SNF	"Default, /PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
AAA4B	10/01/11		SNF	"Default, /PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
AAA4C	10/01/11		SNF	"Default, /PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
AAA4D	10/01/11		SNF	"Default, /PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
AAA50	10/01/10		SNF	"Default, /90-day. "					
AAA51	10/01/10		SNF	"Default, /90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
AAA52	10/01/10		SNF	"Default, /90-day AND SOT OMRA (not Medicare short stay)."					
AAA53	10/01/10		SNF	"Default, /90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND CCA. "					
AAA54	10/01/10		SNF	"Default, /90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
AAA55	10/01/10		SNF	"Default, /90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
AAA56	10/01/10		SNF	"Default, /90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
AAA5A	10/01/11		SNF	"Default, /PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
AAA5B	10/01/11		SNF	"Default, /PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
AAA5C	10/01/11		SNF	"Default, /PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
AAA5D	10/01/11		SNF	"Default, /PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
AAA60	10/01/10		SNF	"Default, /OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following:  SNF notified untimely of MSP denial, or 
 SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
BA101	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA."					
BA102	07/01/98	* 09/30/10	SNF	"Behavior Only, ADL Index 4 - 5, not receiving nursing rehabilitation/Medicare 30 day assessment (Full)"					
BA103	07/01/98	* 09/30/10	SNF	"Behavior Only, ADL Index 4 - 5, not receiving nursing rehabilitation/Medicare 60 day assessment (Full)"					
BA104	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA."					
BA105	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
BA106	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
BA107	07/01/98	* 09/30/10	SNF	"Behavior Only, ADL Index 4 - 5, not receiving nursing rehabilitation/Medicare 14 day assessment (Full or comprehensive)"					
BA108	07/01/98	* 09/30/10	SNF	"Behavior Only, ADL Index 4 - 5, not receiving nursing rehabilitation/Other Medicare Required Assessment (OMRA) "					
BA10A	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
BA10B	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
BA10C	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
BA10D	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
BA110	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/5-day or readmission return. "					
BA111	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
BA112	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
BA113	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
BA114	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
BA115	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
BA116	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
BA117	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
BA118 	10/01/00	* 09/30/10	SNF	"Behavior Only, ADL Index 4 - 5, not receiving nursing rehabilitation/OMRA replacing 5-day Medicare assessment"					
BA119	07/01/02	* 09/30/10	SNF	"Behavior Only, ADL Index 4 - 5, not receiving nursing rehabilitation/Special payment situation 5-day assessment"					
BA11A	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
BA11B	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
BA11C	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
BA120	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/14-day. "					
BA121	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
BA124	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
BA125	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
BA126	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
BA128	10/01/00	* 09/30/10	SNF	"Behavior Only, ADL Index 4 - 5, not receiving nursing rehabilitation/OMRA replacing 30-day Medicare assessment"					
BA129	07/01/02	* 09/30/10	SNF	"Behavior Only, ADL Index 4 - 5, not receiving nursing rehabilitation/Special payment situation 30-day assessment"					
BA12A	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
BA12B	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
BA12C	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
BA12D	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
BA130	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/30-day. "					
BA131	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
BA132	07/01/98	* 09/30/10	SNF	"Behavior Only, ADL Index 4 - 5, not receiving nursing rehabilitation/[7/98 def.] SCSA or OMRA/ Medicare 30 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 30-day Medicare required assessment"					
BA133	07/01/98	* 09/30/10	SNF	"Behavior Only, ADL Index 4 - 5, not receiving nursing rehabilitation/[7/98 def.] SCSA or OMRA/ Medicare 60 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 60-day Medicare required assessment"					
BA134	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
BA135	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
BA136	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
BA137	07/01/98	* 09/30/10	SNF	"Behavior Only, ADL Index 4 - 5, not receiving nursing rehabilitation/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
BA138	07/01/98	* 09/30/10	SNF	"Behavior Only, ADL Index 4 - 5, not receiving nursing rehabilitation/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
BA139	07/01/02	* 09/30/10	SNF	"Behavior Only, ADL Index 4 - 5, not receiving nursing rehabilitation/Special payment situation 60-day assessment"					
BA13A	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
BA13B	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
BA13C	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
BA13D	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
BA140	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/60-day. "					
BA141	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
BA142	07/01/98	* 09/30/10	SNF	"Behavior Only, ADL Index 4 - 5, not receiving nursing rehabilitation/Significant Correction of Prior Full Assessment/Medicare 30 Day Assessment "					
BA143	07/01/98	* 09/30/10	SNF	"Behavior Only, ADL Index 4 - 5, not receiving nursing rehabilitation/Significant Correction of Prior Full Assessment/Medicare 60 Day Assessment "					
BA144	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
BA145	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
BA146	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
BA147	07/01/98	* 09/30/10	SNF	"Behavior Only, ADL Index 4 - 5, not receiving nursing rehabilitation/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
BA148	10/01/00	* 09/30/10	SNF	"Behavior Only, ADL Index 4 - 5, not receiving nursing rehabilitation/OMRA replacing 90-day Medicare-required assessment"					
BA149	07/01/02	* 09/30/10	SNF	"Behavior Only, ADL Index 4 - 5, not receiving nursing rehabilitation/Special payment situation 90-day assessment"					
BA14A	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
BA14B	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
BA14C	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
BA14D	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
BA150	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/90-day. "					
BA151	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
BA154	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
BA155	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
BA156	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
BA15A	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
BA15B	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
BA15C	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
BA15D	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
BA160	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following: SNF notified untimely of MSP denial, or 
SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
BA178	10/01/00	* 09/30/10	SNF	"Behavior Only, ADL Index 4 - 5, not receiving nursing rehabilitation/OMRA replacing 14-day Medicare-required assessment"					
BA179	07/01/02	* 09/30/10	SNF	"Behavior Only, ADL Index 4 - 5, not receiving nursing rehabilitation/Special payment situation 14-day assessment"					
BA18A	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/TRICARE 120-day assessment "					
BA18B	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/TRICARE 150-day assessment "					
BA18C	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/TRICARE 180-day assessment "					
BA18D	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/TRICARE 210-day assessment "					
BA18E	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/TRICARE 240-day assessment "					
BA18F	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/TRICARE 270-day assessment "					
BA18G	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/TRICARE 300-day assessment "					
BA18H	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/TRICARE 330-day assessment "					
BA18I	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/TRICARE 360-day assessment "					
BA18X	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval "					
BA201	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA."					
BA202	07/01/98	* 09/30/10	SNF	"Behavior Only, ADL Index 4 - 8/Medicare 30 day assessment (Full)"					
BA203	07/01/98	* 09/30/10	SNF	"Behavior Only, ADL Index 4 - 9/Medicare 60 day assessment (Full)"					
BA204	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA."					
BA205	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
BA206	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
BA207	07/01/98	* 09/30/10	SNF	"Behavior Only, ADL Index 4 - 7/Medicare 14 day assessment (Full or comprehensive)"					
BA208	07/01/98	* 09/30/10	SNF	"Behavior Only, ADL Index 4 - 13/Other Medicare Required Assessment (OMRA) "					
BA20A	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
BA20B	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
BA20C	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
BA20D	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
BA210	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/5-day or readmission return. "					
BA211	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
BA212	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
BA213	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
BA214	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
BA215	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
BA216	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
BA217	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
BA218 	10/01/00	* 09/30/10	SNF	"Behavior Only, ADL Index 4 - 26/OMRA replacing 5-day Medicare assessment"					
BA219	07/01/02	* 09/30/10	SNF	"Behavior Only, ADL Index 4 - 34/Special payment situation 5-day assessment"					
BA21A	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
BA21B	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
BA21C	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
BA220	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/14-day. "					
BA221	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
BA224	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
BA225	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
BA226	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
BA228	10/01/00	* 09/30/10	SNF	"Behavior Only, ADL Index 4 - 27/OMRA replacing 30-day Medicare assessment"					
BA229	07/01/02	* 09/30/10	SNF	"Behavior Only, ADL Index 4 - 35/Special payment situation 30-day assessment"					
BA22A	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
BA22B	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
BA22C	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
BA22D	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
BA230	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/30-day. "					
BA231	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
BA232	07/01/98	* 09/30/10	SNF	"Behavior Only, ADL Index 4 - 21/[7/98 def.] SCSA or OMRA/ Medicare 30 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 30-day Medicare required assessment"					
BA233	07/01/98	* 09/30/10	SNF	"Behavior Only, ADL Index 4 - 22/[7/98 def.] SCSA or OMRA/ Medicare 60 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 60-day Medicare required assessment"					
BA234	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
BA235	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
BA236	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
BA237	07/01/98	* 09/30/10	SNF	"Behavior Only, ADL Index 4 - 20/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
BA238	07/01/98	* 09/30/10	SNF	"Behavior Only, ADL Index 4 - 12/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
BA239	07/01/02	* 09/30/10	SNF	"Behavior Only, ADL Index 4 - 36/Special payment situation 60-day assessment"					
BA23A	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
BA23B	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
BA23C	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
BA23D	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
BA240	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/60-day. "					
BA241	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
BA242	07/01/98	* 09/30/10	SNF	"Behavior Only, ADL Index 4 - 16/Significant Correction of Prior Full Assessment/Medicare 30 Day Assessment "					
BA243	07/01/98	* 09/30/10	SNF	"Behavior Only, ADL Index 4 - 17/Significant Correction of Prior Full Assessment/Medicare 60 Day Assessment "					
BA244	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
BA245	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
BA246	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
BA247	07/01/98	* 09/30/10	SNF	"Behavior Only, ADL Index 4 - 15/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
BA248	10/01/00	* 09/30/10	SNF	"Behavior Only, ADL Index 4 - 32/OMRA replacing 90-day Medicare-required assessment"					
BA249	07/01/02	* 09/30/10	SNF	"Behavior Only, ADL Index 4 - 37/Special payment situation 90-day assessment"					
BA24A	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
BA24B	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
BA24C	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
BA24D	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
BA250	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/90-day. "					
BA251	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
BA254	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
BA255	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
BA256	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
BA25A	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
BA25B	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
BA25C	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
BA25D	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
BA260	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following: SNF notified untimely of MSP denial, or 
SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
BA278	10/01/00	* 09/30/10	SNF	"Behavior Only, ADL Index 4 - 33/OMRA replacing 14-day Medicare-required assessment"					
BA279	07/01/02	* 09/30/10	SNF	"Behavior Only, ADL Index 4 - 38/Special payment situation 14-day assessment"					
BA28A	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/TRICARE 120-day assessment "					
BA28B	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/TRICARE 150-day assessment "					
BA28C	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/TRICARE 180-day assessment "					
BA28D	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/TRICARE 210-day assessment "					
BA28E	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/TRICARE 240-day assessment "					
BA28F	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/TRICARE 270-day assessment "					
BA28G	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/TRICARE 300-day assessment "					
BA28H	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/TRICARE 330-day assessment "					
BA28I	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/TRICARE 360-day assessment "					
BA28X	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval "					
BB101	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA."					
BB102	07/01/98	* 09/30/10	SNF	"Behavior Only, ADL Index 6 - 10, not receiving nursing rehabilitation/Medicare 30 day assessment (Full)"					
BB103	07/01/98	* 09/30/10	SNF	"Behavior Only, ADL Index 6 - 10, not receiving nursing rehabilitation/Medicare 60 day assessment (Full)"					
BB104	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA."					
BB105	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
BB106	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
BB107	07/01/98	* 09/30/10	SNF	"Behavior Only, ADL Index 6 - 10, not receiving nursing rehabilitation/Medicare 14 day assessment (Full or comprehensive)"					
BB108	07/01/98	* 09/30/10	SNF	"Behavior Only, ADL Index 6 - 10, not receiving nursing rehabilitation/Other Medicare Required Assessment (OMRA) "					
BB10A	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
BB10B	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
BB10C	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
BB10D	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
BB110	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/5-day or readmission return. "					
BB111	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
BB112	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
BB113	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
BB114	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
BB115	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
BB116	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
BB117	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
BB118 	10/01/00	* 09/30/10	SNF	"Behavior Only, ADL Index 6 - 10, not receiving nursing rehabilitation/OMRA replacing 5-day Medicare assessment"					
BB119	07/01/02	* 09/30/10	SNF	"Behavior Only, ADL Index 6 - 10, not receiving nursing rehabilitation/Special payment situation 5-day assessment"					
BB11A	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
BB11B	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
BB11C	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
BB120	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/14-day. "					
BB121	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
BB124	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
BB125	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
BB126	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
BB128	10/01/00	* 09/30/10	SNF	"Behavior Only, ADL Index 6 - 10, not receiving nursing rehabilitation/OMRA replacing 30-day Medicare assessment"					
BB129	07/01/02	* 09/30/10	SNF	"Behavior Only, ADL Index 6 - 10, not receiving nursing rehabilitation/Special payment situation 30-day assessment"					
BB12A	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
BB12B	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
BB12C	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
BB12D	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
BB130	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/30-day. "					
BB131	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
BB132	07/01/98	* 09/30/10	SNF	"Behavior Only, ADL Index 6 - 10, not receiving nursing rehabilitation/[7/98 def.] SCSA or OMRA/ Medicare 30 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 30-day Medicare required assessment"					
BB133	07/01/98	* 09/30/10	SNF	"Behavior Only, ADL Index 6 - 10, not receiving nursing rehabilitation/[7/98 def.] SCSA or OMRA/ Medicare 60 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 60-day Medicare required assessment"					
BB134	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
BB135	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
BB136	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
BB137	07/01/98	* 09/30/10	SNF	"Behavior Only, ADL Index 6 - 10, not receiving nursing rehabilitation/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
BB138	07/01/98	* 09/30/10	SNF	"Behavior Only, ADL Index 6 - 10, not receiving nursing rehabilitation/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
BB139	07/01/02	* 09/30/10	SNF	"Behavior Only, ADL Index 6 - 10, not receiving nursing rehabilitation/Special payment situation 60-day assessment"					
BB13A	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
BB13B	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
BB13C	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
BB13D	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
BB140	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/60-day. "					
BB141	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
BB142	07/01/98	* 09/30/10	SNF	"Behavior Only, ADL Index 6 - 10, not receiving nursing rehabilitation/Significant Correction of Prior Full Assessment/Medicare 30 Day Assessment "					
BB143	07/01/98	* 09/30/10	SNF	"Behavior Only, ADL Index 6 - 10, not receiving nursing rehabilitation/Significant Correction of Prior Full Assessment/Medicare 60 Day Assessment "					
BB144	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
BB145	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
BB146	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
BB147	07/01/98	* 09/30/10	SNF	"Behavior Only, ADL Index 6 - 10, not receiving nursing rehabilitation/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
BB148	10/01/00	* 09/30/10	SNF	"Behavior Only, ADL Index 6 - 10, not receiving nursing rehabilitation/OMRA replacing 90-day Medicare-required assessment"					
BB149	07/01/02	* 09/30/10	SNF	"Behavior Only, ADL Index 6 - 10, not receiving nursing rehabilitation/Special payment situation 90-day assessment"					
BB14A	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
BB14B	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
BB14C	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
BB14D	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
BB150	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/90-day. "					
BB151	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
BB154	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
BB155	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
BB156	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
BB15A	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
BB15B	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
BB15C	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
BB15D	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
BB160	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following: SNF notified untimely of MSP denial, or 
SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
BB178	10/01/00	* 09/30/10	SNF	"Behavior Only, ADL Index 6 - 10, not receiving nursing rehabilitation/OMRA replacing 14-day Medicare-required assessment"					
BB179	07/01/02	* 09/30/10	SNF	"Behavior Only, ADL Index 6 - 10, not receiving nursing rehabilitation/Special payment situation 14-day assessment"					
BB18A	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/TRICARE 120-day assessment "					
BB18B	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/TRICARE 150-day assessment "					
BB18C	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/TRICARE 180-day assessment "					
BB18D	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/TRICARE 210-day assessment "					
BB18E	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/TRICARE 240-day assessment "					
BB18F	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/TRICARE 270-day assessment "					
BB18G	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/TRICARE 300-day assessment "					
BB18H	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/TRICARE 330-day assessment "					
BB18I	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/TRICARE 360-day assessment "					
BB18X	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval "					
BB201	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA."					
BB202	07/01/98	* 09/30/10	SNF	"Behavior Only, ADL Index 6 - 10/Medicare 30 day assessment (Full)"					
BB203	07/01/98	* 09/30/10	SNF	"Behavior Only, ADL Index 6 - 10/Medicare 60 day assessment (Full)"					
BB204	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA."					
BB205	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
BB206	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
BB207	07/01/98	* 09/30/10	SNF	"Behavior Only, ADL Index 6 - 10/Medicare 14 day assessment (Full or comprehensive)"					
BB208	07/01/98	* 09/30/10	SNF	"Behavior Only, ADL Index 6 - 10/Other Medicare Required Assessment (OMRA) "					
BB20A	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
BB20B	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
BB20C	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
BB20D	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
BB210	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/5-day or readmission return. "					
BB211	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
BB212	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
BB213	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
BB214	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
BB215	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
BB216	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
BB217	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
BB218 	10/01/00	* 09/30/10	SNF	"Behavior Only, ADL Index 6 - 10/OMRA replacing 5-day Medicare assessment"					
BB219	07/01/02	* 09/30/10	SNF	"Behavior Only, ADL Index 6 - 10/Special payment situation 5-day assessment"					
BB21A	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
BB21B	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
BB21C	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
BB220	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/14-day. "					
BB221	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
BB224	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
BB225	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
BB226	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
BB228	10/01/00	* 09/30/10	SNF	"Behavior Only, ADL Index 6 - 10/OMRA replacing 30-day Medicare assessment"					
BB229	07/01/02	* 09/30/10	SNF	"Behavior Only, ADL Index 6 - 10/Special payment situation 30-day assessment"					
BB22A	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
BB22B	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
BB22C	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
BB22D	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
BB230	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/30-day. "					
BB231	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
BB232	07/01/98	* 09/30/10	SNF	"Behavior Only, ADL Index 6 - 10/[7/98 def.] SCSA or OMRA/ Medicare 30 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 30-day Medicare required assessment"					
BB233	07/01/98	* 09/30/10	SNF	"Behavior Only, ADL Index 6 - 10/[7/98 def.] SCSA or OMRA/ Medicare 60 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 60-day Medicare required assessment"					
BB234	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
BB235	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
BB236	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
BB237	07/01/98	* 09/30/10	SNF	"Behavior Only, ADL Index 6 - 10/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
BB238	07/01/98	* 09/30/10	SNF	"Behavior Only, ADL Index 6 - 10/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
BB239	07/01/02	* 09/30/10	SNF	"Behavior Only, ADL Index 6 - 10/Special payment situation 60-day assessment"					
BB23A	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
BB23B	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
BB23C	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
BB23D	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
BB240	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/60-day. "					
BB241	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
BB242	07/01/98	* 09/30/10	SNF	"Behavior Only, ADL Index 6 - 10/Significant Correction of Prior Full Assessment/Medicare 30 Day Assessment "					
BB243	07/01/98	* 09/30/10	SNF	"Behavior Only, ADL Index 6 - 10/Significant Correction of Prior Full Assessment/Medicare 60 Day Assessment "					
BB244	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
BB245	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
BB246	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
BB247	07/01/98	* 09/30/10	SNF	"Behavior Only, ADL Index 6 - 10/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
BB248	10/01/00	* 09/30/10	SNF	"Behavior Only, ADL Index 6 - 10/OMRA replacing 90-day Medicare-required assessment"					
BB249	07/01/02	* 09/30/10	SNF	"Behavior Only, ADL Index 6 - 10/Special payment situation 90-day assessment"					
BB24A	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
BB24B	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
BB24C	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
BB24D	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
BB250	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/90-day. "					
BB251	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
BB254	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
BB255	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
BB256	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
BB25A	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
BB25B	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
BB25C	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
BB25D	10/01/11		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
BB260	10/01/10		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following: SNF notified untimely of MSP denial, or 
SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
BB278	10/01/00	* 09/30/10	SNF	"Behavior Only, ADL Index 6 - 10/OMRA replacing 14-day Medicare-required assessment"					
BB279	07/01/02	* 09/30/10	SNF	"Behavior Only, ADL Index 6 - 10/Special payment situation 14-day assessment"					
BB28A	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/TRICARE 120-day assessment "					
BB28B	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/TRICARE 150-day assessment "					
BB28C	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/TRICARE 180-day assessment "					
BB28D	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/TRICARE 210-day assessment "					
BB28E	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/TRICARE 240-day assessment "					
BB28F	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/TRICARE 270-day assessment "					
BB28G	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/TRICARE 300-day assessment "					
BB28H	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/TRICARE 330-day assessment "					
BB28I	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/TRICARE 360-day assessment "					
BB28X	07/01/98		SNF	"Behavioral Symptoms and Cognitive Performance , ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval "					
CA101	07/01/98		SNF	"Clinically Complex , ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA."					
CA102	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 4 - 11/Medicare 30 day assessment (Full)"					
CA103	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 4 - 11/Medicare 60 day assessment (Full)"					
CA104	07/01/98		SNF	"Clinically Complex , ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA."					
CA105	07/01/98		SNF	"Clinically Complex , ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
CA106	10/01/10		SNF	"Clinically Complex , ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
CA107	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 4 - 11/Medicare 14 day assessment (Full or comprehensive)"					
CA108	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 4 - 11/Other Medicare Required Assessment (OMRA) "					
CA10A	10/01/11		SNF	"Clinically Complex , ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
CA10B	10/01/11		SNF	"Clinically Complex , ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
CA10C	10/01/11		SNF	"Clinically Complex , ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
CA10D	10/01/11		SNF	"Clinically Complex , ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
CA110	10/01/10		SNF	"Clinically Complex , ADL Index 0-1/5-day or readmission return. "					
CA111	07/01/98		SNF	"Clinically Complex , ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
CA112	10/01/10		SNF	"Clinically Complex , ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
CA113	10/01/10		SNF	"Clinically Complex , ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
CA114	10/01/10		SNF	"Clinically Complex , ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
CA115	10/01/10		SNF	"Clinically Complex , ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
CA116	10/01/10		SNF	"Clinically Complex , ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
CA117	07/01/98		SNF	"Clinically Complex , ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
CA118 	10/01/00	* 09/30/10	SNF	"Clinically Complex, ADL Index 4 - 11/OMRA replacing 5-day Medicare assessment"					
CA119	07/01/02	* 09/30/10	SNF	"Clinically Complex, ADL Index 4 - 11/Special payment situation 5-day assessment"					
CA11A	10/01/11		SNF	"Clinically Complex , ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
CA11B	10/01/11		SNF	"Clinically Complex , ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
CA11C	10/01/11		SNF	"Clinically Complex , ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CA120	10/01/10		SNF	"Clinically Complex , ADL Index 0-1/14-day. "					
CA121	10/01/10		SNF	"Clinically Complex , ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
CA124	10/01/10		SNF	"Clinically Complex , ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
CA125	10/01/10		SNF	"Clinically Complex , ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
CA126	10/01/10		SNF	"Clinically Complex , ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
CA128	10/01/00	* 09/30/10	SNF	"Clinically Complex, ADL Index 4 - 11/OMRA replacing 30-day Medicare assessment"					
CA129	07/01/02	* 09/30/10	SNF	"Clinically Complex, ADL Index 4 - 11/Special payment situation 30-day assessment"					
CA12A	10/01/11		SNF	"Clinically Complex , ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
CA12B	10/01/11		SNF	"Clinically Complex , ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
CA12C	10/01/11		SNF	"Clinically Complex , ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CA12D	10/01/11		SNF	"Clinically Complex , ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CA130	07/01/98		SNF	"Clinically Complex , ADL Index 0-1/30-day. "					
CA131	07/01/98		SNF	"Clinically Complex , ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
CA132	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 4 - 11/[7/98 def.] SCSA or OMRA/ Medicare 30 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 30-day Medicare required assessment"					
CA133	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 4 - 11/[7/98 def.] SCSA or OMRA/ Medicare 60 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 60-day Medicare required assessment"					
CA134	07/01/98		SNF	"Clinically Complex , ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
CA135	07/01/98		SNF	"Clinically Complex , ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
CA136	10/01/10		SNF	"Clinically Complex , ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
CA137	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 4 - 11/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
CA138	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 4 - 11/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
CA139	07/01/02	* 09/30/10	SNF	"Clinically Complex, ADL Index 4 - 11/Special payment situation 60-day assessment"					
CA13A	10/01/11		SNF	"Clinically Complex , ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
CA13B	10/01/11		SNF	"Clinically Complex , ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
CA13C	10/01/11		SNF	"Clinically Complex , ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CA13D	10/01/11		SNF	"Clinically Complex , ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CA140	07/01/98		SNF	"Clinically Complex , ADL Index 0-1/60-day. "					
CA141	07/01/98		SNF	"Clinically Complex , ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
CA142	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 4 - 11/Significant Correction of Prior Full Assessment/Medicare 30 Day Assessment "					
CA143	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 4 - 11/Significant Correction of Prior Full Assessment/Medicare 60 Day Assessment "					
CA144	07/01/98		SNF	"Clinically Complex , ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
CA145	07/01/98		SNF	"Clinically Complex , ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
CA146	10/01/10		SNF	"Clinically Complex , ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
CA147	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 4 - 11/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
CA148	10/01/00	* 09/30/10	SNF	"Clinically Complex, ADL Index 4 - 11/OMRA replacing 90-day Medicare-required assessment"					
CA149	07/01/02	* 09/30/10	SNF	"Clinically Complex, ADL Index 4 - 11/Special payment situation 90-day assessment"					
CA14A	10/01/11		SNF	"Clinically Complex , ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
CA14B	10/01/11		SNF	"Clinically Complex , ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
CA14C	10/01/11		SNF	"Clinically Complex , ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CA14D	10/01/11		SNF	"Clinically Complex , ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CA150	10/01/10		SNF	"Clinically Complex , ADL Index 0-1/90-day. "					
CA151	10/01/10		SNF	"Clinically Complex , ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
CA154	07/01/98		SNF	"Clinically Complex , ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
CA155	10/01/10		SNF	"Clinically Complex , ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
CA156	10/01/10		SNF	"Clinically Complex , ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
CA15A	10/01/11		SNF	"Clinically Complex , ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
CA15B	10/01/11		SNF	"Clinically Complex , ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
CA15C	10/01/11		SNF	"Clinically Complex , ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CA15D	10/01/11		SNF	"Clinically Complex , ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CA160	10/01/10		SNF	"Clinically Complex , ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following: SNF notified untimely of MSP denial, or 
SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
CA178	10/01/00	* 09/30/10	SNF	"Clinically Complex, ADL Index 4 - 11/OMRA replacing 14-day Medicare-required assessment"					
CA179	07/01/02	* 09/30/10	SNF	"Clinically Complex, ADL Index 4 - 11/Special payment situation 14-day assessment"					
CA18A	07/01/98		SNF	"Clinically Complex , ADL Index 0-1/TRICARE 120-day assessment "					
CA18B	07/01/98		SNF	"Clinically Complex , ADL Index 0-1/TRICARE 150-day assessment "					
CA18C	07/01/98		SNF	"Clinically Complex , ADL Index 0-1/TRICARE 180-day assessment "					
CA18D	07/01/98		SNF	"Clinically Complex , ADL Index 0-1/TRICARE 210-day assessment "					
CA18E	07/01/98		SNF	"Clinically Complex , ADL Index 0-1/TRICARE 240-day assessment "					
CA18F	07/01/98		SNF	"Clinically Complex , ADL Index 0-1/TRICARE 270-day assessment "					
CA18G	07/01/98		SNF	"Clinically Complex , ADL Index 0-1/TRICARE 300-day assessment "					
CA18H	07/01/98		SNF	"Clinically Complex , ADL Index 0-1/TRICARE 330-day assessment "					
CA18I	07/01/98		SNF	"Clinically Complex , ADL Index 0-1/TRICARE 360-day assessment "					
CA18X	07/01/98		SNF	"Clinically Complex , ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval "					
CA201	07/01/98		SNF	"Clinically Complex , ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA."					
CA202	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 4 - 11, signs of depression/Medicare 30 day assessment (Full)"					
CA203	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 4 - 11, signs of depression/Medicare 60 day assessment (Full)"					
CA204	07/01/98		SNF	"Clinically Complex , ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA."					
CA205	07/01/98		SNF	"Clinically Complex , ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
CA206	10/01/10		SNF	"Clinically Complex , ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
CA207	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 4 - 11, signs of depression/Medicare 14 day assessment (Full or comprehensive)"					
CA208	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 4 - 11, signs of depression/Other Medicare Required Assessment (OMRA) "					
CA20A	10/01/11		SNF	"Clinically Complex , ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
CA20B	10/01/11		SNF	"Clinically Complex , ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
CA20C	10/01/11		SNF	"Clinically Complex , ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
CA20D	10/01/11		SNF	"Clinically Complex , ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
CA210	10/01/10		SNF	"Clinically Complex , ADL Index 0-1/5-day or readmission return. "					
CA211	07/01/98		SNF	"Clinically Complex , ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
CA212	10/01/10		SNF	"Clinically Complex , ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
CA213	10/01/10		SNF	"Clinically Complex , ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
CA214	10/01/10		SNF	"Clinically Complex , ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
CA215	10/01/10		SNF	"Clinically Complex , ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
CA216	10/01/10		SNF	"Clinically Complex , ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
CA217	07/01/98		SNF	"Clinically Complex , ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
CA218 	10/01/00	* 09/30/10	SNF	"Clinically Complex, ADL Index 4 - 11, signs of depression/OMRA replacing 5-day Medicare assessment"					
CA219	07/01/02	* 09/30/10	SNF	"Clinically Complex, ADL Index 4 - 11, signs of depression/Special payment situation 5-day assessment"					
CA21A	10/01/11		SNF	"Clinically Complex , ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
CA21B	10/01/11		SNF	"Clinically Complex , ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
CA21C	10/01/11		SNF	"Clinically Complex , ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CA220	10/01/10		SNF	"Clinically Complex , ADL Index 0-1/14-day. "					
CA221	10/01/10		SNF	"Clinically Complex , ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
CA224	10/01/10		SNF	"Clinically Complex , ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
CA225	10/01/10		SNF	"Clinically Complex , ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
CA226	10/01/10		SNF	"Clinically Complex , ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
CA228	10/01/00	* 09/30/10	SNF	"Clinically Complex, ADL Index 4 - 11, signs of depression/OMRA replacing 30-day Medicare assessment"					
CA229	07/01/02	* 09/30/10	SNF	"Clinically Complex, ADL Index 4 - 11, signs of depression/Special payment situation 30-day assessment"					
CA22A	10/01/11		SNF	"Clinically Complex , ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
CA22B	10/01/11		SNF	"Clinically Complex , ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
CA22C	10/01/11		SNF	"Clinically Complex , ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CA22D	10/01/11		SNF	"Clinically Complex , ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CA230	07/01/98		SNF	"Clinically Complex , ADL Index 0-1/30-day. "					
CA231	07/01/98		SNF	"Clinically Complex , ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
CA232	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 4 - 11, signs of depression/[7/98 def.] SCSA or OMRA/ Medicare 30 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 30-day Medicare required assessment"					
CA233	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 4 - 11, signs of depression/[7/98 def.] SCSA or OMRA/ Medicare 60 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 60-day Medicare required assessment"					
CA234	07/01/98		SNF	"Clinically Complex , ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
CA235	07/01/98		SNF	"Clinically Complex , ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
CA236	10/01/10		SNF	"Clinically Complex , ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
CA237	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 4 - 11, signs of depression/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
CA238	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 4 - 11, signs of depression/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
CA239	07/01/02	* 09/30/10	SNF	"Clinically Complex, ADL Index 4 - 11, signs of depression/Special payment situation 60-day assessment"					
CA23A	10/01/11		SNF	"Clinically Complex , ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
CA23B	10/01/11		SNF	"Clinically Complex , ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
CA23C	10/01/11		SNF	"Clinically Complex , ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CA23D	10/01/11		SNF	"Clinically Complex , ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CA240	07/01/98		SNF	"Clinically Complex , ADL Index 0-1/60-day. "					
CA241	07/01/98		SNF	"Clinically Complex , ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
CA242	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 4 - 11, signs of depression/Significant Correction of Prior Full Assessment/Medicare 30 Day Assessment "					
CA243	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 4 - 11, signs of depression/Significant Correction of Prior Full Assessment/Medicare 60 Day Assessment "					
CA244	07/01/98		SNF	"Clinically Complex , ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
CA245	07/01/98		SNF	"Clinically Complex , ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
CA246	10/01/10		SNF	"Clinically Complex , ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
CA247	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 4 - 11, signs of depression/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
CA248	10/01/00	* 09/30/10	SNF	"Clinically Complex, ADL Index 4 - 11, signs of depression/OMRA replacing 90-day Medicare-required assessment"					
CA249	07/01/02	* 09/30/10	SNF	"Clinically Complex, ADL Index 4 - 11, signs of depression/Special payment situation 90-day assessment"					
CA24A	10/01/11		SNF	"Clinically Complex , ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
CA24B	10/01/11		SNF	"Clinically Complex , ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
CA24C	10/01/11		SNF	"Clinically Complex , ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CA24D	10/01/11		SNF	"Clinically Complex , ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CA250	10/01/10		SNF	"Clinically Complex , ADL Index 0-1/90-day. "					
CA251	10/01/10		SNF	"Clinically Complex , ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
CA254	07/01/98		SNF	"Clinically Complex , ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
CA255	10/01/10		SNF	"Clinically Complex , ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
CA256	10/01/10		SNF	"Clinically Complex , ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
CA25A	10/01/11		SNF	"Clinically Complex , ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
CA25B	10/01/11		SNF	"Clinically Complex , ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
CA25C	10/01/11		SNF	"Clinically Complex , ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CA25D	10/01/11		SNF	"Clinically Complex , ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CA260	10/01/10		SNF	"Clinically Complex , ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following: SNF notified untimely of MSP denial, or 
SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
CA278	10/01/00	* 09/30/10	SNF	"Clinically Complex, ADL Index 4 - 11, signs of depression/OMRA replacing 14-day Medicare-required assessment"					
CA279	07/01/02	* 09/30/10	SNF	"Clinically Complex, ADL Index 4 - 11, signs of depression/Special payment situation 14-day assessment"					
CA28A	07/01/98		SNF	"Clinically Complex , ADL Index 0-1/TRICARE 120-day assessment "					
CA28B	07/01/98		SNF	"Clinically Complex , ADL Index 0-1/TRICARE 150-day assessment "					
CA28C	07/01/98		SNF	"Clinically Complex , ADL Index 0-1/TRICARE 180-day assessment "					
CA28D	07/01/98		SNF	"Clinically Complex , ADL Index 0-1/TRICARE 210-day assessment "					
CA28E	07/01/98		SNF	"Clinically Complex , ADL Index 0-1/TRICARE 240-day assessment "					
CA28F	07/01/98		SNF	"Clinically Complex , ADL Index 0-1/TRICARE 270-day assessment "					
CA28G	07/01/98		SNF	"Clinically Complex , ADL Index 0-1/TRICARE 300-day assessment "					
CA28H	07/01/98		SNF	"Clinically Complex , ADL Index 0-1/TRICARE 330-day assessment "					
CA28I	07/01/98		SNF	"Clinically Complex , ADL Index 0-1/TRICARE 360-day assessment "					
CA28X	07/01/98		SNF	"Clinically Complex , ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval "					
CB101	07/01/98		SNF	"Clinically Complex , ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA."					
CB102	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 12 - 16/Medicare 30 day assessment (Full)"					
CB103	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 12 - 16/Medicare 60 day assessment (Full)"					
CB104	07/01/98		SNF	"Clinically Complex , ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA."					
CB105	07/01/98		SNF	"Clinically Complex , ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
CB106	10/01/10		SNF	"Clinically Complex , ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
CB107	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 12 - 16/Medicare 14 day assessment (Full or comprehensive)"					
CB108	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 12 - 16/Other Medicare Required Assessment (OMRA) "					
CB10A	10/01/11		SNF	"Clinically Complex , ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
CB10B	10/01/11		SNF	"Clinically Complex , ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
CB10C	10/01/11		SNF	"Clinically Complex , ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
CB10D	10/01/11		SNF	"Clinically Complex , ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
CB110	10/01/10		SNF	"Clinically Complex , ADL Index 2-5/5-day or readmission return. "					
CB111	07/01/98		SNF	"Clinically Complex , ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
CB112	10/01/10		SNF	"Clinically Complex , ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
CB113	10/01/10		SNF	"Clinically Complex , ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
CB114	10/01/10		SNF	"Clinically Complex , ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
CB115	10/01/10		SNF	"Clinically Complex , ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
CB116	10/01/10		SNF	"Clinically Complex , ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
CB117	07/01/98		SNF	"Clinically Complex , ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
CB118 	10/01/00	* 09/30/10	SNF	"Clinically Complex, ADL Index 12 - 16/OMRA replacing 5-day Medicare assessment"					
CB119	07/01/02	* 09/30/10	SNF	"Clinically Complex, ADL Index 12 - 16/Special payment situation 5-day assessment"					
CB11A	10/01/11		SNF	"Clinically Complex , ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
CB11B	10/01/11		SNF	"Clinically Complex , ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
CB11C	10/01/11		SNF	"Clinically Complex , ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CB120	10/01/10		SNF	"Clinically Complex , ADL Index 2-5/14-day. "					
CB121	10/01/10		SNF	"Clinically Complex , ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
CB124	10/01/10		SNF	"Clinically Complex , ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
CB125	10/01/10		SNF	"Clinically Complex , ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
CB126	10/01/10		SNF	"Clinically Complex , ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
CB128	10/01/00	* 09/30/10	SNF	"Clinically Complex, ADL Index 12 - 16/OMRA replacing 30-day Medicare assessment"					
CB129	07/01/02	* 09/30/10	SNF	"Clinically Complex, ADL Index 12 - 16/Special payment situation 30-day assessment"					
CB12A	10/01/11		SNF	"Clinically Complex , ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
CB12B	10/01/11		SNF	"Clinically Complex , ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
CB12C	10/01/11		SNF	"Clinically Complex , ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CB12D	10/01/11		SNF	"Clinically Complex , ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CB130	07/01/98		SNF	"Clinically Complex , ADL Index 2-5/30-day. "					
CB131	07/01/98		SNF	"Clinically Complex , ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
CB132	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 12 - 16/[7/98 def.] SCSA or OMRA/ Medicare 30 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 30-day Medicare required assessment"					
CB133	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 12 - 16/[7/98 def.] SCSA or OMRA/ Medicare 60 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 60-day Medicare required assessment"					
CB134	07/01/98		SNF	"Clinically Complex , ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
CB135	07/01/98		SNF	"Clinically Complex , ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
CB136	10/01/10		SNF	"Clinically Complex , ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
CB137	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 12 - 16/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
CB138	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 12 - 16/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
CB139	07/01/02	* 09/30/10	SNF	"Clinically Complex, ADL Index 12 - 16/Special payment situation 60-day assessment"					
CB13A	10/01/11		SNF	"Clinically Complex , ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
CB13B	10/01/11		SNF	"Clinically Complex , ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
CB13C	10/01/11		SNF	"Clinically Complex , ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CB13D	10/01/11		SNF	"Clinically Complex , ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CB140	07/01/98		SNF	"Clinically Complex , ADL Index 2-5/60-day. "					
CB141	07/01/98		SNF	"Clinically Complex , ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
CB142	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 12 - 16/Significant Correction of Prior Full Assessment/Medicare 30 Day Assessment "					
CB143	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 12 - 16/Significant Correction of Prior Full Assessment/Medicare 60 Day Assessment "					
CB144	07/01/98		SNF	"Clinically Complex , ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
CB145	07/01/98		SNF	"Clinically Complex , ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
CB146	10/01/10		SNF	"Clinically Complex , ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
CB147	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 12 - 16/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
CB148	10/01/00	* 09/30/10	SNF	"Clinically Complex, ADL Index 12 - 16/OMRA replacing 90-day Medicare-required assessment"					
CB149	07/01/02	* 09/30/10	SNF	"Clinically Complex, ADL Index 12 - 16/Special payment situation 90-day assessment"					
CB14A	10/01/11		SNF	"Clinically Complex , ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
CB14B	10/01/11		SNF	"Clinically Complex , ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
CB14C	10/01/11		SNF	"Clinically Complex , ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CB14D	10/01/11		SNF	"Clinically Complex , ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CB150	10/01/10		SNF	"Clinically Complex , ADL Index 2-5/90-day. "					
CB151	10/01/10		SNF	"Clinically Complex , ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
CB154	07/01/98		SNF	"Clinically Complex , ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
CB155	10/01/10		SNF	"Clinically Complex , ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
CB156	10/01/10		SNF	"Clinically Complex , ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
CB15A	10/01/11		SNF	"Clinically Complex , ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
CB15B	10/01/11		SNF	"Clinically Complex , ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
CB15C	10/01/11		SNF	"Clinically Complex , ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CB15D	10/01/11		SNF	"Clinically Complex , ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CB160	10/01/10		SNF	"Clinically Complex , ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following: SNF notified untimely of MSP denial, or 
SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
CB178	10/01/00	* 09/30/10	SNF	"Clinically Complex, ADL Index 12 - 16/OMRA replacing 14-day Medicare-required assessment"					
CB179	07/01/02	* 09/30/10	SNF	"Clinically Complex, ADL Index 12 - 16/Special payment situation 14-day assessment"					
CB18A	07/01/98		SNF	"Clinically Complex , ADL Index 2-5/TRICARE 120-day assessment "					
CB18B	07/01/98		SNF	"Clinically Complex , ADL Index 2-5/TRICARE 150-day assessment "					
CB18C	07/01/98		SNF	"Clinically Complex , ADL Index 2-5/TRICARE 180-day assessment "					
CB18D	07/01/98		SNF	"Clinically Complex , ADL Index 2-5/TRICARE 210-day assessment "					
CB18E	07/01/98		SNF	"Clinically Complex , ADL Index 2-5/TRICARE 240-day assessment "					
CB18F	07/01/98		SNF	"Clinically Complex , ADL Index 2-5/TRICARE 270-day assessment "					
CB18G	07/01/98		SNF	"Clinically Complex , ADL Index 2-5/TRICARE 300-day assessment "					
CB18H	07/01/98		SNF	"Clinically Complex , ADL Index 2-5/TRICARE 330-day assessment "					
CB18I	07/01/98		SNF	"Clinically Complex , ADL Index 2-5/TRICARE 360-day assessment "					
CB18X	07/01/98		SNF	"Clinically Complex , ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval "					
CB201	07/01/98		SNF	"Clinically Complex , ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA."					
CB202	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 12 - 16, signs of depression/Medicare 30 day assessment (Full)"					
CB203	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 12 - 16, signs of depression/Medicare 60 day assessment (Full)"					
CB204	07/01/98		SNF	"Clinically Complex , ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA."					
CB205	07/01/98		SNF	"Clinically Complex , ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
CB206	10/01/10		SNF	"Clinically Complex , ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
CB207	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 12 - 16, signs of depression/Medicare 14 day assessment (Full or comprehensive)"					
CB208	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 12 - 16, signs of depression/Other Medicare Required Assessment (OMRA) "					
CB20A	10/01/11		SNF	"Clinically Complex , ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
CB20B	10/01/11		SNF	"Clinically Complex , ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
CB20C	10/01/11		SNF	"Clinically Complex , ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
CB20D	10/01/11		SNF	"Clinically Complex , ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
CB210	10/01/10		SNF	"Clinically Complex , ADL Index 2-5/5-day or readmission return. "					
CB211	10/01/10		SNF	"Clinically Complex , ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
CB212	10/01/10		SNF	"Clinically Complex , ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
CB213	10/01/10		SNF	"Clinically Complex , ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
CB214	10/01/10		SNF	"Clinically Complex , ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
CB215	10/01/10		SNF	"Clinically Complex , ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
CB216	10/01/10		SNF	"Clinically Complex , ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
CB217	07/01/98		SNF	"Clinically Complex , ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
CB218 	10/01/00	* 09/30/10	SNF	"Clinically Complex, ADL Index 12 - 16, signs of depression/OMRA replacing 5-day Medicare assessment"					
CB219	07/01/02	* 09/30/10	SNF	"Clinically Complex, ADL Index 12 - 16, signs of depression/Special payment situation 5-day assessment"					
CB21A	10/01/11		SNF	"Clinically Complex , ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
CB21B	10/01/11		SNF	"Clinically Complex , ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
CB21C	10/01/11		SNF	"Clinically Complex , ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CB220	10/01/10		SNF	"Clinically Complex , ADL Index 2-5/14-day. "					
CB221	10/01/10		SNF	"Clinically Complex , ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
CB224	10/01/10		SNF	"Clinically Complex , ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
CB225	10/01/10		SNF	"Clinically Complex , ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
CB226	10/01/10		SNF	"Clinically Complex , ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
CB228	10/01/00	* 09/30/10	SNF	"Clinically Complex, ADL Index 12 - 16, signs of depression/OMRA replacing 30-day Medicare assessment"					
CB229	07/01/02	* 09/30/10	SNF	"Clinically Complex, ADL Index 12 - 16, signs of depression/Special payment situation 30-day assessment"					
CB22A	10/01/11		SNF	"Clinically Complex , ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
CB22B	10/01/11		SNF	"Clinically Complex , ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
CB22C	10/01/11		SNF	"Clinically Complex , ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CB22D	10/01/11		SNF	"Clinically Complex , ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CB230	07/01/98		SNF	"Clinically Complex , ADL Index 2-5/30-day. "					
CB231	07/01/98		SNF	"Clinically Complex , ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
CB232	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 12 - 16, signs of depression/[7/98 def.] SCSA or OMRA/ Medicare 30 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 30-day Medicare required assessment"					
CB233	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 12 - 16, signs of depression/[7/98 def.] SCSA or OMRA/ Medicare 60 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 60-day Medicare required assessment"					
CB234	07/01/98		SNF	"Clinically Complex , ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
CB235	07/01/98		SNF	"Clinically Complex , ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
CB236	10/01/10		SNF	"Clinically Complex , ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
CB237	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 12 - 16, signs of depression/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
CB238	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 12 - 16, signs of depression/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
CB239	07/01/02	* 09/30/10	SNF	"Clinically Complex, ADL Index 12 - 16, signs of depression/Special payment situation 60-day assessment"					
CB23A	10/01/11		SNF	"Clinically Complex , ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
CB23B	10/01/11		SNF	"Clinically Complex , ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
CB23C	10/01/11		SNF	"Clinically Complex , ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CB23D	10/01/11		SNF	"Clinically Complex , ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CB240	07/01/98		SNF	"Clinically Complex , ADL Index 2-5/60-day. "					
CB241	07/01/98		SNF	"Clinically Complex , ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
CB242	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 12 - 16, signs of depression/Significant Correction of Prior Full Assessment/Medicare 30 Day Assessment "					
CB243	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 12 - 16, signs of depression/Significant Correction of Prior Full Assessment/Medicare 60 Day Assessment "					
CB244	07/01/98		SNF	"Clinically Complex , ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
CB245	07/01/98		SNF	"Clinically Complex , ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
CB246	10/01/10		SNF	"Clinically Complex , ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
CB247	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 12 - 16, signs of depression/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
CB248	10/01/00	* 09/30/10	SNF	"Clinically Complex, ADL Index 12 - 16, signs of depression/OMRA replacing 90-day Medicare-required assessment"					
CB249	07/01/02	* 09/30/10	SNF	"Clinically Complex, ADL Index 12 - 16, signs of depression/Special payment situation 90-day assessment"					
CB24A	10/01/11		SNF	"Clinically Complex , ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
CB24B	10/01/11		SNF	"Clinically Complex , ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
CB24C	10/01/11		SNF	"Clinically Complex , ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CB24D	10/01/11		SNF	"Clinically Complex , ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CB250	10/01/10		SNF	"Clinically Complex , ADL Index 2-5/90-day. "					
CB251	10/01/10		SNF	"Clinically Complex , ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
CB254	07/01/98		SNF	"Clinically Complex , ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
CB255	10/01/10		SNF	"Clinically Complex , ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
CB256	10/01/10		SNF	"Clinically Complex , ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
CB25A	10/01/11		SNF	"Clinically Complex , ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
CB25B	10/01/11		SNF	"Clinically Complex , ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
CB25C	10/01/11		SNF	"Clinically Complex , ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CB25D	10/01/11		SNF	"Clinically Complex , ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CB260	10/01/10		SNF	"Clinically Complex , ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following: SNF notified untimely of MSP denial, or SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
CB278	10/01/00	* 09/30/10	SNF	"Clinically Complex, ADL Index 12 - 16, signs of depression/OMRA replacing 14-day Medicare-required assessment"					
CB279	07/01/02	* 09/30/10	SNF	"Clinically Complex, ADL Index 12 - 16, signs of depression/Special payment situation 14-day assessment"					
CB28A	07/01/98		SNF	"Clinically Complex , ADL Index 2-5/TRICARE 120-day assessment "					
CB28B	07/01/98		SNF	"Clinically Complex , ADL Index 2-5/TRICARE 150-day assessment "					
CB28C	07/01/98		SNF	"Clinically Complex , ADL Index 2-5/TRICARE 180-day assessment "					
CB28D	07/01/98		SNF	"Clinically Complex , ADL Index 2-5/TRICARE 210-day assessment "					
CB28E	07/01/98		SNF	"Clinically Complex , ADL Index 2-5/TRICARE 240-day assessment "					
CB28F	07/01/98		SNF	"Clinically Complex , ADL Index 2-5/TRICARE 270-day assessment "					
CB28G	07/01/98		SNF	"Clinically Complex , ADL Index 2-5/TRICARE 300-day assessment "					
CB28H	07/01/98		SNF	"Clinically Complex , ADL Index 2-5/TRICARE 330-day assessment "					
CB28I	07/01/98		SNF	"Clinically Complex , ADL Index 2-5/TRICARE 360-day assessment "					
CB28X	07/01/98		SNF	"Clinically Complex , ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval "					
CC101	07/01/98		SNF	"Clinically Complex , ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA."					
CC102	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 17 - 18/Medicare 30 day assessment (Full)"					
CC103	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 17 - 18/Medicare 60 day assessment (Full)"					
CC104	07/01/98		SNF	"Clinically Complex , ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA."					
CC105	07/01/98		SNF	"Clinically Complex , ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
CC106	10/01/10		SNF	"Clinically Complex , ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
CC107	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 17 - 18/Medicare 14 day assessment (Full or comprehensive)"					
CC108	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 17 - 18/Other Medicare Required Assessment (OMRA) "					
CC10A	10/01/11		SNF	"Clinically Complex , ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
CC10B	10/01/11		SNF	"Clinically Complex , ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
CC10C	10/01/11		SNF	"Clinically Complex , ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
CC10D	10/01/11		SNF	"Clinically Complex , ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
CC110	10/01/10		SNF	"Clinically Complex , ADL Index 6-10/5-day or readmission return. "					
CC111	07/01/98		SNF	"Clinically Complex , ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
CC112	10/01/10		SNF	"Clinically Complex , ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
CC113	10/01/10		SNF	"Clinically Complex , ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
CC114	10/01/10		SNF	"Clinically Complex , ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
CC115	10/01/10		SNF	"Clinically Complex , ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
CC116	10/01/10		SNF	"Clinically Complex , ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
CC117	07/01/98		SNF	"Clinically Complex , ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
CC118 	10/01/00	* 09/30/10	SNF	"Clinically Complex, ADL Index 17 - 18/OMRA replacing 5-day Medicare assessment"					
CC119	07/01/02	* 09/30/10	SNF	"Clinically Complex, ADL Index 17 - 18/Special payment situation 5-day assessment"					
CC11A	10/01/11		SNF	"Clinically Complex , ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
CC11B	10/01/11		SNF	"Clinically Complex , ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
CC11C	10/01/11		SNF	"Clinically Complex , ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CC120	10/01/10		SNF	"Clinically Complex , ADL Index 6-10/14-day. "					
CC121	10/01/10		SNF	"Clinically Complex , ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
CC124	10/01/10		SNF	"Clinically Complex , ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
CC125	10/01/10		SNF	"Clinically Complex , ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
CC126	10/01/10		SNF	"Clinically Complex , ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
CC128	10/01/00	* 09/30/10	SNF	"Clinically Complex, ADL Index 17 - 18/OMRA replacing 30-day Medicare assessment"					
CC129	07/01/02	* 09/30/10	SNF	"Clinically Complex, ADL Index 17 - 18/Special payment situation 30-day assessment"					
CC12A	10/01/11		SNF	"Clinically Complex , ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
CC12B	10/01/11		SNF	"Clinically Complex , ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
CC12C	10/01/11		SNF	"Clinically Complex , ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CC12D	10/01/11		SNF	"Clinically Complex , ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CC130	07/01/98		SNF	"Clinically Complex , ADL Index 6-10/30-day. "					
CC131	07/01/98		SNF	"Clinically Complex , ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
CC132	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 17 - 18/[7/98 def.] SCSA or OMRA/ Medicare 30 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 30-day Medicare required assessment"					
CC133	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 17 - 18/[7/98 def.] SCSA or OMRA/ Medicare 60 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 60-day Medicare required assessment"					
CC134	07/01/98		SNF	"Clinically Complex , ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
CC135	07/01/98		SNF	"Clinically Complex , ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
CC136	10/01/10		SNF	"Clinically Complex , ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
CC137	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 17 - 18/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
CC138	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 17 - 18/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
CC139	07/01/02	* 09/30/10	SNF	"Clinically Complex, ADL Index 17 - 18/Special payment situation 60-day assessment"					
CC13A	10/01/11		SNF	"Clinically Complex , ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
CC13B	10/01/11		SNF	"Clinically Complex , ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
CC13C	10/01/11		SNF	"Clinically Complex , ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CC13D	10/01/11		SNF	"Clinically Complex , ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CC140	07/01/98		SNF	"Clinically Complex , ADL Index 6-10/60-day. "					
CC141	07/01/98		SNF	"Clinically Complex , ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
CC142	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 17 - 18/Significant Correction of Prior Full Assessment/Medicare 30 Day Assessment "					
CC143	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 17 - 18/Significant Correction of Prior Full Assessment/Medicare 60 Day Assessment "					
CC144	07/01/98		SNF	"Clinically Complex , ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
CC145	07/01/98		SNF	"Clinically Complex , ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
CC146	10/01/10		SNF	"Clinically Complex , ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
CC147	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 17 - 18/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
CC148	10/01/00	* 09/30/10	SNF	"Clinically Complex, ADL Index 17 - 18/OMRA replacing 90-day Medicare-required assessment"					
CC149	07/01/02	* 09/30/10	SNF	"Clinically Complex, ADL Index 17 - 18/Special payment situation 90-day assessment"					
CC14A	10/01/11		SNF	"Clinically Complex , ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
CC14B	10/01/11		SNF	"Clinically Complex , ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
CC14C	10/01/11		SNF	"Clinically Complex , ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CC14D	10/01/11		SNF	"Clinically Complex , ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CC150	10/01/10		SNF	"Clinically Complex , ADL Index 6-10/90-day. "					
CC151	10/01/10		SNF	"Clinically Complex , ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
CC154	07/01/98		SNF	"Clinically Complex , ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
CC155	10/01/10		SNF	"Clinically Complex , ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
CC156	10/01/10		SNF	"Clinically Complex , ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
CC15A	10/01/11		SNF	"Clinically Complex , ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
CC15B	10/01/11		SNF	"Clinically Complex , ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
CC15C	10/01/11		SNF	"Clinically Complex , ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CC15D	10/01/11		SNF	"Clinically Complex , ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CC160	10/01/10		SNF	"Clinically Complex , ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following: SNF notified untimely of MSP denial, or SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
CC178	10/01/00	* 09/30/10	SNF	"Clinically Complex, ADL Index 17 - 18/OMRA replacing 14-day Medicare-required assessment"					
CC179	07/01/02	* 09/30/10	SNF	"Clinically Complex, ADL Index 17 - 18/Special payment situation 14-day assessment"					
CC18A	07/01/98		SNF	"Clinically Complex , ADL Index 6-10/TRICARE 120-day assessment "					
CC18B	07/01/98		SNF	"Clinically Complex , ADL Index 6-10/TRICARE 150-day assessment "					
CC18C	07/01/98		SNF	"Clinically Complex , ADL Index 6-10/TRICARE 180-day assessment "					
CC18D	07/01/98		SNF	"Clinically Complex , ADL Index 6-10/TRICARE 210-day assessment "					
CC18E	07/01/98		SNF	"Clinically Complex , ADL Index 6-10/TRICARE 240-day assessment "					
CC18F	07/01/98		SNF	"Clinically Complex , ADL Index 6-10/TRICARE 270-day assessment "					
CC18G	07/01/98		SNF	"Clinically Complex , ADL Index 6-10/TRICARE 300-day assessment "					
CC18H	07/01/98		SNF	"Clinically Complex , ADL Index 6-10/TRICARE 330-day assessment "					
CC18I	07/01/98		SNF	"Clinically Complex , ADL Index 6-10/TRICARE 360-day assessment "					
CC18X	07/01/98		SNF	"Clinically Complex , ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval "					
CC201	07/01/98		SNF	"Clinically Complex , ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA."					
CC202	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 17 - 18, signs of depression/Medicare 30 day assessment (Full)"					
CC203	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 17 - 18, signs of depression/Medicare 60 day assessment (Full)"					
CC204	07/01/98		SNF	"Clinically Complex , ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA."					
CC205	07/01/98		SNF	"Clinically Complex , ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
CC206	10/01/10		SNF	"Clinically Complex , ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
CC207	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 17 - 18, signs of depression/Medicare 14 day assessment (Full or comprehensive)"					
CC208	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 17 - 18, signs of depression/Other Medicare Required Assessment (OMRA) "					
CC20A	10/01/11		SNF	"Clinically Complex , ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
CC20B	10/01/11		SNF	"Clinically Complex , ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
CC20C	10/01/11		SNF	"Clinically Complex , ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
CC20D	10/01/11		SNF	"Clinically Complex , ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
CC210	10/01/10		SNF	"Clinically Complex , ADL Index 6-10/5-day or readmission return. "					
CC211	07/01/98		SNF	"Clinically Complex , ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
CC212	10/01/10		SNF	"Clinically Complex , ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
CC213	10/01/10		SNF	"Clinically Complex , ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
CC214	10/01/10		SNF	"Clinically Complex , ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
CC215	10/01/10		SNF	"Clinically Complex , ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
CC216	10/01/10		SNF	"Clinically Complex , ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
CC217	07/01/98		SNF	"Clinically Complex , ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
CC218 	10/01/00	* 09/30/10	SNF	"Clinically Complex, ADL Index 17 - 18, signs of depression/OMRA replacing 5-day Medicare assessment"					
CC219	07/01/02	* 09/30/10	SNF	"Clinically Complex, ADL Index 17 - 18, signs of depression/Special payment situation 5-day assessment"					
CC21A	10/01/11		SNF	"Clinically Complex , ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
CC21B	10/01/11		SNF	"Clinically Complex , ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
CC21C	10/01/11		SNF	"Clinically Complex , ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CC220	10/01/10		SNF	"Clinically Complex , ADL Index 6-10/14-day. "					
CC221	10/01/10		SNF	"Clinically Complex , ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
CC224	10/01/10		SNF	"Clinically Complex , ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
CC225	10/01/10		SNF	"Clinically Complex , ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
CC226	10/01/10		SNF	"Clinically Complex , ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
CC228	10/01/00	* 09/30/10	SNF	"Clinically Complex, ADL Index 17 - 18, signs of depression/OMRA replacing 30-day Medicare assessment"					
CC229	07/01/02	* 09/30/10	SNF	"Clinically Complex, ADL Index 17 - 18, signs of depression/Special payment situation 30-day assessment"					
CC22A	10/01/11		SNF	"Clinically Complex , ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
CC22B	10/01/11		SNF	"Clinically Complex , ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
CC22C	10/01/11		SNF	"Clinically Complex , ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CC22D	10/01/11		SNF	"Clinically Complex , ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CC230	07/01/98		SNF	"Clinically Complex , ADL Index 6-10/30-day. "					
CC231	07/01/98		SNF	"Clinically Complex , ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
CC232	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 17 - 18, signs of depression/[7/98 def.] SCSA or OMRA/ Medicare 30 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 30-day Medicare required assessment"					
CC233	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 17 - 18, signs of depression/[7/98 def.] SCSA or OMRA/ Medicare 60 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 60-day Medicare required assessment"					
CC234	07/01/98		SNF	"Clinically Complex , ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
CC235	07/01/98		SNF	"Clinically Complex , ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
CC236	10/01/10		SNF	"Clinically Complex , ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
CC237	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 17 - 18, signs of depression/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
CC238	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 17 - 18, signs of depression/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
CC239	07/01/02	* 09/30/10	SNF	"Clinically Complex, ADL Index 17 - 18, signs of depression/Special payment situation 60-day assessment"					
CC23A	10/01/11		SNF	"Clinically Complex , ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
CC23B	10/01/11		SNF	"Clinically Complex , ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
CC23C	10/01/11		SNF	"Clinically Complex , ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CC23D	10/01/11		SNF	"Clinically Complex , ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CC240	07/01/98		SNF	"Clinically Complex , ADL Index 6-10/60-day. "					
CC241	07/01/98		SNF	"Clinically Complex , ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
CC242	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 17 - 18, signs of depression/Significant Correction of Prior Full Assessment/Medicare 30 Day Assessment "					
CC243	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 17 - 18, signs of depression/Significant Correction of Prior Full Assessment/Medicare 60 Day Assessment "					
CC244	07/01/98		SNF	"Clinically Complex , ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
CC245	07/01/98		SNF	"Clinically Complex , ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
CC246	10/01/10		SNF	"Clinically Complex , ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
CC247	07/01/98	* 09/30/10	SNF	"Clinically Complex, ADL Index 17 - 18, signs of depression/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
CC248	10/01/00	* 09/30/10	SNF	"Clinically Complex, ADL Index 17 - 18, signs of depression/OMRA replacing 90-day Medicare-required assessment"					
CC249	07/01/02	* 09/30/10	SNF	"Clinically Complex, ADL Index 17 - 18, signs of depression/Special payment situation 90-day assessment"					
CC24A	10/01/11		SNF	"Clinically Complex , ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
CC24B	10/01/11		SNF	"Clinically Complex , ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
CC24C	10/01/11		SNF	"Clinically Complex , ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CC24D	10/01/11		SNF	"Clinically Complex , ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CC250	10/01/10		SNF	"Clinically Complex , ADL Index 6-10/90-day. "					
CC251	10/01/10		SNF	"Clinically Complex , ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
CC254	07/01/98		SNF	"Clinically Complex , ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
CC255	10/01/10		SNF	"Clinically Complex , ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
CC256	10/01/10		SNF	"Clinically Complex , ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
CC25A	10/01/11		SNF	"Clinically Complex , ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
CC25B	10/01/11		SNF	"Clinically Complex , ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
CC25C	10/01/11		SNF	"Clinically Complex , ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CC25D	10/01/11		SNF	"Clinically Complex , ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CC260	10/01/10		SNF	"Clinically Complex , ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following: SNF notified untimely of MSP denial, or SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
CC278	10/01/00	* 09/30/10	SNF	"Clinically Complex, ADL Index 17 - 18, signs of depression/OMRA replacing 14-day Medicare-required assessment"					
CC279	07/01/02	* 09/30/10	SNF	"Clinically Complex, ADL Index 17 - 18, signs of depression/Special payment situation 14-day assessment"					
CC28A	07/01/98		SNF	"Clinically Complex , ADL Index 6-10/TRICARE 120-day assessment "					
CC28B	07/01/98		SNF	"Clinically Complex , ADL Index 6-10/TRICARE 150-day assessment "					
CC28C	07/01/98		SNF	"Clinically Complex , ADL Index 6-10/TRICARE 180-day assessment "					
CC28D	07/01/98		SNF	"Clinically Complex , ADL Index 6-10/TRICARE 210-day assessment "					
CC28E	07/01/98		SNF	"Clinically Complex , ADL Index 6-10/TRICARE 240-day assessment "					
CC28F	07/01/98		SNF	"Clinically Complex , ADL Index 6-10/TRICARE 270-day assessment "					
CC28G	07/01/98		SNF	"Clinically Complex , ADL Index 6-10/TRICARE 300-day assessment "					
CC28H	07/01/98		SNF	"Clinically Complex , ADL Index 6-10/TRICARE 330-day assessment "					
CC28I	07/01/98		SNF	"Clinically Complex , ADL Index 6-10/TRICARE 360-day assessment "					
CC28X	07/01/98		SNF	"Clinically Complex , ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval "					
CD101	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA."					
CD104	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA."					
CD105	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
CD106	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
CD10A	10/01/11		SNF	"Clinically Complex , ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
CD10B	10/01/11		SNF	"Clinically Complex , ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
CD10C	10/01/11		SNF	"Clinically Complex , ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
CD10D	10/01/11		SNF	"Clinically Complex , ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
CD110	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/5-day or readmission return. "					
CD111	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
CD112	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
CD113	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
CD114	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
CD115	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
CD116	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
CD117	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
CD11A	10/01/11		SNF	"Clinically Complex , ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
CD11B	10/01/11		SNF	"Clinically Complex , ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
CD11C	10/01/11		SNF	"Clinically Complex , ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CD120	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/14-day. "					
CD121	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
CD124	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
CD125	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
CD126	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
CD12A	10/01/11		SNF	"Clinically Complex , ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
CD12B	10/01/11		SNF	"Clinically Complex , ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
CD12C	10/01/11		SNF	"Clinically Complex , ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CD12D	10/01/11		SNF	"Clinically Complex , ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CD130	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/30-day. "					
CD131	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
CD134	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
CD135	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
CD136	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
CD13A	10/01/11		SNF	"Clinically Complex , ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
CD13B	10/01/11		SNF	"Clinically Complex , ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
CD13C	10/01/11		SNF	"Clinically Complex , ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CD13D	10/01/11		SNF	"Clinically Complex , ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CD140	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/60-day. "					
CD141	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
CD144	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
CD145	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
CD146	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
CD14A	10/01/11		SNF	"Clinically Complex , ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
CD14B	10/01/11		SNF	"Clinically Complex , ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
CD14C	10/01/11		SNF	"Clinically Complex , ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CD14D	10/01/11		SNF	"Clinically Complex , ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CD150	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/90-day. "					
CD151	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
CD154	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
CD155	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
CD156	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
CD15A	10/01/11		SNF	"Clinically Complex , ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
CD15B	10/01/11		SNF	"Clinically Complex , ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
CD15C	10/01/11		SNF	"Clinically Complex , ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CD15D	10/01/11		SNF	"Clinically Complex , ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CD160	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following: SNF notified untimely of MSP denial, or SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
CD18A	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/TRICARE 120-day assessment "					
CD18B	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/TRICARE 150-day assessment "					
CD18C	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/TRICARE 180-day assessment "					
CD18D	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/TRICARE 210-day assessment "					
CD18E	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/TRICARE 240-day assessment "					
CD18F	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/TRICARE 270-day assessment "					
CD18G	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/TRICARE 300-day assessment "					
CD18H	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/TRICARE 330-day assessment "					
CD18I	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/TRICARE 360-day assessment "					
CD18X	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval "					
CD201	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA."					
CD204	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA."					
CD205	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
CD206	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
CD20A	10/01/11		SNF	"Clinically Complex , ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
CD20B	10/01/11		SNF	"Clinically Complex , ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
CD20C	10/01/11		SNF	"Clinically Complex , ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
CD20D	10/01/11		SNF	"Clinically Complex , ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
CD210	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/5-day or readmission return. "					
CD211	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
CD212	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
CD213	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
CD214	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
CD215	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
CD216	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
CD217	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
CD21A	10/01/11		SNF	"Clinically Complex , ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
CD21B	10/01/11		SNF	"Clinically Complex , ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
CD21C	10/01/11		SNF	"Clinically Complex , ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CD220	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/14-day. "					
CD221	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
CD224	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
CD225	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
CD226	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
CD22A	10/01/11		SNF	"Clinically Complex , ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
CD22B	10/01/11		SNF	"Clinically Complex , ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
CD22C	10/01/11		SNF	"Clinically Complex , ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CD22D	10/01/11		SNF	"Clinically Complex , ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CD230	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/30-day. "					
CD231	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
CD234	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
CD235	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
CD236	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
CD23A	10/01/11		SNF	"Clinically Complex , ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
CD23B	10/01/11		SNF	"Clinically Complex , ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
CD23C	10/01/11		SNF	"Clinically Complex , ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CD23D	10/01/11		SNF	"Clinically Complex , ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CD240	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/60-day. "					
CD241	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
CD244	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
CD245	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
CD246	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
CD24A	10/01/11		SNF	"Clinically Complex , ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
CD24B	10/01/11		SNF	"Clinically Complex , ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
CD24C	10/01/11		SNF	"Clinically Complex , ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CD24D	10/01/11		SNF	"Clinically Complex , ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CD250	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/90-day. "					
CD251	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
CD254	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
CD255	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
CD256	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
CD25A	10/01/11		SNF	"Clinically Complex , ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
CD25B	10/01/11		SNF	"Clinically Complex , ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
CD25C	10/01/11		SNF	"Clinically Complex , ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CD25D	10/01/11		SNF	"Clinically Complex , ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CD260	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following: SNF notified untimely of MSP denial, or SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
CD28A	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/TRICARE 120-day assessment "					
CD28B	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/TRICARE 150-day assessment "					
CD28C	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/TRICARE 180-day assessment "					
CD28D	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/TRICARE 210-day assessment "					
CD28E	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/TRICARE 240-day assessment "					
CD28F	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/TRICARE 270-day assessment "					
CD28G	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/TRICARE 300-day assessment "					
CD28H	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/TRICARE 330-day assessment "					
CD28I	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/TRICARE 360-day assessment "					
CD28X	10/01/10		SNF	"Clinically Complex , ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval "					
CE101	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA."					
CE104	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA."					
CE105	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
CE106	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
CE10A	10/01/11		SNF	"Clinically Complex , ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
CE10B	10/01/11		SNF	"Clinically Complex , ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
CE10C	10/01/11		SNF	"Clinically Complex , ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
CE10D	10/01/11		SNF	"Clinically Complex , ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
CE110	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/5-day or readmission return. "					
CE111	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
CE112	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
CE113	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
CE114	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
CE115	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
CE116	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
CE117	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
CE11A	10/01/11		SNF	"Clinically Complex , ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
CE11B	10/01/11		SNF	"Clinically Complex , ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
CE11C	10/01/11		SNF	"Clinically Complex , ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CE120	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/14-day. "					
CE121	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
CE124	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
CE125	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
CE126	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
CE12A	10/01/11		SNF	"Clinically Complex , ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
CE12B	10/01/11		SNF	"Clinically Complex , ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
CE12C	10/01/11		SNF	"Clinically Complex , ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CE12D	10/01/11		SNF	"Clinically Complex , ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CE130	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/30-day. "					
CE131	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
CE134	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
CE135	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
CE136	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
CE13A	10/01/11		SNF	"Clinically Complex , ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
CE13B	10/01/11		SNF	"Clinically Complex , ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
CE13C	10/01/11		SNF	"Clinically Complex , ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CE13D	10/01/11		SNF	"Clinically Complex , ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CE140	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/60-day. "					
CE141	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
CE144	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
CE145	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
CE146	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
CE14A	10/01/11		SNF	"Clinically Complex , ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
CE14B	10/01/11		SNF	"Clinically Complex , ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
CE14C	10/01/11		SNF	"Clinically Complex , ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CE14D	10/01/11		SNF	"Clinically Complex , ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CE150	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/90-day. "					
CE151	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
CE154	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
CE155	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
CE156	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
CE15A	10/01/11		SNF	"Clinically Complex , ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
CE15B	10/01/11		SNF	"Clinically Complex , ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
CE15C	10/01/11		SNF	"Clinically Complex , ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CE15D	10/01/11		SNF	"Clinically Complex , ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CE160	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following: SNF notified untimely of MSP denial, or SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
CE18A	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/TRICARE 120-day assessment "					
CE18B	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/TRICARE 150-day assessment "					
CE18C	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/TRICARE 180-day assessment "					
CE18D	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/TRICARE 210-day assessment "					
CE18E	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/TRICARE 240-day assessment "					
CE18F	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/TRICARE 270-day assessment "					
CE18G	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/TRICARE 300-day assessment "					
CE18H	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/TRICARE 330-day assessment "					
CE18I	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/TRICARE 360-day assessment "					
CE18X	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval "					
CE201	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA."					
CE204	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA."					
CE205	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
CE206	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
CE20A	10/01/11		SNF	"Clinically Complex , ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
CE20B	10/01/11		SNF	"Clinically Complex , ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
CE20C	10/01/11		SNF	"Clinically Complex , ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
CE20D	10/01/11		SNF	"Clinically Complex , ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
CE210	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/5-day or readmission return. "					
CE211	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
CE212	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
CE213	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
CE214	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
CE215	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
CE216	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
CE217	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
CE21A	10/01/11		SNF	"Clinically Complex , ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
CE21B	10/01/11		SNF	"Clinically Complex , ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
CE21C	10/01/11		SNF	"Clinically Complex , ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CE220	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/14-day. "					
CE221	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
CE224	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
CE225	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
CE226	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
CE22A	10/01/11		SNF	"Clinically Complex , ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
CE22B	10/01/11		SNF	"Clinically Complex , ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
CE22C	10/01/11		SNF	"Clinically Complex , ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CE22D	10/01/11		SNF	"Clinically Complex , ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CE230	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/30-day. "					
CE231	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
CE234	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
CE235	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
CE236	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
CE23A	10/01/11		SNF	"Clinically Complex , ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
CE23B	10/01/11		SNF	"Clinically Complex , ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
CE23C	10/01/11		SNF	"Clinically Complex , ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CE23D	10/01/11		SNF	"Clinically Complex , ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CE240	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/60-day. "					
CE241	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
CE244	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
CE245	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
CE246	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
CE24A	10/01/11		SNF	"Clinically Complex , ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
CE24B	10/01/11		SNF	"Clinically Complex , ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
CE24C	10/01/11		SNF	"Clinically Complex , ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CE24D	10/01/11		SNF	"Clinically Complex , ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CE250	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/90-day. "					
CE251	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
CE254	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
CE255	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
CE256	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
CE25A	10/01/11		SNF	"Clinically Complex , ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
CE25B	10/01/11		SNF	"Clinically Complex , ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
CE25C	10/01/11		SNF	"Clinically Complex , ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CE25D	10/01/11		SNF	"Clinically Complex , ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
CE260	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following: SNF notified untimely of MSP denial, or SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
CE28A	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/TRICARE 120-day assessment "					
CE28B	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/TRICARE 150-day assessment "					
CE28C	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/TRICARE 180-day assessment "					
CE28D	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/TRICARE 210-day assessment "					
CE28E	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/TRICARE 240-day assessment "					
CE28F	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/TRICARE 270-day assessment "					
CE28G	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/TRICARE 300-day assessment "					
CE28H	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/TRICARE 330-day assessment "					
CE28I	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/TRICARE 360-day assessment "					
CE28X	10/01/10		SNF	"Clinically Complex , ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval "					
ES101	10/01/10		SNF	"Extensive Services , ADL Index 2-16/Stand-alone OBRA SCSA OR SCPA OR CCA."					
ES104	10/01/10		SNF	"Extensive Services , ADL Index 2-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA."					
ES105	10/01/10		SNF	"Extensive Services , ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
ES106	10/01/10		SNF	"Extensive Services , ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
ES10A	10/01/11		SNF	"Extensive Services , ADL Index 2-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
ES10B	10/01/11		SNF	"Extensive Services , ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
ES10C	10/01/11		SNF	"Extensive Services , ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
ES10D	10/01/11		SNF	"Extensive Services , ADL Index 2-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
ES110	10/01/10		SNF	"Extensive Services , ADL Index 2-16/5-day or readmission return. "					
ES111	10/01/10		SNF	"Extensive Services , ADL Index 2-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
ES112	10/01/10		SNF	"Extensive Services , ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
ES113	10/01/10		SNF	"Extensive Services , ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
ES114	10/01/10		SNF	"Extensive Services , ADL Index 2-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
ES115	10/01/10		SNF	"Extensive Services , ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
ES116	10/01/10		SNF	"Extensive Services , ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
ES117	10/01/10		SNF	"Extensive Services , ADL Index 2-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
ES11A	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
ES11B	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
ES11C	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
ES120	10/01/10		SNF	"Extensive Services , ADL Index 2-16/14-day. "					
ES121	10/01/10		SNF	"Extensive Services , ADL Index 2-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
ES124	10/01/10		SNF	"Extensive Services , ADL Index 2-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
ES125	10/01/10		SNF	"Extensive Services , ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
ES126	10/01/10		SNF	"Extensive Services , ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
ES12A	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
ES12B	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
ES12C	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
ES12D	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
ES130	10/01/10		SNF	"Extensive Services , ADL Index 2-16/30-day. "					
ES131	10/01/10		SNF	"Extensive Services , ADL Index 2-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
ES134	10/01/10		SNF	"Extensive Services , ADL Index 2-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
ES135	10/01/10		SNF	"Extensive Services , ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
ES136	10/01/10		SNF	"Extensive Services , ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
ES13A	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
ES13B	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
ES13C	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
ES13D	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
ES140	10/01/10		SNF	"Extensive Services , ADL Index 2-16/60-day. "					
ES141	10/01/10		SNF	"Extensive Services , ADL Index 2-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
ES144	10/01/10		SNF	"Extensive Services , ADL Index 2-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
ES145	10/01/10		SNF	"Extensive Services , ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
ES146	10/01/10		SNF	"Extensive Services , ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
ES14A	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
ES14B	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
ES14C	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
ES14D	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
ES150	10/01/10		SNF	"Extensive Services , ADL Index 2-16/90-day. "					
ES151	10/01/10		SNF	"Extensive Services , ADL Index 2-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
ES154	10/01/10		SNF	"Extensive Services , ADL Index 2-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
ES155	10/01/10		SNF	"Extensive Services , ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
ES156	10/01/10		SNF	"Extensive Services , ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
ES15A	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
ES15B	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
ES15C	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
ES15D	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
ES160	10/01/10		SNF	"Extensive Services , ADL Index 2-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following: SNF notified untimely of MSP denial, or 
SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
ES18A	10/01/10		SNF	"Extensive Services , ADL Index 2-16/TRICARE 120-day assessment "					
ES18B	10/01/10		SNF	"Extensive Services , ADL Index 2-16/TRICARE 150-day assessment "					
ES18C	10/01/10		SNF	"Extensive Services , ADL Index 2-16/TRICARE 180-day assessment "					
ES18D	10/01/10		SNF	"Extensive Services , ADL Index 2-16/TRICARE 210-day assessment "					
ES18E	10/01/10		SNF	"Extensive Services , ADL Index 2-16/TRICARE 240-day assessment "					
ES18F	10/01/10		SNF	"Extensive Services , ADL Index 2-16/TRICARE 270-day assessment "					
ES18G	10/01/10		SNF	"Extensive Services , ADL Index 2-16/TRICARE 300-day assessment "					
ES18H	10/01/10		SNF	"Extensive Services , ADL Index 2-16/TRICARE 330-day assessment "					
ES18I	10/01/10		SNF	"Extensive Services , ADL Index 2-16/TRICARE 360-day assessment "					
ES18X	10/01/10		SNF	"Extensive Services , ADL Index 2-16/TRICARE Post 360-day assessments with 30-day interval "					
ES201	10/01/10		SNF	"Extensive Services , ADL Index 2-16/Stand-alone OBRA SCSA OR SCPA OR CCA."					
ES204	10/01/10		SNF	"Extensive Services , ADL Index 2-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA."					
ES205	10/01/10		SNF	"Extensive Services , ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
ES206	10/01/10		SNF	"Extensive Services , ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
ES20A	10/01/11		SNF	"Extensive Services , ADL Index 2-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
ES20B	10/01/11		SNF	"Extensive Services , ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
ES20C	10/01/11		SNF	"Extensive Services , ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
ES20D	10/01/11		SNF	"Extensive Services , ADL Index 2-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
ES210	10/01/10		SNF	"Extensive Services , ADL Index 2-16/5-day or readmission return. "					
ES211	10/01/10		SNF	"Extensive Services , ADL Index 2-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
ES212	10/01/10		SNF	"Extensive Services , ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
ES213	10/01/10		SNF	"Extensive Services , ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
ES214	10/01/10		SNF	"Extensive Services , ADL Index 2-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
ES215	10/01/10		SNF	"Extensive Services , ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
ES216	10/01/10		SNF	"Extensive Services , ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
ES217	10/01/10		SNF	"Extensive Services , ADL Index 2-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
ES21A	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
ES21B	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
ES21C	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
ES220	10/01/10		SNF	"Extensive Services , ADL Index 2-16/14-day. "					
ES221	10/01/10		SNF	"Extensive Services , ADL Index 2-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
ES224	10/01/10		SNF	"Extensive Services , ADL Index 2-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
ES225	10/01/10		SNF	"Extensive Services , ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
ES226	10/01/10		SNF	"Extensive Services , ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
ES22A	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
ES22B	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
ES22C	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
ES22D	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
ES230	10/01/10		SNF	"Extensive Services , ADL Index 2-16/30-day. "					
ES231	10/01/10		SNF	"Extensive Services , ADL Index 2-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
ES234	10/01/10		SNF	"Extensive Services , ADL Index 2-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
ES235	10/01/10		SNF	"Extensive Services , ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
ES236	10/01/10		SNF	"Extensive Services , ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
ES23A	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
ES23B	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
ES23C	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
ES23D	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
ES240	10/01/10		SNF	"Extensive Services , ADL Index 2-16/60-day. "					
ES241	10/01/10		SNF	"Extensive Services , ADL Index 2-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
ES244	10/01/10		SNF	"Extensive Services , ADL Index 2-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
ES245	10/01/10		SNF	"Extensive Services , ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
ES246	10/01/10		SNF	"Extensive Services , ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
ES24A	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
ES24B	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
ES24C	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
ES24D	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
ES250	10/01/10		SNF	"Extensive Services , ADL Index 2-16/90-day. "					
ES251	10/01/10		SNF	"Extensive Services , ADL Index 2-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
ES254	10/01/10		SNF	"Extensive Services , ADL Index 2-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
ES255	10/01/10		SNF	"Extensive Services , ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
ES256	10/01/10		SNF	"Extensive Services , ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
ES25A	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
ES25B	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
ES25C	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
ES25D	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
ES260	10/01/10		SNF	"Extensive Services , ADL Index 2-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following: SNF notified untimely of MSP denial, or 
SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
ES28A	10/01/10		SNF	"Extensive Services , ADL Index 2-16/TRICARE 120-day assessment "					
ES28B	10/01/10		SNF	"Extensive Services , ADL Index 2-16/TRICARE 150-day assessment "					
ES28C	10/01/10		SNF	"Extensive Services , ADL Index 2-16/TRICARE 180-day assessment "					
ES28D	10/01/10		SNF	"Extensive Services , ADL Index 2-16/TRICARE 210-day assessment "					
ES28E	10/01/10		SNF	"Extensive Services , ADL Index 2-16/TRICARE 240-day assessment "					
ES28F	10/01/10		SNF	"Extensive Services , ADL Index 2-16/TRICARE 270-day assessment "					
ES28G	10/01/10		SNF	"Extensive Services , ADL Index 2-16/TRICARE 300-day assessment "					
ES28H	10/01/10		SNF	"Extensive Services , ADL Index 2-16/TRICARE 330-day assessment "					
ES28I	10/01/10		SNF	"Extensive Services , ADL Index 2-16/TRICARE 360-day assessment "					
ES28X	10/01/10		SNF	"Extensive Services , ADL Index 2-16/TRICARE Post 360-day assessments with 30-day interval "					
ES301	10/01/10		SNF	"Extensive Services , ADL Index 2-16/Stand-alone OBRA SCSA OR SCPA OR CCA."					
ES304	10/01/10		SNF	"Extensive Services , ADL Index 2-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA."					
ES305	10/01/10		SNF	"Extensive Services , ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
ES306	10/01/10		SNF	"Extensive Services , ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
ES30A	10/01/11		SNF	"Extensive Services , ADL Index 2-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
ES30B	10/01/11		SNF	"Extensive Services , ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
ES30C	10/01/11		SNF	"Extensive Services , ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
ES30D	10/01/11		SNF	"Extensive Services , ADL Index 2-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
ES310	10/01/10		SNF	"Extensive Services , ADL Index 2-16/5-day or readmission return. "					
ES311	10/01/10		SNF	"Extensive Services , ADL Index 2-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
ES312	10/01/10		SNF	"Extensive Services , ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
ES313	10/01/10		SNF	"Extensive Services , ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
ES314	10/01/10		SNF	"Extensive Services , ADL Index 2-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
ES315	10/01/10		SNF	"Extensive Services , ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
ES316	10/01/10		SNF	"Extensive Services , ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
ES317	10/01/10		SNF	"Extensive Services , ADL Index 2-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
ES31A	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
ES31B	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
ES31C	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
ES320	10/01/10		SNF	"Extensive Services , ADL Index 2-16/14-day. "					
ES321	10/01/10		SNF	"Extensive Services , ADL Index 2-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
ES324	10/01/10		SNF	"Extensive Services , ADL Index 2-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
ES325	10/01/10		SNF	"Extensive Services , ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
ES326	10/01/10		SNF	"Extensive Services , ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
ES32A	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
ES32B	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
ES32C	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
ES32D	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
ES330	10/01/10		SNF	"Extensive Services , ADL Index 2-16/30-day. "					
ES331	10/01/10		SNF	"Extensive Services , ADL Index 2-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
ES334	10/01/10		SNF	"Extensive Services , ADL Index 2-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
ES335	10/01/10		SNF	"Extensive Services , ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
ES336	10/01/10		SNF	"Extensive Services , ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
ES33A	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
ES33B	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
ES33C	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
ES33D	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
ES340	10/01/10		SNF	"Extensive Services , ADL Index 2-16/60-day. "					
ES341	10/01/10		SNF	"Extensive Services , ADL Index 2-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
ES344	10/01/10		SNF	"Extensive Services , ADL Index 2-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
ES345	10/01/10		SNF	"Extensive Services , ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
ES346	10/01/10		SNF	"Extensive Services , ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
ES34A	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
ES34B	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
ES34C	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
ES34D	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
ES350	10/01/10		SNF	"Extensive Services , ADL Index 2-16/90-day. "					
ES351	10/01/10		SNF	"Extensive Services , ADL Index 2-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
ES354	10/01/10		SNF	"Extensive Services , ADL Index 2-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
ES355	10/01/10		SNF	"Extensive Services , ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
ES356	10/01/10		SNF	"Extensive Services , ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
ES35A	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
ES35B	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
ES35C	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
ES35D	10/01/11		SNF	"Extensive Services , ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
ES360	10/01/10		SNF	"Extensive Services , ADL Index 2-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following: SNF notified untimely of MSP denial, or 
SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
ES38A	10/01/10		SNF	"Extensive Services , ADL Index 2-16/TRICARE 120-day assessment "					
ES38B	10/01/10		SNF	"Extensive Services , ADL Index 2-16/TRICARE 150-day assessment "					
ES38C	10/01/10		SNF	"Extensive Services , ADL Index 2-16/TRICARE 180-day assessment "					
ES38D	10/01/10		SNF	"Extensive Services , ADL Index 2-16/TRICARE 210-day assessment "					
ES38E	10/01/10		SNF	"Extensive Services , ADL Index 2-16/TRICARE 240-day assessment "					
ES38F	10/01/10		SNF	"Extensive Services , ADL Index 2-16/TRICARE 270-day assessment "					
ES38G	10/01/10		SNF	"Extensive Services , ADL Index 2-16/TRICARE 300-day assessment "					
ES38H	10/01/10		SNF	"Extensive Services , ADL Index 2-16/TRICARE 330-day assessment "					
ES38I	10/01/10		SNF	"Extensive Services , ADL Index 2-16/TRICARE 360-day assessment "					
ES38X	10/01/10		SNF	"Extensive Services , ADL Index 2-16/TRICARE Post 360-day assessments with 30-day interval "					
HB101	10/01/10		SNF	"Special Care High , ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA."					
HB104	10/01/10		SNF	"Special Care High , ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA."					
HB105	10/01/10		SNF	"Special Care High , ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
HB106	10/01/10		SNF	"Special Care High , ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
HB10A	10/01/11		SNF	"Special Care High , ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
HB10B	10/01/11		SNF	"Special Care High , ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
HB10C	10/01/11		SNF	"Special Care High , ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
HB10D	10/01/11		SNF	"Special Care High , ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
HB110	10/01/10		SNF	"Special Care High , ADL Index 2-5/5-day or readmission return. "					
HB111	10/01/10		SNF	"Special Care High , ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
HB112	10/01/10		SNF	"Special Care High , ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
HB113	10/01/10		SNF	"Special Care High , ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
HB114	10/01/10		SNF	"Special Care High , ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
HB115	10/01/10		SNF	"Special Care High , ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
HB116	10/01/10		SNF	"Special Care High , ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
HB117	10/01/10		SNF	"Special Care High , ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
HB11A	10/01/11		SNF	"Special Care High , ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
HB11B	10/01/11		SNF	"Special Care High , ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
HB11C	10/01/11		SNF	"Special Care High , ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HB120	10/01/10		SNF	"Special Care High , ADL Index 2-5/14-day. "					
HB121	10/01/10		SNF	"Special Care High , ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
HB124	10/01/10		SNF	"Special Care High , ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
HB125	10/01/10		SNF	"Special Care High , ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
HB126	10/01/10		SNF	"Special Care High , ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
HB12A	10/01/11		SNF	"Special Care High , ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
HB12B	10/01/11		SNF	"Special Care High , ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
HB12C	10/01/11		SNF	"Special Care High , ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HB12D	10/01/11		SNF	"Special Care High , ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HB130	10/01/10		SNF	"Special Care High , ADL Index 2-5/30-day. "					
HB131	10/01/10		SNF	"Special Care High , ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
HB134	10/01/10		SNF	"Special Care High , ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
HB135	10/01/10		SNF	"Special Care High , ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
HB136	10/01/10		SNF	"Special Care High , ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
HB13A	10/01/11		SNF	"Special Care High , ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
HB13B	10/01/11		SNF	"Special Care High , ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
HB13C	10/01/11		SNF	"Special Care High , ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HB13D	10/01/11		SNF	"Special Care High , ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HB140	10/01/10		SNF	"Special Care High , ADL Index 2-5/60-day. "					
HB141	10/01/10		SNF	"Special Care High , ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
HB144	10/01/10		SNF	"Special Care High , ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
HB145	10/01/10		SNF	"Special Care High , ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
HB146	10/01/10		SNF	"Special Care High , ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
HB14A	10/01/11		SNF	"Special Care High , ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
HB14B	10/01/11		SNF	"Special Care High , ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
HB14C	10/01/11		SNF	"Special Care High , ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HB14D	10/01/11		SNF	"Special Care High , ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HB150	10/01/10		SNF	"Special Care High , ADL Index 2-5/90-day. "					
HB151	10/01/10		SNF	"Special Care High , ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
HB154	10/01/10		SNF	"Special Care High , ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
HB155	10/01/10		SNF	"Special Care High , ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
HB156	10/01/10		SNF	"Special Care High , ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
HB15A	10/01/11		SNF	"Special Care High , ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
HB15B	10/01/11		SNF	"Special Care High , ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
HB15C	10/01/11		SNF	"Special Care High , ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HB15D	10/01/11		SNF	"Special Care High , ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HB160	10/01/10		SNF	"Special Care High , ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following: SNF notified untimely of MSP denial, or 
SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
HB18A	10/01/10		SNF	"Special Care High , ADL Index 2-5/TRICARE 120-day assessment "					
HB18B	10/01/10		SNF	"Special Care High , ADL Index 2-5/TRICARE 150-day assessment "					
HB18C	10/01/10		SNF	"Special Care High , ADL Index 2-5/TRICARE 180-day assessment "					
HB18D	10/01/10		SNF	"Special Care High , ADL Index 2-5/TRICARE 210-day assessment "					
HB18E	10/01/10		SNF	"Special Care High , ADL Index 2-5/TRICARE 240-day assessment "					
HB18F	10/01/10		SNF	"Special Care High , ADL Index 2-5/TRICARE 270-day assessment "					
HB18G	10/01/10		SNF	"Special Care High , ADL Index 2-5/TRICARE 300-day assessment "					
HB18H	10/01/10		SNF	"Special Care High , ADL Index 2-5/TRICARE 330-day assessment "					
HB18I	10/01/10		SNF	"Special Care High , ADL Index 2-5/TRICARE 360-day assessment "					
HB18X	10/01/10		SNF	"Special Care High , ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval "					
HB201	10/01/10		SNF	"Special Care High , ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA."					
HB204	10/01/10		SNF	"Special Care High , ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA."					
HB205	10/01/10		SNF	"Special Care High , ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
HB206	10/01/10		SNF	"Special Care High , ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
HB20A	10/01/11		SNF	"Special Care High , ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
HB20B	10/01/11		SNF	"Special Care High , ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
HB20C	10/01/11		SNF	"Special Care High , ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
HB20D	10/01/11		SNF	"Special Care High , ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
HB210	10/01/10		SNF	"Special Care High , ADL Index 2-5/5-day or readmission return. "					
HB211	10/01/10		SNF	"Special Care High , ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
HB212	10/01/10		SNF	"Special Care High , ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
HB213	10/01/10		SNF	"Special Care High , ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
HB214	10/01/10		SNF	"Special Care High , ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
HB215	10/01/10		SNF	"Special Care High , ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
HB216	10/01/10		SNF	"Special Care High , ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
HB217	10/01/10		SNF	"Special Care High , ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
HB21A	10/01/11		SNF	"Special Care High , ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
HB21B	10/01/11		SNF	"Special Care High , ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
HB21C	10/01/11		SNF	"Special Care High , ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HB220	10/01/10		SNF	"Special Care High , ADL Index 2-5/14-day. "					
HB221	10/01/10		SNF	"Special Care High , ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
HB224	10/01/10		SNF	"Special Care High , ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
HB225	10/01/10		SNF	"Special Care High , ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
HB226	10/01/10		SNF	"Special Care High , ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
HB22A	10/01/11		SNF	"Special Care High , ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
HB22B	10/01/11		SNF	"Special Care High , ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
HB22C	10/01/11		SNF	"Special Care High , ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HB22D	10/01/11		SNF	"Special Care High , ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HB230	10/01/10		SNF	"Special Care High , ADL Index 2-5/30-day. "					
HB231	10/01/10		SNF	"Special Care High , ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
HB234	10/01/10		SNF	"Special Care High , ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
HB235	10/01/10		SNF	"Special Care High , ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
HB236	10/01/10		SNF	"Special Care High , ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
HB23A	10/01/11		SNF	"Special Care High , ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
HB23B	10/01/11		SNF	"Special Care High , ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
HB23C	10/01/11		SNF	"Special Care High , ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HB23D	10/01/11		SNF	"Special Care High , ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HB240	10/01/10		SNF	"Special Care High , ADL Index 2-5/60-day. "					
HB241	10/01/10		SNF	"Special Care High , ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
HB244	10/01/10		SNF	"Special Care High , ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
HB245	10/01/10		SNF	"Special Care High , ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
HB246	10/01/10		SNF	"Special Care High , ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
HB24A	10/01/11		SNF	"Special Care High , ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
HB24B	10/01/11		SNF	"Special Care High , ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
HB24C	10/01/11		SNF	"Special Care High , ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HB24D	10/01/11		SNF	"Special Care High , ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HB250	10/01/10		SNF	"Special Care High , ADL Index 2-5/90-day. "					
HB251	10/01/10		SNF	"Special Care High , ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
HB254	10/01/10		SNF	"Special Care High , ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
HB255	10/01/10		SNF	"Special Care High , ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
HB256	10/01/10		SNF	"Special Care High , ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
HB25A	10/01/11		SNF	"Special Care High , ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
HB25B	10/01/11		SNF	"Special Care High , ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
HB25C	10/01/11		SNF	"Special Care High , ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HB25D	10/01/11		SNF	"Special Care High , ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HB260	10/01/10		SNF	"Special Care High , ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following: SNF notified untimely of MSP denial, or 
SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
HB28A	10/01/10		SNF	"Special Care High , ADL Index 2-5/TRICARE 120-day assessment "					
HB28B	10/01/10		SNF	"Special Care High , ADL Index 2-5/TRICARE 150-day assessment "					
HB28C	10/01/10		SNF	"Special Care High , ADL Index 2-5/TRICARE 180-day assessment "					
HB28D	10/01/10		SNF	"Special Care High , ADL Index 2-5/TRICARE 210-day assessment "					
HB28E	10/01/10		SNF	"Special Care High , ADL Index 2-5/TRICARE 240-day assessment "					
HB28F	10/01/10		SNF	"Special Care High , ADL Index 2-5/TRICARE 270-day assessment "					
HB28G	10/01/10		SNF	"Special Care High , ADL Index 2-5/TRICARE 300-day assessment "					
HB28H	10/01/10		SNF	"Special Care High , ADL Index 2-5/TRICARE 330-day assessment "					
HB28I	10/01/10		SNF	"Special Care High , ADL Index 2-5/TRICARE 360-day assessment "					
HB28X	10/01/10		SNF	"Special Care High , ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval "					
HC101	10/01/10		SNF	"Special Care High , ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA."					
HC104	10/01/10		SNF	"Special Care High , ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA."					
HC105	10/01/10		SNF	"Special Care High , ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
HC106	10/01/10		SNF	"Special Care High , ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
HC10A	10/01/11		SNF	"Special Care High , ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
HC10B	10/01/11		SNF	"Special Care High , ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
HC10C	10/01/11		SNF	"Special Care High , ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
HC10D	10/01/11		SNF	"Special Care High , ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
HC110	10/01/10		SNF	"Special Care High , ADL Index 6-10/5-day or readmission return. "					
HC111	10/01/10		SNF	"Special Care High , ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
HC112	10/01/10		SNF	"Special Care High , ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
HC113	10/01/10		SNF	"Special Care High , ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
HC114	10/01/10		SNF	"Special Care High , ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
HC115	10/01/10		SNF	"Special Care High , ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
HC116	10/01/10		SNF	"Special Care High , ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
HC117	10/01/10		SNF	"Special Care High , ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
HC11A	10/01/11		SNF	"Special Care High , ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
HC11B	10/01/11		SNF	"Special Care High , ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
HC11C	10/01/11		SNF	"Special Care High , ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HC120	10/01/10		SNF	"Special Care High , ADL Index 6-10/14-day. "					
HC121	10/01/10		SNF	"Special Care High , ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
HC124	10/01/10		SNF	"Special Care High , ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
HC125	10/01/10		SNF	"Special Care High , ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
HC126	10/01/10		SNF	"Special Care High , ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
HC12A	10/01/11		SNF	"Special Care High , ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
HC12B	10/01/11		SNF	"Special Care High , ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
HC12C	10/01/11		SNF	"Special Care High , ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HC12D	10/01/11		SNF	"Special Care High , ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HC130	10/01/10		SNF	"Special Care High , ADL Index 6-10/30-day. "					
HC131	10/01/10		SNF	"Special Care High , ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
HC134	10/01/10		SNF	"Special Care High , ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
HC135	10/01/10		SNF	"Special Care High , ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
HC136	10/01/10		SNF	"Special Care High , ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
HC13A	10/01/11		SNF	"Special Care High , ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
HC13B	10/01/11		SNF	"Special Care High , ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
HC13C	10/01/11		SNF	"Special Care High , ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HC13D	10/01/11		SNF	"Special Care High , ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HC140	10/01/10		SNF	"Special Care High , ADL Index 6-10/60-day. "					
HC141	10/01/10		SNF	"Special Care High , ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
HC144	10/01/10		SNF	"Special Care High , ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
HC145	10/01/10		SNF	"Special Care High , ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
HC146	10/01/10		SNF	"Special Care High , ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
HC14A	10/01/11		SNF	"Special Care High , ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
HC14B	10/01/11		SNF	"Special Care High , ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
HC14C	10/01/11		SNF	"Special Care High , ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HC14D	10/01/11		SNF	"Special Care High , ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HC150	10/01/10		SNF	"Special Care High , ADL Index 6-10/90-day. "					
HC151	10/01/10		SNF	"Special Care High , ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
HC154	10/01/10		SNF	"Special Care High , ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
HC155	10/01/10		SNF	"Special Care High , ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
HC156	10/01/10		SNF	"Special Care High , ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
HC15A	10/01/11		SNF	"Special Care High , ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
HC15B	10/01/11		SNF	"Special Care High , ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
HC15C	10/01/11		SNF	"Special Care High , ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HC15D	10/01/11		SNF	"Special Care High , ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HC160	10/01/10		SNF	"Special Care High , ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following: SNF notified untimely of MSP denial, or 
SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
HC18A	10/01/10		SNF	"Special Care High , ADL Index 6-10/TRICARE 120-day assessment "					
HC18B	10/01/10		SNF	"Special Care High , ADL Index 6-10/TRICARE 150-day assessment "					
HC18C	10/01/10		SNF	"Special Care High , ADL Index 6-10/TRICARE 180-day assessment "					
HC18D	10/01/10		SNF	"Special Care High , ADL Index 6-10/TRICARE 210-day assessment "					
HC18E	10/01/10		SNF	"Special Care High , ADL Index 6-10/TRICARE 240-day assessment "					
HC18F	10/01/10		SNF	"Special Care High , ADL Index 6-10/TRICARE 270-day assessment "					
HC18G	10/01/10		SNF	"Special Care High , ADL Index 6-10/TRICARE 300-day assessment "					
HC18H	10/01/10		SNF	"Special Care High , ADL Index 6-10/TRICARE 330-day assessment "					
HC18I	10/01/10		SNF	"Special Care High , ADL Index 6-10/TRICARE 360-day assessment "					
HC18X	10/01/10		SNF	"Special Care High , ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval "					
HC201	10/01/10		SNF	"Special Care High , ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA."					
HC204	10/01/10		SNF	"Special Care High , ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA."					
HC205	10/01/10		SNF	"Special Care High , ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
HC206	10/01/10		SNF	"Special Care High , ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
HC20A	10/01/11		SNF	"Special Care High , ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
HC20B	10/01/11		SNF	"Special Care High , ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
HC20C	10/01/11		SNF	"Special Care High , ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
HC20D	10/01/11		SNF	"Special Care High , ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
HC210	10/01/10		SNF	"Special Care High , ADL Index 6-10/5-day or readmission return. "					
HC211	10/01/10		SNF	"Special Care High , ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
HC212	10/01/10		SNF	"Special Care High , ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
HC213	10/01/10		SNF	"Special Care High , ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
HC214	10/01/10		SNF	"Special Care High , ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
HC215	10/01/10		SNF	"Special Care High , ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
HC216	10/01/10		SNF	"Special Care High , ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
HC217	10/01/10		SNF	"Special Care High , ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
HC21A	10/01/11		SNF	"Special Care High , ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
HC21B	10/01/11		SNF	"Special Care High , ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
HC21C	10/01/11		SNF	"Special Care High , ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HC220	10/01/10		SNF	"Special Care High , ADL Index 6-10/14-day. "					
HC221	10/01/10		SNF	"Special Care High , ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
HC224	10/01/10		SNF	"Special Care High , ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
HC225	10/01/10		SNF	"Special Care High , ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
HC226	10/01/10		SNF	"Special Care High , ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
HC22A	10/01/11		SNF	"Special Care High , ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
HC22B	10/01/11		SNF	"Special Care High , ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
HC22C	10/01/11		SNF	"Special Care High , ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HC22D	10/01/11		SNF	"Special Care High , ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HC230	10/01/10		SNF	"Special Care High , ADL Index 6-10/30-day. "					
HC231	10/01/10		SNF	"Special Care High , ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
HC234	10/01/10		SNF	"Special Care High , ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
HC235	10/01/10		SNF	"Special Care High , ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
HC236	10/01/10		SNF	"Special Care High , ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
HC23A	10/01/11		SNF	"Special Care High , ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
HC23B	10/01/11		SNF	"Special Care High , ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
HC23C	10/01/11		SNF	"Special Care High , ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HC23D	10/01/11		SNF	"Special Care High , ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HC240	10/01/10		SNF	"Special Care High , ADL Index 6-10/60-day. "					
HC241	10/01/10		SNF	"Special Care High , ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
HC244	10/01/10		SNF	"Special Care High , ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
HC245	10/01/10		SNF	"Special Care High , ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
HC246	10/01/10		SNF	"Special Care High , ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
HC24A	10/01/11		SNF	"Special Care High , ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
HC24B	10/01/11		SNF	"Special Care High , ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
HC24C	10/01/11		SNF	"Special Care High , ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HC24D	10/01/11		SNF	"Special Care High , ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HC250	10/01/10		SNF	"Special Care High , ADL Index 6-10/90-day. "					
HC251	10/01/10		SNF	"Special Care High , ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
HC254	10/01/10		SNF	"Special Care High , ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
HC255	10/01/10		SNF	"Special Care High , ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
HC256	10/01/10		SNF	"Special Care High , ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
HC25A	10/01/11		SNF	"Special Care High , ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
HC25B	10/01/11		SNF	"Special Care High , ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
HC25C	10/01/11		SNF	"Special Care High , ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HC25D	10/01/11		SNF	"Special Care High , ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HC260	10/01/10		SNF	"Special Care High , ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following: SNF notified untimely of MSP denial, or 
SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
HC28A	10/01/10		SNF	"Special Care High , ADL Index 6-10/TRICARE 120-day assessment "					
HC28B	10/01/10		SNF	"Special Care High , ADL Index 6-10/TRICARE 150-day assessment "					
HC28C	10/01/10		SNF	"Special Care High , ADL Index 6-10/TRICARE 180-day assessment "					
HC28D	10/01/10		SNF	"Special Care High , ADL Index 6-10/TRICARE 210-day assessment "					
HC28E	10/01/10		SNF	"Special Care High , ADL Index 6-10/TRICARE 240-day assessment "					
HC28F	10/01/10		SNF	"Special Care High , ADL Index 6-10/TRICARE 270-day assessment "					
HC28G	10/01/10		SNF	"Special Care High , ADL Index 6-10/TRICARE 300-day assessment "					
HC28H	10/01/10		SNF	"Special Care High , ADL Index 6-10/TRICARE 330-day assessment "					
HC28I	10/01/10		SNF	"Special Care High , ADL Index 6-10/TRICARE 360-day assessment "					
HC28X	10/01/10		SNF	"Special Care High , ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval "					
HD101	10/01/10		SNF	"Special Care High , ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA."					
HD104	10/01/10		SNF	"Special Care High , ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA."					
HD105	10/01/10		SNF	"Special Care High , ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
HD106	10/01/10		SNF	"Special Care High , ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
HD10A	10/01/11		SNF	"Special Care High , ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
HD10B	10/01/11		SNF	"Special Care High , ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
HD10C	10/01/11		SNF	"Special Care High , ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
HD10D	10/01/11		SNF	"Special Care High , ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
HD110	10/01/10		SNF	"Special Care High , ADL Index 11-14/5-day or readmission return. "					
HD111	10/01/10		SNF	"Special Care High , ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
HD112	10/01/10		SNF	"Special Care High , ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
HD113	10/01/10		SNF	"Special Care High , ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
HD114	10/01/10		SNF	"Special Care High , ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
HD115	10/01/10		SNF	"Special Care High , ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
HD116	10/01/10		SNF	"Special Care High , ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
HD117	10/01/10		SNF	"Special Care High , ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
HD11A	10/01/11		SNF	"Special Care High , ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
HD11B	10/01/11		SNF	"Special Care High , ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
HD11C	10/01/11		SNF	"Special Care High , ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HD120	10/01/10		SNF	"Special Care High , ADL Index 11-14/14-day. "					
HD121	10/01/10		SNF	"Special Care High , ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
HD124	10/01/10		SNF	"Special Care High , ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
HD125	10/01/10		SNF	"Special Care High , ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
HD126	10/01/10		SNF	"Special Care High , ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
HD12A	10/01/11		SNF	"Special Care High , ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
HD12B	10/01/11		SNF	"Special Care High , ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
HD12C	10/01/11		SNF	"Special Care High , ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HD12D	10/01/11		SNF	"Special Care High , ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HD130	10/01/10		SNF	"Special Care High , ADL Index 11-14/30-day. "					
HD131	10/01/10		SNF	"Special Care High , ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
HD134	10/01/10		SNF	"Special Care High , ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
HD135	10/01/10		SNF	"Special Care High , ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
HD136	10/01/10		SNF	"Special Care High , ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
HD13A	10/01/11		SNF	"Special Care High , ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
HD13B	10/01/11		SNF	"Special Care High , ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
HD13C	10/01/11		SNF	"Special Care High , ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HD13D	10/01/11		SNF	"Special Care High , ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HD140	10/01/10		SNF	"Special Care High , ADL Index 11-14/60-day. "					
HD141	10/01/10		SNF	"Special Care High , ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
HD144	10/01/10		SNF	"Special Care High , ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
HD145	10/01/10		SNF	"Special Care High , ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
HD146	10/01/10		SNF	"Special Care High , ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
HD14A	10/01/11		SNF	"Special Care High , ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
HD14B	10/01/11		SNF	"Special Care High , ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
HD14C	10/01/11		SNF	"Special Care High , ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HD14D	10/01/11		SNF	"Special Care High , ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HD150	10/01/10		SNF	"Special Care High , ADL Index 11-14/90-day. "					
HD151	10/01/10		SNF	"Special Care High , ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
HD154	10/01/10		SNF	"Special Care High , ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
HD155	10/01/10		SNF	"Special Care High , ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
HD156	10/01/10		SNF	"Special Care High , ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
HD15A	10/01/11		SNF	"Special Care High , ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
HD15B	10/01/11		SNF	"Special Care High , ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
HD15C	10/01/11		SNF	"Special Care High , ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HD15D	10/01/11		SNF	"Special Care High , ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HD160	10/01/10		SNF	"Special Care High , ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following: SNF notified untimely of MSP denial, or 
SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
HD18A	10/01/10		SNF	"Special Care High , ADL Index 11-14/TRICARE 120-day assessment "					
HD18B	10/01/10		SNF	"Special Care High , ADL Index 11-14/TRICARE 150-day assessment "					
HD18C	10/01/10		SNF	"Special Care High , ADL Index 11-14/TRICARE 180-day assessment "					
HD18D	10/01/10		SNF	"Special Care High , ADL Index 11-14/TRICARE 210-day assessment "					
HD18E	10/01/10		SNF	"Special Care High , ADL Index 11-14/TRICARE 240-day assessment "					
HD18F	10/01/10		SNF	"Special Care High , ADL Index 11-14/TRICARE 270-day assessment "					
HD18G	10/01/10		SNF	"Special Care High , ADL Index 11-14/TRICARE 300-day assessment "					
HD18H	10/01/10		SNF	"Special Care High , ADL Index 11-14/TRICARE 330-day assessment "					
HD18I	10/01/10		SNF	"Special Care High , ADL Index 11-14/TRICARE 360-day assessment "					
HD18X	10/01/10		SNF	"Special Care High , ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval "					
HD201	10/01/10		SNF	"Special Care High , ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA."					
HD204	10/01/10		SNF	"Special Care High , ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA."					
HD205	10/01/10		SNF	"Special Care High , ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
HD206	10/01/10		SNF	"Special Care High , ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
HD20A	10/01/11		SNF	"Special Care High , ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
HD20B	10/01/11		SNF	"Special Care High , ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
HD20C	10/01/11		SNF	"Special Care High , ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
HD20D	10/01/11		SNF	"Special Care High , ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
HD210	10/01/10		SNF	"Special Care High , ADL Index 11-14/5-day or readmission return. "					
HD211	10/01/10		SNF	"Special Care High , ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
HD212	10/01/10		SNF	"Special Care High , ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
HD213	10/01/10		SNF	"Special Care High , ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
HD214	10/01/10		SNF	"Special Care High , ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
HD215	10/01/10		SNF	"Special Care High , ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
HD216	10/01/10		SNF	"Special Care High , ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
HD217	10/01/10		SNF	"Special Care High , ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
HD21A	10/01/11		SNF	"Special Care High , ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
HD21B	10/01/11		SNF	"Special Care High , ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
HD21C	10/01/11		SNF	"Special Care High , ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HD220	10/01/10		SNF	"Special Care High , ADL Index 11-14/14-day. "					
HD221	10/01/10		SNF	"Special Care High , ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
HD224	10/01/10		SNF	"Special Care High , ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
HD225	10/01/10		SNF	"Special Care High , ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
HD226	10/01/10		SNF	"Special Care High , ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
HD22A	10/01/11		SNF	"Special Care High , ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
HD22B	10/01/11		SNF	"Special Care High , ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
HD22C	10/01/11		SNF	"Special Care High , ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HD22D	10/01/11		SNF	"Special Care High , ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HD230	10/01/10		SNF	"Special Care High , ADL Index 11-14/30-day. "					
HD231	10/01/10		SNF	"Special Care High , ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
HD234	10/01/10		SNF	"Special Care High , ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
HD235	10/01/10		SNF	"Special Care High , ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
HD236	10/01/10		SNF	"Special Care High , ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
HD23A	10/01/11		SNF	"Special Care High , ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
HD23B	10/01/11		SNF	"Special Care High , ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
HD23C	10/01/11		SNF	"Special Care High , ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HD23D	10/01/11		SNF	"Special Care High , ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HD240	10/01/10		SNF	"Special Care High , ADL Index 11-14/60-day. "					
HD241	10/01/10		SNF	"Special Care High , ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
HD244	10/01/10		SNF	"Special Care High , ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
HD245	10/01/10		SNF	"Special Care High , ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
HD246	10/01/10		SNF	"Special Care High , ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
HD24A	10/01/11		SNF	"Special Care High , ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
HD24B	10/01/11		SNF	"Special Care High , ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
HD24C	10/01/11		SNF	"Special Care High , ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HD24D	10/01/11		SNF	"Special Care High , ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HD250	10/01/10		SNF	"Special Care High , ADL Index 11-14/90-day. "					
HD251	10/01/10		SNF	"Special Care High , ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
HD254	10/01/10		SNF	"Special Care High , ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
HD255	10/01/10		SNF	"Special Care High , ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
HD256	10/01/10		SNF	"Special Care High , ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
HD25A	10/01/11		SNF	"Special Care High , ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
HD25B	10/01/11		SNF	"Special Care High , ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
HD25C	10/01/11		SNF	"Special Care High , ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HD25D	10/01/11		SNF	"Special Care High , ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HD260	10/01/10		SNF	"Special Care High , ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following: SNF notified untimely of MSP denial, or 
SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
HD28A	10/01/10		SNF	"Special Care High , ADL Index 11-14/TRICARE 120-day assessment "					
HD28B	10/01/10		SNF	"Special Care High , ADL Index 11-14/TRICARE 150-day assessment "					
HD28C	10/01/10		SNF	"Special Care High , ADL Index 11-14/TRICARE 180-day assessment "					
HD28D	10/01/10		SNF	"Special Care High , ADL Index 11-14/TRICARE 210-day assessment "					
HD28E	10/01/10		SNF	"Special Care High , ADL Index 11-14/TRICARE 240-day assessment "					
HD28F	10/01/10		SNF	"Special Care High , ADL Index 11-14/TRICARE 270-day assessment "					
HD28G	10/01/10		SNF	"Special Care High , ADL Index 11-14/TRICARE 300-day assessment "					
HD28H	10/01/10		SNF	"Special Care High , ADL Index 11-14/TRICARE 330-day assessment "					
HD28I	10/01/10		SNF	"Special Care High , ADL Index 11-14/TRICARE 360-day assessment "					
HD28X	10/01/10		SNF	"Special Care High , ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval "					
HE101	10/01/10		SNF	"Special Care High , ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA."					
HE104	10/01/10		SNF	"Special Care High , ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA."					
HE105	10/01/10		SNF	"Special Care High , ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
HE106	10/01/10		SNF	"Special Care High , ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
HE10A	10/01/11		SNF	"Special Care High , ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
HE10B	10/01/11		SNF	"Special Care High , ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
HE10C	10/01/11		SNF	"Special Care High , ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
HE10D	10/01/11		SNF	"Special Care High , ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
HE110	10/01/10		SNF	"Special Care High , ADL Index 15-16/5-day or readmission return. "					
HE111	10/01/10		SNF	"Special Care High , ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
HE112	10/01/10		SNF	"Special Care High , ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
HE113	10/01/10		SNF	"Special Care High , ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
HE114	10/01/10		SNF	"Special Care High , ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
HE115	10/01/10		SNF	"Special Care High , ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
HE116	10/01/10		SNF	"Special Care High , ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
HE117	10/01/10		SNF	"Special Care High , ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
HE11A	10/01/11		SNF	"Special Care High , ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
HE11B	10/01/11		SNF	"Special Care High , ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
HE11C	10/01/11		SNF	"Special Care High , ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HE120	10/01/10		SNF	"Special Care High , ADL Index 15-16/14-day. "					
HE121	10/01/10		SNF	"Special Care High , ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
HE124	10/01/10		SNF	"Special Care High , ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
HE125	10/01/10		SNF	"Special Care High , ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
HE126	10/01/10		SNF	"Special Care High , ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
HE12A	10/01/11		SNF	"Special Care High , ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
HE12B	10/01/11		SNF	"Special Care High , ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
HE12C	10/01/11		SNF	"Special Care High , ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HE12D	10/01/11		SNF	"Special Care High , ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HE130	10/01/10		SNF	"Special Care High , ADL Index 15-16/30-day. "					
HE131	10/01/10		SNF	"Special Care High , ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
HE134	10/01/10		SNF	"Special Care High , ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
HE135	10/01/10		SNF	"Special Care High , ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
HE136	10/01/10		SNF	"Special Care High , ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
HE13A	10/01/11		SNF	"Special Care High , ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
HE13B	10/01/11		SNF	"Special Care High , ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
HE13C	10/01/11		SNF	"Special Care High , ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HE13D	10/01/11		SNF	"Special Care High , ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HE140	10/01/10		SNF	"Special Care High , ADL Index 15-16/60-day. "					
HE141	10/01/10		SNF	"Special Care High , ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
HE144	10/01/10		SNF	"Special Care High , ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
HE145	10/01/10		SNF	"Special Care High , ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
HE146	10/01/10		SNF	"Special Care High , ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
HE14A	10/01/11		SNF	"Special Care High , ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
HE14B	10/01/11		SNF	"Special Care High , ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
HE14C	10/01/11		SNF	"Special Care High , ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HE14D	10/01/11		SNF	"Special Care High , ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HE150	10/01/10		SNF	"Special Care High , ADL Index 15-16/90-day. "					
HE151	10/01/10		SNF	"Special Care High , ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
HE154	10/01/10		SNF	"Special Care High , ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
HE155	10/01/10		SNF	"Special Care High , ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
HE156	10/01/10		SNF	"Special Care High , ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
HE15A	10/01/11		SNF	"Special Care High , ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
HE15B	10/01/11		SNF	"Special Care High , ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
HE15C	10/01/11		SNF	"Special Care High , ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HE15D	10/01/11		SNF	"Special Care High , ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HE160	10/01/10		SNF	"Special Care High , ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following: SNF notified untimely of MSP denial, or 
SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
HE18A	10/01/10		SNF	"Special Care High , ADL Index 15-16/TRICARE 120-day assessment "					
HE18B	10/01/10		SNF	"Special Care High , ADL Index 15-16/TRICARE 150-day assessment "					
HE18C	10/01/10		SNF	"Special Care High , ADL Index 15-16/TRICARE 180-day assessment "					
HE18D	10/01/10		SNF	"Special Care High , ADL Index 15-16/TRICARE 210-day assessment "					
HE18E	10/01/10		SNF	"Special Care High , ADL Index 15-16/TRICARE 240-day assessment "					
HE18F	10/01/10		SNF	"Special Care High , ADL Index 15-16/TRICARE 270-day assessment "					
HE18G	10/01/10		SNF	"Special Care High , ADL Index 15-16/TRICARE 300-day assessment "					
HE18H	10/01/10		SNF	"Special Care High , ADL Index 15-16/TRICARE 330-day assessment "					
HE18I	10/01/10		SNF	"Special Care High , ADL Index 15-16/TRICARE 360-day assessment "					
HE18X	10/01/10		SNF	"Special Care High , ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval "					
HE201	10/01/10		SNF	"Special Care High , ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA."					
HE204	10/01/10		SNF	"Special Care High , ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA."					
HE205	10/01/10		SNF	"Special Care High , ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
HE206	10/01/10		SNF	"Special Care High , ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
HE20A	10/01/11		SNF	"Special Care High , ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
HE20B	10/01/11		SNF	"Special Care High , ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
HE20C	10/01/11		SNF	"Special Care High , ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
HE20D	10/01/11		SNF	"Special Care High , ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
HE210	10/01/10		SNF	"Special Care High , ADL Index 15-16/5-day or readmission return. "					
HE211	10/01/10		SNF	"Special Care High , ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
HE212	10/01/10		SNF	"Special Care High , ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
HE213	10/01/10		SNF	"Special Care High , ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
HE214	10/01/10		SNF	"Special Care High , ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
HE215	10/01/10		SNF	"Special Care High , ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
HE216	10/01/10		SNF	"Special Care High , ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
HE217	10/01/10		SNF	"Special Care High , ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
HE21A	10/01/11		SNF	"Special Care High , ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
HE21B	10/01/11		SNF	"Special Care High , ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
HE21C	10/01/11		SNF	"Special Care High , ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HE220	10/01/10		SNF	"Special Care High , ADL Index 15-16/14-day. "					
HE221	10/01/10		SNF	"Special Care High , ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
HE224	10/01/10		SNF	"Special Care High , ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
HE225	10/01/10		SNF	"Special Care High , ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
HE226	10/01/10		SNF	"Special Care High , ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
HE22A	10/01/11		SNF	"Special Care High , ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
HE22B	10/01/11		SNF	"Special Care High , ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
HE22C	10/01/11		SNF	"Special Care High , ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HE22D	10/01/11		SNF	"Special Care High , ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HE230	10/01/10		SNF	"Special Care High , ADL Index 15-16/30-day. "					
HE231	10/01/10		SNF	"Special Care High , ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
HE234	10/01/10		SNF	"Special Care High , ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
HE235	10/01/10		SNF	"Special Care High , ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
HE236	10/01/10		SNF	"Special Care High , ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
HE23A	10/01/11		SNF	"Special Care High , ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
HE23B	10/01/11		SNF	"Special Care High , ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
HE23C	10/01/11		SNF	"Special Care High , ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HE23D	10/01/11		SNF	"Special Care High , ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HE240	10/01/10		SNF	"Special Care High , ADL Index 15-16/60-day. "					
HE241	10/01/10		SNF	"Special Care High , ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
HE244	10/01/10		SNF	"Special Care High , ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
HE245	10/01/10		SNF	"Special Care High , ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
HE246	10/01/10		SNF	"Special Care High , ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
HE24A	10/01/11		SNF	"Special Care High , ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
HE24B	10/01/11		SNF	"Special Care High , ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
HE24C	10/01/11		SNF	"Special Care High , ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HE24D	10/01/11		SNF	"Special Care High , ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HE250	10/01/10		SNF	"Special Care High , ADL Index 15-16/90-day. "					
HE251	10/01/10		SNF	"Special Care High , ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
HE254	10/01/10		SNF	"Special Care High , ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
HE255	10/01/10		SNF	"Special Care High , ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
HE256	10/01/10		SNF	"Special Care High , ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
HE25A	10/01/11		SNF	"Special Care High , ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
HE25B	10/01/11		SNF	"Special Care High , ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
HE25C	10/01/11		SNF	"Special Care High , ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HE25D	10/01/11		SNF	"Special Care High , ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
HE260	10/01/10		SNF	"Special Care High , ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following: SNF notified untimely of MSP denial, or 
SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
HE28A	10/01/10		SNF	"Special Care High , ADL Index 15-16/TRICARE 120-day assessment "					
HE28B	10/01/10		SNF	"Special Care High , ADL Index 15-16/TRICARE 150-day assessment "					
HE28C	10/01/10		SNF	"Special Care High , ADL Index 15-16/TRICARE 180-day assessment "					
HE28D	10/01/10		SNF	"Special Care High , ADL Index 15-16/TRICARE 210-day assessment "					
HE28E	10/01/10		SNF	"Special Care High , ADL Index 15-16/TRICARE 240-day assessment "					
HE28F	10/01/10		SNF	"Special Care High , ADL Index 15-16/TRICARE 270-day assessment "					
HE28G	10/01/10		SNF	"Special Care High , ADL Index 15-16/TRICARE 300-day assessment "					
HE28H	10/01/10		SNF	"Special Care High , ADL Index 15-16/TRICARE 330-day assessment "					
HE28I	10/01/10		SNF	"Special Care High , ADL Index 15-16/TRICARE 360-day assessment "					
HE28X	10/01/10		SNF	"Special Care High , ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval "					
HIPPS code	Code Effective From Date	Code Effective Through Date	Payment System Indicator	Description					
IA101	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5, not receiving nursing rehabilitation/Medicare 5 day assessment (Full)"					
IA102	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5, not receiving nursing rehabilitation/Medicare 30 day assessment (Full)"					
IA103	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5, not receiving nursing rehabilitation/Medicare 60 day assessment (Full)"					
IA104	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5, not receiving nursing rehabilitation/Medicare 90 day assessment (Full)"					
IA105	10/01/00	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5, not receiving nursing rehabilitation/Readmission/Return Medicare assessment"					
IA107	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5, not receiving nursing rehabilitation/Medicare 14 day assessment (Full or comprehensive)"					
IA108	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5, not receiving nursing rehabilitation/Other Medicare Required Assessment (OMRA) "					
IA111	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5, not receiving nursing rehabilitation/Medicare 5 day assessment (comprehensive) AND initial admission assessment"					
IA117	10/01/00	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5, not receiving nursing rehabilitation/14-day Medicare assessment AND initial admission assessment"					
IA118 	10/01/00	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5, not receiving nursing rehabilitation/OMRA replacing 5-day Medicare assessment"					
IA119	07/01/02	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5, not receiving nursing rehabilitation/Special payment situation 5-day assessment"					
IA128	10/01/00	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5, not receiving nursing rehabilitation/OMRA replacing 30-day Medicare assessment"					
IA129	07/01/02	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5, not receiving nursing rehabilitation/Special payment situation 30-day assessment"					
IA130	10/01/00	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5, not receiving nursing rehabilitation/Off-cycle significant change assessment (outside assessment window) "					
IA131	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5, not receiving nursing rehabilitation/[7/98 def.] SCSA or OMRA/ Medicare 5 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 5-day Medicare required assessment"					
IA132	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5, not receiving nursing rehabilitation/[7/98 def.] SCSA or OMRA/ Medicare 30 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 30-day Medicare required assessment"					
IA133	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5, not receiving nursing rehabilitation/[7/98 def.] SCSA or OMRA/ Medicare 60 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 60-day Medicare required assessment"					
IA134	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5, not receiving nursing rehabilitation/[7/98 def.] SCSA or OMRA/ Medicare 90 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 90-day Medicare required assessment"					
IA135	10/01/00	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5, not receiving nursing rehabilitation/Significant change assessment REPLACES a readmission/return Medicare-required assessment"					
IA137	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5, not receiving nursing rehabilitation/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
IA138	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5, not receiving nursing rehabilitation/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
IA139	07/01/02	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5, not receiving nursing rehabilitation/Special payment situation 60-day assessment"					
IA140	10/01/00	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5, not receiving nursing rehabilitation/Off-cycle significant change correction assessment of a prior assessment (outside assessment window)"					
IA141	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5, not receiving nursing rehabilitation/Significant Correction of Prior Full Assessment/Medicare 5 Day Assessment "					
IA142	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5, not receiving nursing rehabilitation/Significant Correction of Prior Full Assessment/Medicare 30 Day Assessment "					
IA143	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5, not receiving nursing rehabilitation/Significant Correction of Prior Full Assessment/Medicare 60 Day Assessment "					
IA144	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5, not receiving nursing rehabilitation/Significant Correction of Prior Full Assessment/Medicare 90 Day Assessment "					
IA145	10/01/00	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5, not receiving nursing rehabilitation/Significant correction of a prior assessment REPLACES a readmission/return assessment"					
IA147	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5, not receiving nursing rehabilitation/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
IA148	10/01/00	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5, not receiving nursing rehabilitation/OMRA replacing 90-day Medicare-required assessment"					
IA149	07/01/02	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5, not receiving nursing rehabilitation/Special payment situation 90-day assessment"					
IA154	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5, not receiving nursing rehabilitation/Quarterly review assessment-Medicare 90 day assessment (Full) "					
IA178	10/01/00	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5, not receiving nursing rehabilitation/OMRA replacing 14-day Medicare-required assessment"					
IA179	07/01/02	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5, not receiving nursing rehabilitation/Special payment situation 14-day assessment"					
IA18A	08/01/03	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5, not receiving nursing rehabilitation/TRICARE 120-day assessment "					
IA18B	08/01/03	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5, not receiving nursing rehabilitation/TRICARE 150-day assessment "					
IA18C	08/01/03	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5, not receiving nursing rehabilitation/TRICARE 180-day assessment "					
IA18D	08/01/03	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5, not receiving nursing rehabilitation/TRICARE 210-day assessment "					
IA18E	08/01/03	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5, not receiving nursing rehabilitation/TRICARE 240-day assessment "					
IA18F	08/01/03	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5, not receiving nursing rehabilitation/TRICARE 270-day assessment "					
IA18G	08/01/03	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5, not receiving nursing rehabilitation/TRICARE 300-day assessment "					
IA18H	08/01/03	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5, not receiving nursing rehabilitation/TRICARE 330-day assessment"					
IA18I	08/01/03	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5, not receiving nursing rehabilitation/TRICARE 360-day assessment  "					
IA18X	08/01/03	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5, not receiving nursing rehabilitation/TRICARE Post 360-day assessments with 30-day interval "					
IA201	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5/Medicare 5 day assessment (Full)"					
IA202	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5/Medicare 30 day assessment (Full)"					
IA203	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5/Medicare 60 day assessment (Full)"					
IA204	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5/Medicare 90 day assessment (Full)"					
IA205	10/01/00	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5/Readmission/Return Medicare assessment"					
IA207	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5/Medicare 14 day assessment (Full or comprehensive)"					
IA208	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5/Other Medicare Required Assessment (OMRA) "					
IA211	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5/Medicare 5 day assessment (comprehensive) AND initial admission assessment"					
IA217	10/01/00	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5/14-day Medicare assessment AND initial admission assessment"					
IA218 	10/01/00	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5/OMRA replacing 5-day Medicare assessment"					
IA219	07/01/02	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5/Special payment situation 5-day assessment"					
IA228	10/01/00	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5/OMRA replacing 30-day Medicare assessment"					
IA229	07/01/02	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5/Special payment situation 30-day assessment"					
IA230	10/01/00	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5/Off-cycle significant change assessment (outside assessment window) "					
IA231	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5/[7/98 def.] SCSA or OMRA/ Medicare 5 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 5-day Medicare required assessment"					
IA232	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5/[7/98 def.] SCSA or OMRA/ Medicare 30 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 30-day Medicare required assessment"					
IA233	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5/[7/98 def.] SCSA or OMRA/ Medicare 60 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 60-day Medicare required assessment"					
IA234	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5/[7/98 def.] SCSA or OMRA/ Medicare 90 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 90-day Medicare required assessment"					
IA235	10/01/00	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5/Significant change assessment REPLACES a readmission/return Medicare-required assessment"					
IA237	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
IA238	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
IA239	07/01/02	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5/Special payment situation 60-day assessment"					
IA240	10/01/00	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5/Off-cycle significant change correction assessment of a prior assessment (outside assessment window)"					
IA241	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5/Significant Correction of Prior Full Assessment/Medicare 5 Day Assessment "					
IA242	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5/Significant Correction of Prior Full Assessment/Medicare 30 Day Assessment "					
IA243	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5/Significant Correction of Prior Full Assessment/Medicare 60 Day Assessment "					
IA244	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5/Significant Correction of Prior Full Assessment/Medicare 90 Day Assessment "					
IA245	10/01/00	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5/Significant correction of a prior assessment REPLACES a readmission/return assessment"					
IA247	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
IA248	10/01/00	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5/OMRA replacing 90-day Medicare-required assessment"					
IA249	07/01/02	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5/Special payment situation 90-day assessment"					
IA254	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5/Quarterly review assessment-Medicare 90 day assessment (Full) "					
IA278	10/01/00	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5/OMRA replacing 14-day Medicare-required assessment"					
IA279	07/01/02	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5/Special payment situation 14-day assessment"					
IA28A	08/01/03	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5/TRICARE 120-day assessment "					
IA28B	08/01/03	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5/TRICARE 150-day assessment "					
IA28C	08/01/03	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5/TRICARE 180-day assessment "					
IA28D	08/01/03	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5/TRICARE 210-day assessment "					
IA28E	08/01/03	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5/TRICARE 240-day assessment "					
IA28F	08/01/03	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5/TRICARE 270-day assessment "					
IA28G	08/01/03	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5/TRICARE 300-day assessment "					
IA28H	08/01/03	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5/TRICARE 330-day assessment"					
IA28I	08/01/03	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5/TRICARE 360-day assessment  "					
IA28X	08/01/03	* 09/30/10	SNF	"Impaired Cognition, ADL Index 4 - 5/TRICARE Post 360-day assessments with 30-day interval "					
IB101	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10, not receiving nursing rehabilitation/Medicare 5 day assessment (Full)"					
IB102	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10, not receiving nursing rehabilitation/Medicare 30 day assessment (Full)"					
IB103	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10, not receiving nursing rehabilitation/Medicare 60 day assessment (Full)"					
IB104	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10, not receiving nursing rehabilitation/Medicare 90 day assessment (Full)"					
IB105	10/01/00	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10, not receiving nursing rehabilitation/Readmission/Return Medicare assessment"					
IB107	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10, not receiving nursing rehabilitation/Medicare 14 day assessment (Full or comprehensive)"					
IB108	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10, not receiving nursing rehabilitation/Other Medicare Required Assessment (OMRA) "					
IB111	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10, not receiving nursing rehabilitation/Medicare 5 day assessment (comprehensive) AND initial admission assessment"					
IB117	10/01/00	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10, not receiving nursing rehabilitation/14-day Medicare assessment AND initial admission assessment"					
IB118 	10/01/00	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10, not receiving nursing rehabilitation/OMRA replacing 5-day Medicare assessment"					
IB119	07/01/02	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10, not receiving nursing rehabilitation/Special payment situation 5-day assessment"					
IB128	10/01/00	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10, not receiving nursing rehabilitation/OMRA replacing 30-day Medicare assessment"					
IB129	07/01/02	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10, not receiving nursing rehabilitation/Special payment situation 30-day assessment"					
IB130	10/01/00	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10, not receiving nursing rehabilitation/Off-cycle significant change assessment (outside assessment window) "					
IB131	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10, not receiving nursing rehabilitation/[7/98 def.] SCSA or OMRA/ Medicare 5 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 5-day Medicare required assessment"					
IB132	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10, not receiving nursing rehabilitation/[7/98 def.] SCSA or OMRA/ Medicare 30 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 30-day Medicare required assessment"					
IB133	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10, not receiving nursing rehabilitation/[7/98 def.] SCSA or OMRA/ Medicare 60 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 60-day Medicare required assessment"					
IB134	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10, not receiving nursing rehabilitation/[7/98 def.] SCSA or OMRA/ Medicare 90 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 90-day Medicare required assessment"					
IB135	10/01/00	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10, not receiving nursing rehabilitation/Significant change assessment REPLACES a readmission/return Medicare-required assessment"					
IB137	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10, not receiving nursing rehabilitation/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
IB138	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10, not receiving nursing rehabilitation/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
IB139	07/01/02	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10, not receiving nursing rehabilitation/Special payment situation 60-day assessment"					
IB140	10/01/00	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10, not receiving nursing rehabilitation/Off-cycle significant change correction assessment of a prior assessment (outside assessment window)"					
IB141	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10, not receiving nursing rehabilitation/Significant Correction of Prior Full Assessment/Medicare 5 Day Assessment "					
IB142	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10, not receiving nursing rehabilitation/Significant Correction of Prior Full Assessment/Medicare 30 Day Assessment "					
IB143	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10, not receiving nursing rehabilitation/Significant Correction of Prior Full Assessment/Medicare 60 Day Assessment "					
IB144	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10, not receiving nursing rehabilitation/Significant Correction of Prior Full Assessment/Medicare 90 Day Assessment "					
IB145	10/01/00	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10, not receiving nursing rehabilitation/Significant correction of a prior assessment REPLACES a readmission/return assessment"					
IB147	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10, not receiving nursing rehabilitation/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
IB148	10/01/00	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10, not receiving nursing rehabilitation/OMRA replacing 90-day Medicare-required assessment"					
IB149	07/01/02	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10, not receiving nursing rehabilitation/Special payment situation 90-day assessment"					
IB154	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10, not receiving nursing rehabilitation/Quarterly review assessment-Medicare 90 day assessment (Full) "					
IB178	10/01/00	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10, not receiving nursing rehabilitation/OMRA replacing 14-day Medicare-required assessment"					
IB179	07/01/02	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10, not receiving nursing rehabilitation/Special payment situation 14-day assessment"					
IB18A	08/01/03	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10, not receiving nursing rehabilitation/TRICARE 120-day assessment "					
IB18B	08/01/03	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10, not receiving nursing rehabilitation/TRICARE 150-day assessment "					
IB18C	08/01/03	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10, not receiving nursing rehabilitation/TRICARE 180-day assessment "					
IB18D	08/01/03	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10, not receiving nursing rehabilitation/TRICARE 210-day assessment "					
IB18E	08/01/03	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10, not receiving nursing rehabilitation/TRICARE 240-day assessment "					
IB18F	08/01/03	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10, not receiving nursing rehabilitation/TRICARE 270-day assessment "					
IB18G	08/01/03	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10, not receiving nursing rehabilitation/TRICARE 300-day assessment "					
IB18H	08/01/03	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10, not receiving nursing rehabilitation/TRICARE 330-day assessment"					
IB18I	08/01/03	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10, not receiving nursing rehabilitation/TRICARE 360-day assessment  "					
IB18X	08/01/03	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10, not receiving nursing rehabilitation/TRICARE Post 360-day assessments with 30-day interval "					
IB201	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10/Medicare 5 day assessment (Full)"					
IB202	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10/Medicare 30 day assessment (Full)"					
IB203	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10/Medicare 60 day assessment (Full)"					
IB204	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10/Medicare 90 day assessment (Full)"					
IB205	10/01/00	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10/Readmission/Return Medicare assessment"					
IB207	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10/Medicare 14 day assessment (Full or comprehensive)"					
IB208	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10/Other Medicare Required Assessment (OMRA) "					
IB211	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10/Medicare 5 day assessment (comprehensive) AND initial admission assessment"					
IB217	10/01/00	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10/14-day Medicare assessment AND initial admission assessment"					
IB218 	10/01/00	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10/OMRA replacing 5-day Medicare assessment"					
IB219	07/01/02	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10/Special payment situation 5-day assessment"					
IB228	10/01/00	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10/OMRA replacing 30-day Medicare assessment"					
IB229	07/01/02	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10/Special payment situation 30-day assessment"					
IB230	10/01/00	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10/Off-cycle significant change assessment (outside assessment window) "					
IB231	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10/[7/98 def.] SCSA or OMRA/ Medicare 5 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 5-day Medicare required assessment"					
IB232	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10/[7/98 def.] SCSA or OMRA/ Medicare 30 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 30-day Medicare required assessment"					
IB233	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10/[7/98 def.] SCSA or OMRA/ Medicare 60 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 60-day Medicare required assessment"					
IB234	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10/[7/98 def.] SCSA or OMRA/ Medicare 90 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 90-day Medicare required assessment"					
IB235	10/01/00	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10/Significant change assessment REPLACES a readmission/return Medicare-required assessment"					
IB237	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
IB238	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
IB239	07/01/02	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10/Special payment situation 60-day assessment"					
IB240	10/01/00	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10/Off-cycle significant change correction assessment of a prior assessment (outside assessment window)"					
IB241	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10/Significant Correction of Prior Full Assessment/Medicare 5 Day Assessment "					
IB242	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10/Significant Correction of Prior Full Assessment/Medicare 30 Day Assessment "					
IB243	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10/Significant Correction of Prior Full Assessment/Medicare 60 Day Assessment "					
IB244	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10/Significant Correction of Prior Full Assessment/Medicare 90 Day Assessment "					
IB245	10/01/00	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10/Significant correction of a prior assessment REPLACES a readmission/return assessment"					
IB247	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
IB248	10/01/00	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10/OMRA replacing 90-day Medicare-required assessment"					
IB249	07/01/02	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10/Special payment situation 90-day assessment"					
IB254	07/01/98	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10/Quarterly review assessment-Medicare 90 day assessment (Full) "					
IB278	10/01/00	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10/OMRA replacing 14-day Medicare-required assessment"					
IB279	07/01/02	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10/Special payment situation 14-day assessment"					
IB28A	08/01/03	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10/TRICARE 120-day assessment "					
IB28B	08/01/03	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10/TRICARE 150-day assessment "					
IB28C	08/01/03	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10/TRICARE 180-day assessment "					
IB28D	08/01/03	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10/TRICARE 210-day assessment "					
IB28E	08/01/03	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10/TRICARE 240-day assessment "					
IB28F	08/01/03	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10/TRICARE 270-day assessment "					
IB28G	08/01/03	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10/TRICARE 300-day assessment "					
IB28H	08/01/03	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10/TRICARE 330-day assessment"					
IB28I	08/01/03	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10/TRICARE 360-day assessment  "					
IB28X	08/01/03	* 09/30/10	SNF	"Impaired Cognition, ADL Index 6 -10/TRICARE Post 360-day assessments with 30-day interval "					
LB101	10/01/10		SNF	"Special Care Low , ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA."					
LB104	10/01/10		SNF	"Special Care Low , ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA."					
LB105	10/01/10		SNF	"Special Care Low , ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
LB106	10/01/10		SNF	"Special Care Low , ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
LB10A	10/01/11		SNF	"Special Care Low , ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
LB10B	10/01/11		SNF	"Special Care Low , ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
LB10C	10/01/11		SNF	"Special Care Low , ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
LB10D	10/01/11		SNF	"Special Care Low , ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
LB110	10/01/10		SNF	"Special Care Low , ADL Index 2-5/5-day or readmission return. "					
LB111	10/01/10		SNF	"Special Care Low , ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
LB112	10/01/10		SNF	"Special Care Low , ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
LB113	10/01/10		SNF	"Special Care Low , ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
LB114	10/01/10		SNF	"Special Care Low , ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
LB115	10/01/10		SNF	"Special Care Low , ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
LB116	10/01/10		SNF	"Special Care Low , ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
LB117	10/01/10		SNF	"Special Care Low , ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
LB11A	10/01/11		SNF	"Special Care Low , ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
LB11B	10/01/11		SNF	"Special Care Low , ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
LB11C	10/01/11		SNF	"Special Care Low , ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LB120	10/01/10		SNF	"Special Care Low , ADL Index 2-5/14-day. "					
LB121	10/01/10		SNF	"Special Care Low , ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
LB124	10/01/10		SNF	"Special Care Low , ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
LB125	10/01/10		SNF	"Special Care Low , ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
LB126	10/01/10		SNF	"Special Care Low , ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
LB12A	10/01/11		SNF	"Special Care Low , ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
LB12B	10/01/11		SNF	"Special Care Low , ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
LB12C	10/01/11		SNF	"Special Care Low , ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LB12D	10/01/11		SNF	"Special Care Low , ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LB130	10/01/10		SNF	"Special Care Low , ADL Index 2-5/30-day. "					
LB131	10/01/10		SNF	"Special Care Low , ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
LB134	10/01/10		SNF	"Special Care Low , ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
LB135	10/01/10		SNF	"Special Care Low , ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
LB136	10/01/10		SNF	"Special Care Low , ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
LB13A	10/01/11		SNF	"Special Care Low , ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
LB13B	10/01/11		SNF	"Special Care Low , ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
LB13C	10/01/11		SNF	"Special Care Low , ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LB13D	10/01/11		SNF	"Special Care Low , ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LB140	10/01/10		SNF	"Special Care Low , ADL Index 2-5/60-day. "					
LB141	10/01/10		SNF	"Special Care Low , ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
LB144	10/01/10		SNF	"Special Care Low , ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
LB145	10/01/10		SNF	"Special Care Low , ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
LB146	10/01/10		SNF	"Special Care Low , ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
LB14A	10/01/11		SNF	"Special Care Low , ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
LB14B	10/01/11		SNF	"Special Care Low , ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
LB14C	10/01/11		SNF	"Special Care Low , ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LB14D	10/01/11		SNF	"Special Care Low , ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LB150	10/01/10		SNF	"Special Care Low , ADL Index 2-5/90-day. "					
LB151	10/01/10		SNF	"Special Care Low , ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
LB154	10/01/10		SNF	"Special Care Low , ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
LB155	10/01/10		SNF	"Special Care Low , ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
LB156	10/01/10		SNF	"Special Care Low , ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
LB15A	10/01/11		SNF	"Special Care Low , ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
LB15B	10/01/11		SNF	"Special Care Low , ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
LB15C	10/01/11		SNF	"Special Care Low , ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LB15D	10/01/11		SNF	"Special Care Low , ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LB160	10/01/10		SNF	"Special Care Low , ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following: SNF notified untimely of MSP denial, or SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
LB18A	10/01/10		SNF	"Special Care Low , ADL Index 2-5/TRICARE 120-day assessment "					
LB18B	10/01/10		SNF	"Special Care Low , ADL Index 2-5/TRICARE 150-day assessment "					
LB18C	10/01/10		SNF	"Special Care Low , ADL Index 2-5/TRICARE 180-day assessment "					
LB18D	10/01/10		SNF	"Special Care Low , ADL Index 2-5/TRICARE 210-day assessment "					
LB18E	10/01/10		SNF	"Special Care Low , ADL Index 2-5/TRICARE 240-day assessment "					
LB18F	10/01/10		SNF	"Special Care Low , ADL Index 2-5/TRICARE 270-day assessment "					
LB18G	10/01/10		SNF	"Special Care Low , ADL Index 2-5/TRICARE 300-day assessment "					
LB18H	10/01/10		SNF	"Special Care Low , ADL Index 2-5/TRICARE 330-day assessment "					
LB18I	10/01/10		SNF	"Special Care Low , ADL Index 2-5/TRICARE 360-day assessment "					
LB18X	10/01/10		SNF	"Special Care Low , ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval "					
LB201	10/01/10		SNF	"Special Care Low , ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA."					
LB204	10/01/10		SNF	"Special Care Low , ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA."					
LB205	10/01/10		SNF	"Special Care Low , ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
LB206	10/01/10		SNF	"Special Care Low , ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
LB20A	10/01/11		SNF	"Special Care Low , ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
LB20B	10/01/11		SNF	"Special Care Low , ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
LB20C	10/01/11		SNF	"Special Care Low , ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
LB20D	10/01/11		SNF	"Special Care Low , ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
LB210	10/01/10		SNF	"Special Care Low , ADL Index 2-5/5-day or readmission return. "					
LB211	10/01/10		SNF	"Special Care Low , ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
LB212	10/01/10		SNF	"Special Care Low , ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
LB213	10/01/10		SNF	"Special Care Low , ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
LB214	10/01/10		SNF	"Special Care Low , ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
LB215	10/01/10		SNF	"Special Care Low , ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
LB216	10/01/10		SNF	"Special Care Low , ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
LB217	10/01/10		SNF	"Special Care Low , ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
LB21A	10/01/11		SNF	"Special Care Low , ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
LB21B	10/01/11		SNF	"Special Care Low , ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
LB21C	10/01/11		SNF	"Special Care Low , ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LB220	10/01/10		SNF	"Special Care Low , ADL Index 2-5/14-day. "					
LB221	10/01/10		SNF	"Special Care Low , ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
LB224	10/01/10		SNF	"Special Care Low , ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
LB225	10/01/10		SNF	"Special Care Low , ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
LB226	10/01/10		SNF	"Special Care Low , ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
LB22A	10/01/11		SNF	"Special Care Low , ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
LB22B	10/01/11		SNF	"Special Care Low , ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
LB22C	10/01/11		SNF	"Special Care Low , ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LB22D	10/01/11		SNF	"Special Care Low , ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LB230	10/01/10		SNF	"Special Care Low , ADL Index 2-5/30-day. "					
LB231	10/01/10		SNF	"Special Care Low , ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
LB234	10/01/10		SNF	"Special Care Low , ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
LB235	10/01/10		SNF	"Special Care Low , ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
LB236	10/01/10		SNF	"Special Care Low , ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
LB23A	10/01/11		SNF	"Special Care Low , ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
LB23B	10/01/11		SNF	"Special Care Low , ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
LB23C	10/01/11		SNF	"Special Care Low , ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LB23D	10/01/11		SNF	"Special Care Low , ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LB240	10/01/10		SNF	"Special Care Low , ADL Index 2-5/60-day. "					
LB241	10/01/10		SNF	"Special Care Low , ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
LB244	10/01/10		SNF	"Special Care Low , ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
LB245	10/01/10		SNF	"Special Care Low , ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
LB246	10/01/10		SNF	"Special Care Low , ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
LB24A	10/01/11		SNF	"Special Care Low , ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
LB24B	10/01/11		SNF	"Special Care Low , ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
LB24C	10/01/11		SNF	"Special Care Low , ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LB24D	10/01/11		SNF	"Special Care Low , ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LB250	10/01/10		SNF	"Special Care Low , ADL Index 2-5/90-day. "					
LB251	10/01/10		SNF	"Special Care Low , ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
LB254	10/01/10		SNF	"Special Care Low , ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
LB255	10/01/10		SNF	"Special Care Low , ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
LB256	10/01/10		SNF	"Special Care Low , ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
LB25A	10/01/11		SNF	"Special Care Low , ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
LB25B	10/01/11		SNF	"Special Care Low , ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
LB25C	10/01/11		SNF	"Special Care Low , ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LB25D	10/01/11		SNF	"Special Care Low , ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LB260	10/01/10		SNF	"Special Care Low , ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following: SNF notified untimely of MSP denial, or 
SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
LB28A	10/01/10		SNF	"Special Care Low , ADL Index 2-5/TRICARE 120-day assessment "					
LB28B	10/01/10		SNF	"Special Care Low , ADL Index 2-5/TRICARE 150-day assessment "					
LB28C	10/01/10		SNF	"Special Care Low , ADL Index 2-5/TRICARE 180-day assessment "					
LB28D	10/01/10		SNF	"Special Care Low , ADL Index 2-5/TRICARE 210-day assessment "					
LB28E	10/01/10		SNF	"Special Care Low , ADL Index 2-5/TRICARE 240-day assessment "					
LB28F	10/01/10		SNF	"Special Care Low , ADL Index 2-5/TRICARE 270-day assessment "					
LB28G	10/01/10		SNF	"Special Care Low , ADL Index 2-5/TRICARE 300-day assessment "					
LB28H	10/01/10		SNF	"Special Care Low , ADL Index 2-5/TRICARE 330-day assessment "					
LB28I	10/01/10		SNF	"Special Care Low , ADL Index 2-5/TRICARE 360-day assessment "					
LB28X	10/01/10		SNF	"Special Care Low , ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval "					
LC101	10/01/10		SNF	"Special Care Low , ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA."					
LC104	10/01/10		SNF	"Special Care Low , ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA."					
LC105	10/01/10		SNF	"Special Care Low , ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
LC106	10/01/10		SNF	"Special Care Low , ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
LC10A	10/01/11		SNF	"Special Care Low , ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
LC10B	10/01/11		SNF	"Special Care Low , ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
LC10C	10/01/11		SNF	"Special Care Low , ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
LC10D	10/01/11		SNF	"Special Care Low , ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
LC110	10/01/10		SNF	"Special Care Low , ADL Index 6-10/5-day or readmission return. "					
LC111	10/01/10		SNF	"Special Care Low , ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
LC112	10/01/10		SNF	"Special Care Low , ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
LC113	10/01/10		SNF	"Special Care Low , ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
LC114	10/01/10		SNF	"Special Care Low , ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
LC115	10/01/10		SNF	"Special Care Low , ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
LC116	10/01/10		SNF	"Special Care Low , ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
LC117	10/01/10		SNF	"Special Care Low , ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
LC11A	10/01/11		SNF	"Special Care Low , ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
LC11B	10/01/11		SNF	"Special Care Low , ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
LC11C	10/01/11		SNF	"Special Care Low , ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LC120	10/01/10		SNF	"Special Care Low , ADL Index 6-10/14-day. "					
LC121	10/01/10		SNF	"Special Care Low , ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
LC124	10/01/10		SNF	"Special Care Low , ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
LC125	10/01/10		SNF	"Special Care Low , ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
LC126	10/01/10		SNF	"Special Care Low , ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
LC12A	10/01/11		SNF	"Special Care Low , ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
LC12B	10/01/11		SNF	"Special Care Low , ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
LC12C	10/01/11		SNF	"Special Care Low , ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LC12D	10/01/11		SNF	"Special Care Low , ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LC130	10/01/10		SNF	"Special Care Low , ADL Index 6-10/30-day. "					
LC131	10/01/10		SNF	"Special Care Low , ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
LC134	10/01/10		SNF	"Special Care Low , ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
LC135	10/01/10		SNF	"Special Care Low , ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
LC136	10/01/10		SNF	"Special Care Low , ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
LC13A	10/01/11		SNF	"Special Care Low , ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
LC13B	10/01/11		SNF	"Special Care Low , ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
LC13C	10/01/11		SNF	"Special Care Low , ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LC13D	10/01/11		SNF	"Special Care Low , ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LC140	10/01/10		SNF	"Special Care Low , ADL Index 6-10/60-day. "					
LC141	10/01/10		SNF	"Special Care Low , ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
LC144	10/01/10		SNF	"Special Care Low , ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
LC145	10/01/10		SNF	"Special Care Low , ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
LC146	10/01/10		SNF	"Special Care Low , ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
LC14A	10/01/11		SNF	"Special Care Low , ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
LC14B	10/01/11		SNF	"Special Care Low , ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
LC14C	10/01/11		SNF	"Special Care Low , ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LC14D	10/01/11		SNF	"Special Care Low , ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LC150	10/01/10		SNF	"Special Care Low , ADL Index 6-10/90-day. "					
LC151	10/01/10		SNF	"Special Care Low , ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
LC154	10/01/10		SNF	"Special Care Low , ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
LC155	10/01/10		SNF	"Special Care Low , ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
LC156	10/01/10		SNF	"Special Care Low , ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
LC15A	10/01/11		SNF	"Special Care Low , ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
LC15B	10/01/11		SNF	"Special Care Low , ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
LC15C	10/01/11		SNF	"Special Care Low , ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LC15D	10/01/11		SNF	"Special Care Low , ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LC160	10/01/10		SNF	"Special Care Low , ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following: SNF notified untimely of MSP denial, or 
SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
LC18A	10/01/10		SNF	"Special Care Low , ADL Index 6-10/TRICARE 120-day assessment "					
LC18B	10/01/10		SNF	"Special Care Low , ADL Index 6-10/TRICARE 150-day assessment "					
LC18C	10/01/10		SNF	"Special Care Low , ADL Index 6-10/TRICARE 180-day assessment "					
LC18D	10/01/10		SNF	"Special Care Low , ADL Index 6-10/TRICARE 210-day assessment "					
LC18E	10/01/10		SNF	"Special Care Low , ADL Index 6-10/TRICARE 240-day assessment "					
LC18F	10/01/10		SNF	"Special Care Low , ADL Index 6-10/TRICARE 270-day assessment "					
LC18G	10/01/10		SNF	"Special Care Low , ADL Index 6-10/TRICARE 300-day assessment "					
LC18H	10/01/10		SNF	"Special Care Low , ADL Index 6-10/TRICARE 330-day assessment "					
LC18I	10/01/10		SNF	"Special Care Low , ADL Index 6-10/TRICARE 360-day assessment "					
LC18X	10/01/10		SNF	"Special Care Low , ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval "					
LC201	10/01/10		SNF	"Special Care Low , ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA."					
LC204	10/01/10		SNF	"Special Care Low , ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA."					
LC205	10/01/10		SNF	"Special Care Low , ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
LC206	10/01/10		SNF	"Special Care Low , ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
LC20A	10/01/11		SNF	"Special Care Low , ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
LC20B	10/01/11		SNF	"Special Care Low , ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
LC20C	10/01/11		SNF	"Special Care Low , ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
LC20D	10/01/11		SNF	"Special Care Low , ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
LC210	10/01/10		SNF	"Special Care Low , ADL Index 6-10/5-day or readmission return. "					
LC211	10/01/10		SNF	"Special Care Low , ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
LC212	10/01/10		SNF	"Special Care Low , ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
LC213	10/01/10		SNF	"Special Care Low , ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
LC214	10/01/10		SNF	"Special Care Low , ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
LC215	10/01/10		SNF	"Special Care Low , ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
LC216	10/01/10		SNF	"Special Care Low , ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
LC217	10/01/10		SNF	"Special Care Low , ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
LC21A	10/01/11		SNF	"Special Care Low , ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
LC21B	10/01/11		SNF	"Special Care Low , ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
LC21C	10/01/11		SNF	"Special Care Low , ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LC220	10/01/10		SNF	"Special Care Low , ADL Index 6-10/14-day. "					
LC221	10/01/10		SNF	"Special Care Low , ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
LC224	10/01/10		SNF	"Special Care Low , ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
LC225	10/01/10		SNF	"Special Care Low , ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
LC226	10/01/10		SNF	"Special Care Low , ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
LC22A	10/01/11		SNF	"Special Care Low , ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
LC22B	10/01/11		SNF	"Special Care Low , ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
LC22C	10/01/11		SNF	"Special Care Low , ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LC22D	10/01/11		SNF	"Special Care Low , ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LC230	10/01/10		SNF	"Special Care Low , ADL Index 6-10/30-day. "					
LC231	10/01/10		SNF	"Special Care Low , ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
LC234	10/01/10		SNF	"Special Care Low , ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
LC235	10/01/10		SNF	"Special Care Low , ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
LC236	10/01/10		SNF	"Special Care Low , ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
LC23A	10/01/11		SNF	"Special Care Low , ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
LC23B	10/01/11		SNF	"Special Care Low , ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
LC23C	10/01/11		SNF	"Special Care Low , ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LC23D	10/01/11		SNF	"Special Care Low , ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LC240	10/01/10		SNF	"Special Care Low , ADL Index 6-10/60-day. "					
LC241	10/01/10		SNF	"Special Care Low , ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
LC244	10/01/10		SNF	"Special Care Low , ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
LC245	10/01/10		SNF	"Special Care Low , ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
LC246	10/01/10		SNF	"Special Care Low , ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
LC24A	10/01/11		SNF	"Special Care Low , ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
LC24B	10/01/11		SNF	"Special Care Low , ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
LC24C	10/01/11		SNF	"Special Care Low , ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LC24D	10/01/11		SNF	"Special Care Low , ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LC250	10/01/10		SNF	"Special Care Low , ADL Index 6-10/90-day. "					
LC251	10/01/10		SNF	"Special Care Low , ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
LC254	10/01/10		SNF	"Special Care Low , ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
LC255	10/01/10		SNF	"Special Care Low , ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
LC256	10/01/10		SNF	"Special Care Low , ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
LC25A	10/01/11		SNF	"Special Care Low , ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
LC25B	10/01/11		SNF	"Special Care Low , ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
LC25C	10/01/11		SNF	"Special Care Low , ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LC25D	10/01/11		SNF	"Special Care Low , ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LC260	10/01/10		SNF	"Special Care Low , ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following: SNF notified untimely of MSP denial, or 
SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
LC28A	10/01/10		SNF	"Special Care Low , ADL Index 6-10/TRICARE 120-day assessment "					
LC28B	10/01/10		SNF	"Special Care Low , ADL Index 6-10/TRICARE 150-day assessment "					
LC28C	10/01/10		SNF	"Special Care Low , ADL Index 6-10/TRICARE 180-day assessment "					
LC28D	10/01/10		SNF	"Special Care Low , ADL Index 6-10/TRICARE 210-day assessment "					
LC28E	10/01/10		SNF	"Special Care Low , ADL Index 6-10/TRICARE 240-day assessment "					
LC28F	10/01/10		SNF	"Special Care Low , ADL Index 6-10/TRICARE 270-day assessment "					
LC28G	10/01/10		SNF	"Special Care Low , ADL Index 6-10/TRICARE 300-day assessment "					
LC28H	10/01/10		SNF	"Special Care Low , ADL Index 6-10/TRICARE 330-day assessment "					
LC28I	10/01/10		SNF	"Special Care Low , ADL Index 6-10/TRICARE 360-day assessment "					
LC28X	10/01/10		SNF	"Special Care Low , ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval "					
LD101	10/01/10		SNF	"Special Care Low , ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA."					
LD104	10/01/10		SNF	"Special Care Low , ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA."					
LD105	10/01/10		SNF	"Special Care Low , ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
LD106	10/01/10		SNF	"Special Care Low , ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
LD10A	10/01/11		SNF	"Special Care Low , ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
LD10B	10/01/11		SNF	"Special Care Low , ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
LD10C	10/01/11		SNF	"Special Care Low , ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
LD10D	10/01/11		SNF	"Special Care Low , ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
LD110	10/01/10		SNF	"Special Care Low , ADL Index 11-14/5-day or readmission return. "					
LD111	10/01/10		SNF	"Special Care Low , ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
LD112	10/01/10		SNF	"Special Care Low , ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
LD113	10/01/10		SNF	"Special Care Low , ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
LD114	10/01/10		SNF	"Special Care Low , ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
LD115	10/01/10		SNF	"Special Care Low , ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
LD116	10/01/10		SNF	"Special Care Low , ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
LD117	10/01/10		SNF	"Special Care Low , ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
LD11A	10/01/11		SNF	"Special Care Low , ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
LD11B	10/01/11		SNF	"Special Care Low , ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
LD11C	10/01/11		SNF	"Special Care Low , ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LD120	10/01/10		SNF	"Special Care Low , ADL Index 11-14/14-day. "					
LD121	10/01/10		SNF	"Special Care Low , ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
LD124	10/01/10		SNF	"Special Care Low , ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
LD125	10/01/10		SNF	"Special Care Low , ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
LD126	10/01/10		SNF	"Special Care Low , ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
LD12A	10/01/11		SNF	"Special Care Low , ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
LD12B	10/01/11		SNF	"Special Care Low , ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
LD12C	10/01/11		SNF	"Special Care Low , ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LD12D	10/01/11		SNF	"Special Care Low , ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LD130	10/01/10		SNF	"Special Care Low , ADL Index 11-14/30-day. "					
LD131	10/01/10		SNF	"Special Care Low , ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
LD134	10/01/10		SNF	"Special Care Low , ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
LD135	10/01/10		SNF	"Special Care Low , ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
LD136	10/01/10		SNF	"Special Care Low , ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
LD13A	10/01/11		SNF	"Special Care Low , ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
LD13B	10/01/11		SNF	"Special Care Low , ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
LD13C	10/01/11		SNF	"Special Care Low , ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LD13D	10/01/11		SNF	"Special Care Low , ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LD140	10/01/10		SNF	"Special Care Low , ADL Index 11-14/60-day. "					
LD141	10/01/10		SNF	"Special Care Low , ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
LD144	10/01/10		SNF	"Special Care Low , ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
LD145	10/01/10		SNF	"Special Care Low , ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
LD146	10/01/10		SNF	"Special Care Low , ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
LD14A	10/01/11		SNF	"Special Care Low , ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
LD14B	10/01/11		SNF	"Special Care Low , ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
LD14C	10/01/11		SNF	"Special Care Low , ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LD14D	10/01/11		SNF	"Special Care Low , ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LD150	10/01/10		SNF	"Special Care Low , ADL Index 11-14/90-day. "					
LD151	10/01/10		SNF	"Special Care Low , ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
LD154	10/01/10		SNF	"Special Care Low , ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
LD155	10/01/10		SNF	"Special Care Low , ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
LD156	10/01/10		SNF	"Special Care Low , ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
LD15A	10/01/11		SNF	"Special Care Low , ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
LD15B	10/01/11		SNF	"Special Care Low , ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
LD15C	10/01/11		SNF	"Special Care Low , ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LD15D	10/01/11		SNF	"Special Care Low , ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LD160	10/01/10		SNF	"Special Care Low , ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following: SNF notified untimely of MSP denial, or 
SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
LD18A	10/01/10		SNF	"Special Care Low , ADL Index 11-14/TRICARE 120-day assessment "					
LD18B	10/01/10		SNF	"Special Care Low , ADL Index 11-14/TRICARE 150-day assessment "					
LD18C	10/01/10		SNF	"Special Care Low , ADL Index 11-14/TRICARE 180-day assessment "					
LD18D	10/01/10		SNF	"Special Care Low , ADL Index 11-14/TRICARE 210-day assessment "					
LD18E	10/01/10		SNF	"Special Care Low , ADL Index 11-14/TRICARE 240-day assessment "					
LD18F	10/01/10		SNF	"Special Care Low , ADL Index 11-14/TRICARE 270-day assessment "					
LD18G	10/01/10		SNF	"Special Care Low , ADL Index 11-14/TRICARE 300-day assessment "					
LD18H	10/01/10		SNF	"Special Care Low , ADL Index 11-14/TRICARE 330-day assessment "					
LD18I	10/01/10		SNF	"Special Care Low , ADL Index 11-14/TRICARE 360-day assessment "					
LD18X	10/01/10		SNF	"Special Care Low , ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval "					
LD201	10/01/10		SNF	"Special Care Low , ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA."					
LD204	10/01/10		SNF	"Special Care Low , ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA."					
LD205	10/01/10		SNF	"Special Care Low , ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
LD206	10/01/10		SNF	"Special Care Low , ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
LD20A	10/01/11		SNF	"Special Care Low , ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
LD20B	10/01/11		SNF	"Special Care Low , ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
LD20C	10/01/11		SNF	"Special Care Low , ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
LD20D	10/01/11		SNF	"Special Care Low , ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
LD210	10/01/10		SNF	"Special Care Low , ADL Index 11-14/5-day or readmission return. "					
LD211	10/01/10		SNF	"Special Care Low , ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
LD212	10/01/10		SNF	"Special Care Low , ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
LD213	10/01/10		SNF	"Special Care Low , ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
LD214	10/01/10		SNF	"Special Care Low , ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
LD215	10/01/10		SNF	"Special Care Low , ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
LD216	10/01/10		SNF	"Special Care Low , ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
LD217	10/01/10		SNF	"Special Care Low , ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
LD21A	10/01/11		SNF	"Special Care Low , ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
LD21B	10/01/11		SNF	"Special Care Low , ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
LD21C	10/01/11		SNF	"Special Care Low , ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LD220	10/01/10		SNF	"Special Care Low , ADL Index 11-14/14-day. "					
LD221	10/01/10		SNF	"Special Care Low , ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
LD224	10/01/10		SNF	"Special Care Low , ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
LD225	10/01/10		SNF	"Special Care Low , ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
LD226	10/01/10		SNF	"Special Care Low , ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
LD22A	10/01/11		SNF	"Special Care Low , ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
LD22B	10/01/11		SNF	"Special Care Low , ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
LD22C	10/01/11		SNF	"Special Care Low , ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LD22D	10/01/11		SNF	"Special Care Low , ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LD230	10/01/10		SNF	"Special Care Low , ADL Index 11-14/30-day. "					
LD231	10/01/10		SNF	"Special Care Low , ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
LD234	10/01/10		SNF	"Special Care Low , ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
LD235	10/01/10		SNF	"Special Care Low , ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
LD236	10/01/10		SNF	"Special Care Low , ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
LD23A	10/01/11		SNF	"Special Care Low , ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
LD23B	10/01/11		SNF	"Special Care Low , ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
LD23C	10/01/11		SNF	"Special Care Low , ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LD23D	10/01/11		SNF	"Special Care Low , ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LD240	10/01/10		SNF	"Special Care Low , ADL Index 11-14/60-day. "					
LD241	10/01/10		SNF	"Special Care Low , ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
LD244	10/01/10		SNF	"Special Care Low , ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
LD245	10/01/10		SNF	"Special Care Low , ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
LD246	10/01/10		SNF	"Special Care Low , ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
LD24A	10/01/11		SNF	"Special Care Low , ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
LD24B	10/01/11		SNF	"Special Care Low , ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
LD24C	10/01/11		SNF	"Special Care Low , ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LD24D	10/01/11		SNF	"Special Care Low , ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LD250	10/01/10		SNF	"Special Care Low , ADL Index 11-14/90-day. "					
LD251	10/01/10		SNF	"Special Care Low , ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
LD254	10/01/10		SNF	"Special Care Low , ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
LD255	10/01/10		SNF	"Special Care Low , ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
LD256	10/01/10		SNF	"Special Care Low , ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
LD25A	10/01/11		SNF	"Special Care Low , ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
LD25B	10/01/11		SNF	"Special Care Low , ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
LD25C	10/01/11		SNF	"Special Care Low , ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LD25D	10/01/11		SNF	"Special Care Low , ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LD260	10/01/10		SNF	"Special Care Low , ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following: SNF notified untimely of MSP denial, or SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
LD28A	10/01/10		SNF	"Special Care Low , ADL Index 11-14/TRICARE 120-day assessment "					
LD28B	10/01/10		SNF	"Special Care Low , ADL Index 11-14/TRICARE 150-day assessment "					
LD28C	10/01/10		SNF	"Special Care Low , ADL Index 11-14/TRICARE 180-day assessment "					
LD28D	10/01/10		SNF	"Special Care Low , ADL Index 11-14/TRICARE 210-day assessment "					
LD28E	10/01/10		SNF	"Special Care Low , ADL Index 11-14/TRICARE 240-day assessment "					
LD28F	10/01/10		SNF	"Special Care Low , ADL Index 11-14/TRICARE 270-day assessment "					
LD28G	10/01/10		SNF	"Special Care Low , ADL Index 11-14/TRICARE 300-day assessment "					
LD28H	10/01/10		SNF	"Special Care Low , ADL Index 11-14/TRICARE 330-day assessment "					
LD28I	10/01/10		SNF	"Special Care Low , ADL Index 11-14/TRICARE 360-day assessment "					
LD28X	10/01/10		SNF	"Special Care Low , ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval "					
LE101	10/01/10		SNF	"Special Care Low , ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA."					
LE104	10/01/10		SNF	"Special Care Low , ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA."					
LE105	10/01/10		SNF	"Special Care Low , ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
LE106	10/01/10		SNF	"Special Care Low , ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
LE10A	10/01/11		SNF	"Special Care Low , ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
LE10B	10/01/11		SNF	"Special Care Low , ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
LE10C	10/01/11		SNF	"Special Care Low , ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
LE10D	10/01/11		SNF	"Special Care Low , ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
LE110	10/01/10		SNF	"Special Care Low , ADL Index 15-16/5-day or readmission return. "					
LE111	10/01/10		SNF	"Special Care Low , ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
LE112	10/01/10		SNF	"Special Care Low , ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
LE113	10/01/10		SNF	"Special Care Low , ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
LE114	10/01/10		SNF	"Special Care Low , ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
LE115	10/01/10		SNF	"Special Care Low , ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
LE116	10/01/10		SNF	"Special Care Low , ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
LE117	10/01/10		SNF	"Special Care Low , ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
LE11A	10/01/11		SNF	"Special Care Low , ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
LE11B	10/01/11		SNF	"Special Care Low , ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
LE11C	10/01/11		SNF	"Special Care Low , ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LE120	10/01/10		SNF	"Special Care Low , ADL Index 15-16/14-day. "					
LE121	10/01/10		SNF	"Special Care Low , ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
LE124	10/01/10		SNF	"Special Care Low , ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
LE125	10/01/10		SNF	"Special Care Low , ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
LE126	10/01/10		SNF	"Special Care Low , ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
LE12A	10/01/11		SNF	"Special Care Low , ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
LE12B	10/01/11		SNF	"Special Care Low , ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
LE12C	10/01/11		SNF	"Special Care Low , ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LE12D	10/01/11		SNF	"Special Care Low , ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LE130	10/01/10		SNF	"Special Care Low , ADL Index 15-16/30-day. "					
LE131	10/01/10		SNF	"Special Care Low , ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
LE134	10/01/10		SNF	"Special Care Low , ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
LE135	10/01/10		SNF	"Special Care Low , ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
LE136	10/01/10		SNF	"Special Care Low , ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
LE13A	10/01/11		SNF	"Special Care Low , ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
LE13B	10/01/11		SNF	"Special Care Low , ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
LE13C	10/01/11		SNF	"Special Care Low , ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LE13D	10/01/11		SNF	"Special Care Low , ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LE140	10/01/10		SNF	"Special Care Low , ADL Index 15-16/60-day. "					
LE141	10/01/10		SNF	"Special Care Low , ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
LE144	10/01/10		SNF	"Special Care Low , ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
LE145	10/01/10		SNF	"Special Care Low , ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
LE146	10/01/10		SNF	"Special Care Low , ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
LE14A	10/01/11		SNF	"Special Care Low , ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
LE14B	10/01/11		SNF	"Special Care Low , ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
LE14C	10/01/11		SNF	"Special Care Low , ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LE14D	10/01/11		SNF	"Special Care Low , ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LE150	10/01/10		SNF	"Special Care Low , ADL Index 15-16/90-day. "					
LE151	10/01/10		SNF	"Special Care Low , ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
LE154	10/01/10		SNF	"Special Care Low , ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
LE155	10/01/10		SNF	"Special Care Low , ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
LE156	10/01/10		SNF	"Special Care Low , ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
LE15A	10/01/11		SNF	"Special Care Low , ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
LE15B	10/01/11		SNF	"Special Care Low , ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
LE15C	10/01/11		SNF	"Special Care Low , ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LE15D	10/01/11		SNF	"Special Care Low , ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LE160	10/01/10		SNF	"Special Care Low , ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following: SNF notified untimely of MSP denial, or SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
LE18A	10/01/10		SNF	"Special Care Low , ADL Index 15-16/TRICARE 120-day assessment "					
LE18B	10/01/10		SNF	"Special Care Low , ADL Index 15-16/TRICARE 150-day assessment "					
LE18C	10/01/10		SNF	"Special Care Low , ADL Index 15-16/TRICARE 180-day assessment "					
LE18D	10/01/10		SNF	"Special Care Low , ADL Index 15-16/TRICARE 210-day assessment "					
LE18E	10/01/10		SNF	"Special Care Low , ADL Index 15-16/TRICARE 240-day assessment "					
LE18F	10/01/10		SNF	"Special Care Low , ADL Index 15-16/TRICARE 270-day assessment "					
LE18G	10/01/10		SNF	"Special Care Low , ADL Index 15-16/TRICARE 300-day assessment "					
LE18H	10/01/10		SNF	"Special Care Low , ADL Index 15-16/TRICARE 330-day assessment "					
LE18I	10/01/10		SNF	"Special Care Low , ADL Index 15-16/TRICARE 360-day assessment "					
LE18X	10/01/10		SNF	"Special Care Low , ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval "					
LE201	10/01/10		SNF	"Special Care Low , ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA."					
LE204	10/01/10		SNF	"Special Care Low , ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA."					
LE205	10/01/10		SNF	"Special Care Low , ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
LE206	10/01/10		SNF	"Special Care Low , ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
LE20A	10/01/11		SNF	"Special Care Low , ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
LE20B	10/01/11		SNF	"Special Care Low , ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
LE20C	10/01/11		SNF	"Special Care Low , ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
LE20D	10/01/11		SNF	"Special Care Low , ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
LE210	10/01/10		SNF	"Special Care Low , ADL Index 15-16/5-day or readmission return. "					
LE211	10/01/10		SNF	"Special Care Low , ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
LE212	10/01/10		SNF	"Special Care Low , ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
LE213	10/01/10		SNF	"Special Care Low , ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
LE214	10/01/10		SNF	"Special Care Low , ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
LE215	10/01/10		SNF	"Special Care Low , ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
LE216	10/01/10		SNF	"Special Care Low , ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
LE217	10/01/10		SNF	"Special Care Low , ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
LE21A	10/01/11		SNF	"Special Care Low , ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
LE21B	10/01/11		SNF	"Special Care Low , ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
LE21C	10/01/11		SNF	"Special Care Low , ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LE220	10/01/10		SNF	"Special Care Low , ADL Index 15-16/14-day. "					
LE221	10/01/10		SNF	"Special Care Low , ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
LE224	10/01/10		SNF	"Special Care Low , ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
LE225	10/01/10		SNF	"Special Care Low , ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
LE226	10/01/10		SNF	"Special Care Low , ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
LE22A	10/01/11		SNF	"Special Care Low , ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
LE22B	10/01/11		SNF	"Special Care Low , ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
LE22C	10/01/11		SNF	"Special Care Low , ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LE22D	10/01/11		SNF	"Special Care Low , ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LE230	10/01/10		SNF	"Special Care Low , ADL Index 15-16/30-day. "					
LE231	10/01/10		SNF	"Special Care Low , ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
LE234	10/01/10		SNF	"Special Care Low , ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
LE235	10/01/10		SNF	"Special Care Low , ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
LE236	10/01/10		SNF	"Special Care Low , ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
LE23A	10/01/11		SNF	"Special Care Low , ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
LE23B	10/01/11		SNF	"Special Care Low , ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
LE23C	10/01/11		SNF	"Special Care Low , ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LE23D	10/01/11		SNF	"Special Care Low , ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LE240	10/01/10		SNF	"Special Care Low , ADL Index 15-16/60-day. "					
LE241	10/01/10		SNF	"Special Care Low , ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
LE244	10/01/10		SNF	"Special Care Low , ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
LE245	10/01/10		SNF	"Special Care Low , ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
LE246	10/01/10		SNF	"Special Care Low , ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
LE24A	10/01/11		SNF	"Special Care Low , ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
LE24B	10/01/11		SNF	"Special Care Low , ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
LE24C	10/01/11		SNF	"Special Care Low , ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LE24D	10/01/11		SNF	"Special Care Low , ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LE250	10/01/10		SNF	"Special Care Low , ADL Index 15-16/90-day. "					
LE251	10/01/10		SNF	"Special Care Low , ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
LE254	10/01/10		SNF	"Special Care Low , ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
LE255	10/01/10		SNF	"Special Care Low , ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
LE256	10/01/10		SNF	"Special Care Low , ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
LE25A	10/01/11		SNF	"Special Care Low , ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
LE25B	10/01/11		SNF	"Special Care Low , ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
LE25C	10/01/11		SNF	"Special Care Low , ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LE25D	10/01/11		SNF	"Special Care Low , ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
LE260	10/01/10		SNF	"Special Care Low , ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following: SNF notified untimely of MSP denial, or SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
LE28A	10/01/10		SNF	"Special Care Low , ADL Index 15-16/TRICARE 120-day assessment "					
LE28B	10/01/10		SNF	"Special Care Low , ADL Index 15-16/TRICARE 150-day assessment "					
LE28C	10/01/10		SNF	"Special Care Low , ADL Index 15-16/TRICARE 180-day assessment "					
LE28D	10/01/10		SNF	"Special Care Low , ADL Index 15-16/TRICARE 210-day assessment "					
LE28E	10/01/10		SNF	"Special Care Low , ADL Index 15-16/TRICARE 240-day assessment "					
LE28F	10/01/10		SNF	"Special Care Low , ADL Index 15-16/TRICARE 270-day assessment "					
LE28G	10/01/10		SNF	"Special Care Low , ADL Index 15-16/TRICARE 300-day assessment "					
LE28H	10/01/10		SNF	"Special Care Low , ADL Index 15-16/TRICARE 330-day assessment "					
LE28I	10/01/10		SNF	"Special Care Low , ADL Index 15-16/TRICARE 360-day assessment "					
LE28X	10/01/10		SNF	"Special Care Low , ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval "					
NOTE	Code Effective Through Dates w/ an asterisk (*) are terminated for Medicare payer purposes only								
PA101	07/01/98		SNF	"Reduced Physical Function , ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA."					
PA102	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 4 - 5, not receiving nursing rehabilitation/Medicare 30 day assessment (Full)"					
PA103	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 4 - 5, not receiving nursing rehabilitation/Medicare 60 day assessment (Full)"					
PA104	07/01/98		SNF	"Reduced Physical Function , ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA."					
PA105	07/01/98		SNF	"Reduced Physical Function , ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
PA106	10/01/10		SNF	"Reduced Physical Function , ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
PA107	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 4 - 5, not receiving nursing rehabilitation/Medicare 14 day assessment (Full or comprehensive)"					
PA108	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 4 - 5, not receiving nursing rehabilitation/Other Medicare Required Assessment (OMRA) "					
PA10A	10/01/11		SNF	"Reduced Physical Function , ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
PA10B	10/01/11		SNF	"Reduced Physical Function , ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
PA10C	10/01/11		SNF	"Reduced Physical Function , ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
PA10D	10/01/11		SNF	"Reduced Physical Function , ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
PA110	10/01/10		SNF	"Reduced Physical Function , ADL Index 0-1/5-day or readmission return. "					
PA111	07/01/98		SNF	"Reduced Physical Function , ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
PA112	10/01/10		SNF	"Reduced Physical Function , ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
PA113	10/01/10		SNF	"Reduced Physical Function , ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
PA114	10/01/10		SNF	"Reduced Physical Function , ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
PA115	10/01/10		SNF	"Reduced Physical Function , ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
PA116	10/01/10		SNF	"Reduced Physical Function , ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
PA117	07/01/98		SNF	"Reduced Physical Function , ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
PA118 	10/01/00	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 4 - 5, not receiving nursing rehabilitation/OMRA replacing 5-day Medicare assessment"					
PA119	07/01/02	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 4 - 5, not receiving nursing rehabilitation/Special payment situation 5-day assessment"					
PA11A	10/01/11		SNF	"Reduced Physical Function , ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
PA11B	10/01/11		SNF	"Reduced Physical Function , ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
PA11C	10/01/11		SNF	"Reduced Physical Function , ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PA120	10/01/10		SNF	"Reduced Physical Function , ADL Index 0-1/14-day. "					
PA121	10/01/10		SNF	"Reduced Physical Function , ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
PA124	10/01/10		SNF	"Reduced Physical Function , ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
PA125	10/01/10		SNF	"Reduced Physical Function , ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
PA126	10/01/10		SNF	"Reduced Physical Function , ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
PA128	10/01/00	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 4 - 5, not receiving nursing rehabilitation/OMRA replacing 30-day Medicare assessment"					
PA129	07/01/02	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 4 - 5, not receiving nursing rehabilitation/Special payment situation 30-day assessment"					
PA12A	10/01/11		SNF	"Reduced Physical Function , ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
PA12B	10/01/11		SNF	"Reduced Physical Function , ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
PA12C	10/01/11		SNF	"Reduced Physical Function , ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PA12D	10/01/11		SNF	"Reduced Physical Function , ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PA130	07/01/98		SNF	"Reduced Physical Function , ADL Index 0-1/30-day. "					
PA131	07/01/98		SNF	"Reduced Physical Function , ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
PA132	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 4 - 5, not receiving nursing rehabilitation/[7/98 def.] SCSA or OMRA/ Medicare 30 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 30-day Medicare required assessment"					
PA133	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 4 - 5, not receiving nursing rehabilitation/[7/98 def.] SCSA or OMRA/ Medicare 60 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 60-day Medicare required assessment"					
PA134	07/01/98		SNF	"Reduced Physical Function , ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
PA135	07/01/98		SNF	"Reduced Physical Function , ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
PA136	10/01/10		SNF	"Reduced Physical Function , ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
PA137	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 4 - 5, not receiving nursing rehabilitation/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
PA138	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 4 - 5, not receiving nursing rehabilitation/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
PA139	07/01/02	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 4 - 5, not receiving nursing rehabilitation/Special payment situation 60-day assessment"					
PA13A	10/01/11		SNF	"Reduced Physical Function , ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
PA13B	10/01/11		SNF	"Reduced Physical Function , ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
PA13C	10/01/11		SNF	"Reduced Physical Function , ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PA13D	10/01/11		SNF	"Reduced Physical Function , ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PA140	07/01/98		SNF	"Reduced Physical Function , ADL Index 0-1/60-day. "					
PA141	07/01/98		SNF	"Reduced Physical Function , ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
PA142	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 4 - 5, not receiving nursing rehabilitation/Significant Correction of Prior Full Assessment/Medicare 30 Day Assessment "					
PA143	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 4 - 5, not receiving nursing rehabilitation/Significant Correction of Prior Full Assessment/Medicare 60 Day Assessment "					
PA144	07/01/98		SNF	"Reduced Physical Function , ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
PA145	07/01/98		SNF	"Reduced Physical Function , ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
PA146	10/01/10		SNF	"Reduced Physical Function , ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
PA147	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 4 - 5, not receiving nursing rehabilitation/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
PA148	10/01/00	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 4 - 5, not receiving nursing rehabilitation/OMRA replacing 90-day Medicare-required assessment"					
PA149	07/01/02	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 4 - 5, not receiving nursing rehabilitation/Special payment situation 90-day assessment"					
PA14A	10/01/11		SNF	"Reduced Physical Function , ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
PA14B	10/01/11		SNF	"Reduced Physical Function , ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
PA14C	10/01/11		SNF	"Reduced Physical Function , ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PA14D	10/01/11		SNF	"Reduced Physical Function , ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PA150	10/01/10		SNF	"Reduced Physical Function , ADL Index 0-1/90-day. "					
PA151	10/01/10		SNF	"Reduced Physical Function , ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
PA154	07/01/98		SNF	"Reduced Physical Function , ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
PA155	10/01/10		SNF	"Reduced Physical Function , ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
PA156	10/01/10		SNF	"Reduced Physical Function , ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
PA15A	10/01/11		SNF	"Reduced Physical Function , ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
PA15B	10/01/11		SNF	"Reduced Physical Function , ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
PA15C	10/01/11		SNF	"Reduced Physical Function , ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PA15D	10/01/11		SNF	"Reduced Physical Function , ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PA160	10/01/10		SNF	"Reduced Physical Function , ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following: SNF notified untimely of MSP denial, or 
SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
PA178	10/01/00	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 4 - 5, not receiving nursing rehabilitation/OMRA replacing 14-day Medicare-required assessment"					
PA179	07/01/02	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 4 - 5, not receiving nursing rehabilitation/Special payment situation 14-day assessment"					
PA18A	07/01/98		SNF	"Reduced Physical Function , ADL Index 0-1/TRICARE 120-day assessment "					
PA18B	07/01/98		SNF	"Reduced Physical Function , ADL Index 0-1/TRICARE 150-day assessment "					
PA18C	07/01/98		SNF	"Reduced Physical Function , ADL Index 0-1/TRICARE 180-day assessment "					
PA18D	07/01/98		SNF	"Reduced Physical Function , ADL Index 0-1/TRICARE 210-day assessment "					
PA18E	07/01/98		SNF	"Reduced Physical Function , ADL Index 0-1/TRICARE 240-day assessment "					
PA18F	07/01/98		SNF	"Reduced Physical Function , ADL Index 0-1/TRICARE 270-day assessment "					
PA18G	07/01/98		SNF	"Reduced Physical Function , ADL Index 0-1/TRICARE 300-day assessment "					
PA18H	07/01/98		SNF	"Reduced Physical Function , ADL Index 0-1/TRICARE 330-day assessment "					
PA18I	07/01/98		SNF	"Reduced Physical Function , ADL Index 0-1/TRICARE 360-day assessment "					
PA18X	07/01/98		SNF	"Reduced Physical Function , ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval "					
PA201	07/01/98		SNF	"Reduced Physical Function , ADL Index 0-1/Stand-alone OBRA SCSA OR SCPA OR CCA."					
PA202	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 4 - 5/Medicare 30 day assessment (Full)"					
PA203	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 4 - 5/Medicare 60 day assessment (Full)"					
PA204	07/01/98		SNF	"Reduced Physical Function , ADL Index 0-1/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA."					
PA205	07/01/98		SNF	"Reduced Physical Function , ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
PA206	10/01/10		SNF	"Reduced Physical Function , ADL Index 0-1/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
PA207	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 4 - 5/Medicare 14 day assessment (Full or comprehensive)"					
PA208	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 4 - 5/Other Medicare Required Assessment (OMRA) "					
PA20A	10/01/11		SNF	"Reduced Physical Function , ADL Index 0-1/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
PA20B	10/01/11		SNF	"Reduced Physical Function , ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
PA20C	10/01/11		SNF	"Reduced Physical Function , ADL Index 0-1/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
PA20D	10/01/11		SNF	"Reduced Physical Function , ADL Index 0-1/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
PA210	10/01/10		SNF	"Reduced Physical Function , ADL Index 0-1/5-day or readmission return. "					
PA211	07/01/98		SNF	"Reduced Physical Function , ADL Index 0-1/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
PA212	10/01/10		SNF	"Reduced Physical Function , ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
PA213	10/01/10		SNF	"Reduced Physical Function , ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
PA214	10/01/10		SNF	"Reduced Physical Function , ADL Index 0-1/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
PA215	10/01/10		SNF	"Reduced Physical Function , ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
PA216	10/01/10		SNF	"Reduced Physical Function , ADL Index 0-1/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
PA217	07/01/98		SNF	"Reduced Physical Function , ADL Index 0-1/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
PA218 	10/01/00	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 4 - 5/OMRA replacing 5-day Medicare assessment"					
PA219	07/01/02	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 4 - 5/Special payment situation 5-day assessment"					
PA21A	10/01/11		SNF	"Reduced Physical Function , ADL Index 0-1/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
PA21B	10/01/11		SNF	"Reduced Physical Function , ADL Index 0-1/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
PA21C	10/01/11		SNF	"Reduced Physical Function , ADL Index 0-1/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PA220	10/01/10		SNF	"Reduced Physical Function , ADL Index 0-1/14-day. "					
PA221	10/01/10		SNF	"Reduced Physical Function , ADL Index 0-1/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
PA224	10/01/10		SNF	"Reduced Physical Function , ADL Index 0-1/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
PA225	10/01/10		SNF	"Reduced Physical Function , ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
PA226	10/01/10		SNF	"Reduced Physical Function , ADL Index 0-1/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
PA228	10/01/00	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 4 - 5/OMRA replacing 30-day Medicare assessment"					
PA229	07/01/02	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 4 - 5/Special payment situation 30-day assessment"					
PA22A	10/01/11		SNF	"Reduced Physical Function , ADL Index 0-1/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
PA22B	10/01/11		SNF	"Reduced Physical Function , ADL Index 0-1/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
PA22C	10/01/11		SNF	"Reduced Physical Function , ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PA22D	10/01/11		SNF	"Reduced Physical Function , ADL Index 0-1/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PA230	07/01/98		SNF	"Reduced Physical Function , ADL Index 0-1/30-day. "					
PA231	07/01/98		SNF	"Reduced Physical Function , ADL Index 0-1/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
PA232	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 4 - 5/[7/98 def.] SCSA or OMRA/ Medicare 30 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 30-day Medicare required assessment"					
PA233	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 4 - 5/[7/98 def.] SCSA or OMRA/ Medicare 60 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 60-day Medicare required assessment"					
PA234	07/01/98		SNF	"Reduced Physical Function , ADL Index 0-1/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
PA235	07/01/98		SNF	"Reduced Physical Function , ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
PA236	10/01/10		SNF	"Reduced Physical Function , ADL Index 0-1/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
PA237	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 4 - 5/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
PA238	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 4 - 5/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
PA239	07/01/02	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 4 - 5/Special payment situation 60-day assessment"					
PA23A	10/01/11		SNF	"Reduced Physical Function , ADL Index 0-1/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
PA23B	10/01/11		SNF	"Reduced Physical Function , ADL Index 0-1/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
PA23C	10/01/11		SNF	"Reduced Physical Function , ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PA23D	10/01/11		SNF	"Reduced Physical Function , ADL Index 0-1/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PA240	07/01/98		SNF	"Reduced Physical Function , ADL Index 0-1/60-day. "					
PA241	07/01/98		SNF	"Reduced Physical Function , ADL Index 0-1/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
PA242	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 4 - 5/Significant Correction of Prior Full Assessment/Medicare 30 Day Assessment "					
PA243	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 4 - 5/Significant Correction of Prior Full Assessment/Medicare 60 Day Assessment "					
PA244	07/01/98		SNF	"Reduced Physical Function , ADL Index 0-1/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
PA245	07/01/98		SNF	"Reduced Physical Function , ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
PA246	10/01/10		SNF	"Reduced Physical Function , ADL Index 0-1/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
PA247	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 4 - 5/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
PA248	10/01/00	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 4 - 5/OMRA replacing 90-day Medicare-required assessment"					
PA249	07/01/02	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 4 - 5/Special payment situation 90-day assessment"					
PA24A	10/01/11		SNF	"Reduced Physical Function , ADL Index 0-1/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
PA24B	10/01/11		SNF	"Reduced Physical Function , ADL Index 0-1/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
PA24C	10/01/11		SNF	"Reduced Physical Function , ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PA24D	10/01/11		SNF	"Reduced Physical Function , ADL Index 0-1/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PA250	10/01/10		SNF	"Reduced Physical Function , ADL Index 0-1/90-day. "					
PA251	10/01/10		SNF	"Reduced Physical Function , ADL Index 0-1/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
PA254	07/01/98		SNF	"Reduced Physical Function , ADL Index 0-1/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
PA255	10/01/10		SNF	"Reduced Physical Function , ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
PA256	10/01/10		SNF	"Reduced Physical Function , ADL Index 0-1/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
PA25A	10/01/11		SNF	"Reduced Physical Function , ADL Index 0-1/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
PA25B	10/01/11		SNF	"Reduced Physical Function , ADL Index 0-1/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
PA25C	10/01/11		SNF	"Reduced Physical Function , ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PA25D	10/01/11		SNF	"Reduced Physical Function , ADL Index 0-1/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PA260	10/01/10		SNF	"Reduced Physical Function , ADL Index 0-1/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following: SNF notified untimely of MSP denial, or 
SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
PA278	10/01/00	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 4 - 5/OMRA replacing 14-day Medicare-required assessment"					
PA279	07/01/02	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 4 - 5/Special payment situation 14-day assessment"					
PA28A	07/01/98		SNF	"Reduced Physical Function , ADL Index 0-1/TRICARE 120-day assessment "					
PA28B	07/01/98		SNF	"Reduced Physical Function , ADL Index 0-1/TRICARE 150-day assessment "					
PA28C	07/01/98		SNF	"Reduced Physical Function , ADL Index 0-1/TRICARE 180-day assessment "					
PA28D	07/01/98		SNF	"Reduced Physical Function , ADL Index 0-1/TRICARE 210-day assessment "					
PA28E	07/01/98		SNF	"Reduced Physical Function , ADL Index 0-1/TRICARE 240-day assessment "					
PA28F	07/01/98		SNF	"Reduced Physical Function , ADL Index 0-1/TRICARE 270-day assessment "					
PA28G	07/01/98		SNF	"Reduced Physical Function , ADL Index 0-1/TRICARE 300-day assessment "					
PA28H	07/01/98		SNF	"Reduced Physical Function , ADL Index 0-1/TRICARE 330-day assessment "					
PA28I	07/01/98		SNF	"Reduced Physical Function , ADL Index 0-1/TRICARE 360-day assessment "					
PA28X	07/01/98		SNF	"Reduced Physical Function , ADL Index 0-1/TRICARE Post 360-day assessments with 30-day interval "					
PB101	07/01/98		SNF	"Reduced Physical Function , ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA."					
PB102	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 6 - 8, not receiving nursing rehabilitation/Medicare 30 day assessment (Full)"					
PB103	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 6 - 8, not receiving nursing rehabilitation/Medicare 60 day assessment (Full)"					
PB104	07/01/98		SNF	"Reduced Physical Function , ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA."					
PB105	07/01/98		SNF	"Reduced Physical Function , ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
PB106	10/01/10		SNF	"Reduced Physical Function , ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
PB107	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 6 - 8, not receiving nursing rehabilitation/Medicare 14 day assessment (Full or comprehensive)"					
PB108	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 6 - 8, not receiving nursing rehabilitation/Other Medicare Required Assessment (OMRA) "					
PB10A	10/01/11		SNF	"Reduced Physical Function , ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
PB10B	10/01/11		SNF	"Reduced Physical Function , ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
PB10C	10/01/11		SNF	"Reduced Physical Function , ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
PB10D	10/01/11		SNF	"Reduced Physical Function , ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
PB110	10/01/10		SNF	"Reduced Physical Function , ADL Index 2-5/5-day or readmission return. "					
PB111	07/01/98		SNF	"Reduced Physical Function , ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
PB112	10/01/10		SNF	"Reduced Physical Function , ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
PB113	10/01/10		SNF	"Reduced Physical Function , ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
PB114	10/01/10		SNF	"Reduced Physical Function , ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
PB115	10/01/10		SNF	"Reduced Physical Function , ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
PB116	10/01/10		SNF	"Reduced Physical Function , ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
PB117	07/01/98		SNF	"Reduced Physical Function , ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
PB118 	10/01/00	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 6 - 8, not receiving nursing rehabilitation/OMRA replacing 5-day Medicare assessment"					
PB119	07/01/02	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 6 - 8, not receiving nursing rehabilitation/Special payment situation 5-day assessment"					
PB11A	10/01/11		SNF	"Reduced Physical Function , ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
PB11B	10/01/11		SNF	"Reduced Physical Function , ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
PB11C	10/01/11		SNF	"Reduced Physical Function , ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PB120	10/01/10		SNF	"Reduced Physical Function , ADL Index 2-5/14-day. "					
PB121	10/01/10		SNF	"Reduced Physical Function , ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
PB124	10/01/10		SNF	"Reduced Physical Function , ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
PB125	10/01/10		SNF	"Reduced Physical Function , ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
PB126	10/01/10		SNF	"Reduced Physical Function , ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
PB128	10/01/00	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 6 - 8, not receiving nursing rehabilitation/OMRA replacing 30-day Medicare assessment"					
PB129	07/01/02	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 6 - 8, not receiving nursing rehabilitation/Special payment situation 30-day assessment"					
PB12A	10/01/11		SNF	"Reduced Physical Function , ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
PB12B	10/01/11		SNF	"Reduced Physical Function , ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
PB12C	10/01/11		SNF	"Reduced Physical Function , ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PB12D	10/01/11		SNF	"Reduced Physical Function , ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PB130	07/01/98		SNF	"Reduced Physical Function , ADL Index 2-5/30-day. "					
PB131	07/01/98		SNF	"Reduced Physical Function , ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
PB132	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 6 - 8, not receiving nursing rehabilitation/[7/98 def.] SCSA or OMRA/ Medicare 30 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 30-day Medicare required assessment"					
PB133	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 6 - 8, not receiving nursing rehabilitation/[7/98 def.] SCSA or OMRA/ Medicare 60 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 60-day Medicare required assessment"					
PB134	07/01/98		SNF	"Reduced Physical Function , ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
PB135	07/01/98		SNF	"Reduced Physical Function , ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
PB136	10/01/10		SNF	"Reduced Physical Function , ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
PB137	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 6 - 8, not receiving nursing rehabilitation/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
PB138	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 6 - 8, not receiving nursing rehabilitation/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
PB139	07/01/02	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 6 - 8, not receiving nursing rehabilitation/Special payment situation 60-day assessment"					
PB13A	10/01/11		SNF	"Reduced Physical Function , ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
PB13B	10/01/11		SNF	"Reduced Physical Function , ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
PB13C	10/01/11		SNF	"Reduced Physical Function , ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PB13D	10/01/11		SNF	"Reduced Physical Function , ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PB140	07/01/98		SNF	"Reduced Physical Function , ADL Index 2-5/60-day. "					
PB141	07/01/98		SNF	"Reduced Physical Function , ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
PB142	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 6 - 8, not receiving nursing rehabilitation/Significant Correction of Prior Full Assessment/Medicare 30 Day Assessment "					
PB143	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 6 - 8, not receiving nursing rehabilitation/Significant Correction of Prior Full Assessment/Medicare 60 Day Assessment "					
PB144	07/01/98		SNF	"Reduced Physical Function , ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
PB145	07/01/98		SNF	"Reduced Physical Function , ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
PB146	10/01/10		SNF	"Reduced Physical Function , ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
PB147	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 6 - 8, not receiving nursing rehabilitation/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
PB148	10/01/00	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 6 - 8, not receiving nursing rehabilitation/OMRA replacing 90-day Medicare-required assessment"					
PB149	07/01/02	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 6 - 8, not receiving nursing rehabilitation/Special payment situation 90-day assessment"					
PB14A	10/01/11		SNF	"Reduced Physical Function , ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
PB14B	10/01/11		SNF	"Reduced Physical Function , ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
PB14C	10/01/11		SNF	"Reduced Physical Function , ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PB14D	10/01/11		SNF	"Reduced Physical Function , ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PB150	10/01/10		SNF	"Reduced Physical Function , ADL Index 2-5/90-day. "					
PB151	10/01/10		SNF	"Reduced Physical Function , ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
PB154	07/01/98		SNF	"Reduced Physical Function , ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
PB155	10/01/10		SNF	"Reduced Physical Function , ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
PB156	10/01/10		SNF	"Reduced Physical Function , ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
PB15A	10/01/11		SNF	"Reduced Physical Function , ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
PB15B	10/01/11		SNF	"Reduced Physical Function , ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
PB15C	10/01/11		SNF	"Reduced Physical Function , ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PB15D	10/01/11		SNF	"Reduced Physical Function , ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PB160	10/01/10		SNF	"Reduced Physical Function , ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following: SNF notified untimely of MSP denial, or 
SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
PB178	10/01/00	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 6 - 8, not receiving nursing rehabilitation/OMRA replacing 14-day Medicare-required assessment"					
PB179	07/01/02	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 6 - 8, not receiving nursing rehabilitation/Special payment situation 14-day assessment"					
PB18A	07/01/98		SNF	"Reduced Physical Function , ADL Index 2-5/TRICARE 120-day assessment "					
PB18B	07/01/98		SNF	"Reduced Physical Function , ADL Index 2-5/TRICARE 150-day assessment "					
PB18C	07/01/98		SNF	"Reduced Physical Function , ADL Index 2-5/TRICARE 180-day assessment "					
PB18D	07/01/98		SNF	"Reduced Physical Function , ADL Index 2-5/TRICARE 210-day assessment "					
PB18E	07/01/98		SNF	"Reduced Physical Function , ADL Index 2-5/TRICARE 240-day assessment "					
PB18F	07/01/98		SNF	"Reduced Physical Function , ADL Index 2-5/TRICARE 270-day assessment "					
PB18G	07/01/98		SNF	"Reduced Physical Function , ADL Index 2-5/TRICARE 300-day assessment "					
PB18H	07/01/98		SNF	"Reduced Physical Function , ADL Index 2-5/TRICARE 330-day assessment "					
PB18I	07/01/98		SNF	"Reduced Physical Function , ADL Index 2-5/TRICARE 360-day assessment "					
PB18X	07/01/98		SNF	"Reduced Physical Function , ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval "					
PB201	07/01/98		SNF	"Reduced Physical Function , ADL Index 2-5/Stand-alone OBRA SCSA OR SCPA OR CCA."					
PB202	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 6 - 8/Medicare 30 day assessment (Full)"					
PB203	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 6 - 8/Medicare 60 day assessment (Full)"					
PB204	07/01/98		SNF	"Reduced Physical Function , ADL Index 2-5/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA."					
PB205	07/01/98		SNF	"Reduced Physical Function , ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
PB206	10/01/10		SNF	"Reduced Physical Function , ADL Index 2-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
PB207	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 6 - 8/Medicare 14 day assessment (Full or comprehensive)"					
PB208	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 6 - 8/Other Medicare Required Assessment (OMRA) "					
PB20A	10/01/11		SNF	"Reduced Physical Function , ADL Index 2-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
PB20B	10/01/11		SNF	"Reduced Physical Function , ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
PB20C	10/01/11		SNF	"Reduced Physical Function , ADL Index 2-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
PB20D	10/01/11		SNF	"Reduced Physical Function , ADL Index 2-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
PB210	10/01/10		SNF	"Reduced Physical Function , ADL Index 2-5/5-day or readmission return. "					
PB211	07/01/98		SNF	"Reduced Physical Function , ADL Index 2-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
PB212	10/01/10		SNF	"Reduced Physical Function , ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
PB213	10/01/10		SNF	"Reduced Physical Function , ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
PB214	10/01/10		SNF	"Reduced Physical Function , ADL Index 2-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
PB215	10/01/10		SNF	"Reduced Physical Function , ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
PB216	10/01/10		SNF	"Reduced Physical Function , ADL Index 2-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
PB217	07/01/98		SNF	"Reduced Physical Function , ADL Index 2-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
PB218 	10/01/00	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 6 - 8/OMRA replacing 5-day Medicare assessment"					
PB219	07/01/02	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 6 - 8/Special payment situation 5-day assessment"					
PB21A	10/01/11		SNF	"Reduced Physical Function , ADL Index 2-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
PB21B	10/01/11		SNF	"Reduced Physical Function , ADL Index 2-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
PB21C	10/01/11		SNF	"Reduced Physical Function , ADL Index 2-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PB220	10/01/10		SNF	"Reduced Physical Function , ADL Index 2-5/14-day. "					
PB221	10/01/10		SNF	"Reduced Physical Function , ADL Index 2-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
PB224	10/01/10		SNF	"Reduced Physical Function , ADL Index 2-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
PB225	10/01/10		SNF	"Reduced Physical Function , ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
PB226	10/01/10		SNF	"Reduced Physical Function , ADL Index 2-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
PB228	10/01/00	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 6 - 8/OMRA replacing 30-day Medicare assessment"					
PB229	07/01/02	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 6 - 8/Special payment situation 30-day assessment"					
PB22A	10/01/11		SNF	"Reduced Physical Function , ADL Index 2-5/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
PB22B	10/01/11		SNF	"Reduced Physical Function , ADL Index 2-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
PB22C	10/01/11		SNF	"Reduced Physical Function , ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PB22D	10/01/11		SNF	"Reduced Physical Function , ADL Index 2-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PB230	07/01/98		SNF	"Reduced Physical Function , ADL Index 2-5/30-day. "					
PB231	07/01/98		SNF	"Reduced Physical Function , ADL Index 2-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
PB232	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 6 - 8/[7/98 def.] SCSA or OMRA/ Medicare 30 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 30-day Medicare required assessment"					
PB233	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 6 - 8/[7/98 def.] SCSA or OMRA/ Medicare 60 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 60-day Medicare required assessment"					
PB234	07/01/98		SNF	"Reduced Physical Function , ADL Index 2-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
PB235	07/01/98		SNF	"Reduced Physical Function , ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
PB236	10/01/10		SNF	"Reduced Physical Function , ADL Index 2-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
PB237	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 6 - 8/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
PB238	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 6 - 8/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
PB239	07/01/02	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 6 - 8/Special payment situation 60-day assessment"					
PB23A	10/01/11		SNF	"Reduced Physical Function , ADL Index 2-5/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
PB23B	10/01/11		SNF	"Reduced Physical Function , ADL Index 2-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
PB23C	10/01/11		SNF	"Reduced Physical Function , ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PB23D	10/01/11		SNF	"Reduced Physical Function , ADL Index 2-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PB240	07/01/98		SNF	"Reduced Physical Function , ADL Index 2-5/60-day. "					
PB241	07/01/98		SNF	"Reduced Physical Function , ADL Index 2-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
PB242	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 6 - 8/Significant Correction of Prior Full Assessment/Medicare 30 Day Assessment "					
PB243	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 6 - 8/Significant Correction of Prior Full Assessment/Medicare 60 Day Assessment "					
PB244	07/01/98		SNF	"Reduced Physical Function , ADL Index 2-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
PB245	07/01/98		SNF	"Reduced Physical Function , ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
PB246	10/01/10		SNF	"Reduced Physical Function , ADL Index 2-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
PB247	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 6 - 8/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
PB248	10/01/00	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 6 - 8/OMRA replacing 90-day Medicare-required assessment"					
PB249	07/01/02	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 6 - 8/Special payment situation 90-day assessment"					
PB24A	10/01/11		SNF	"Reduced Physical Function , ADL Index 2-5/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
PB24B	10/01/11		SNF	"Reduced Physical Function , ADL Index 2-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
PB24C	10/01/11		SNF	"Reduced Physical Function , ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PB24D	10/01/11		SNF	"Reduced Physical Function , ADL Index 2-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PB250	10/01/10		SNF	"Reduced Physical Function , ADL Index 2-5/90-day. "					
PB251	10/01/10		SNF	"Reduced Physical Function , ADL Index 2-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
PB254	07/01/98		SNF	"Reduced Physical Function , ADL Index 2-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
PB255	10/01/10		SNF	"Reduced Physical Function , ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
PB256	10/01/10		SNF	"Reduced Physical Function , ADL Index 2-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
PB25A	10/01/11		SNF	"Reduced Physical Function , ADL Index 2-5/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
PB25B	10/01/11		SNF	"Reduced Physical Function , ADL Index 2-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
PB25C	10/01/11		SNF	"Reduced Physical Function , ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PB25D	10/01/11		SNF	"Reduced Physical Function , ADL Index 2-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PB260	10/01/10		SNF	"Reduced Physical Function , ADL Index 2-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following: SNF notified untimely of MSP denial, or 
SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
PB278	10/01/00	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 6 - 8/OMRA replacing 14-day Medicare-required assessment"					
PB279	07/01/02	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 6 - 8/Special payment situation 14-day assessment"					
PB28A	07/01/98		SNF	"Reduced Physical Function , ADL Index 2-5/TRICARE 120-day assessment "					
PB28B	07/01/98		SNF	"Reduced Physical Function , ADL Index 2-5/TRICARE 150-day assessment "					
PB28C	07/01/98		SNF	"Reduced Physical Function , ADL Index 2-5/TRICARE 180-day assessment "					
PB28D	07/01/98		SNF	"Reduced Physical Function , ADL Index 2-5/TRICARE 210-day assessment "					
PB28E	07/01/98		SNF	"Reduced Physical Function , ADL Index 2-5/TRICARE 240-day assessment "					
PB28F	07/01/98		SNF	"Reduced Physical Function , ADL Index 2-5/TRICARE 270-day assessment "					
PB28G	07/01/98		SNF	"Reduced Physical Function , ADL Index 2-5/TRICARE 300-day assessment "					
PB28H	07/01/98		SNF	"Reduced Physical Function , ADL Index 2-5/TRICARE 330-day assessment "					
PB28I	07/01/98		SNF	"Reduced Physical Function , ADL Index 2-5/TRICARE 360-day assessment "					
PB28X	07/01/98		SNF	"Reduced Physical Function , ADL Index 2-5/TRICARE Post 360-day assessments with 30-day interval "					
PC101	07/01/98		SNF	"Reduced Physical Function , ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA."					
PC102	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 9 - 10, not receiving nursing rehabilitation/Medicare 30 day assessment (Full)"					
PC103	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 9 - 10, not receiving nursing rehabilitation/Medicare 60 day assessment (Full)"					
PC104	07/01/98		SNF	"Reduced Physical Function , ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA."					
PC105	07/01/98		SNF	"Reduced Physical Function , ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
PC106	10/01/10		SNF	"Reduced Physical Function , ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
PC107	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 9 - 10, not receiving nursing rehabilitation/Medicare 14 day assessment (Full or comprehensive)"					
PC108	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 9 - 10, not receiving nursing rehabilitation/Other Medicare Required Assessment (OMRA) "					
PC10A	10/01/11		SNF	"Reduced Physical Function , ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
PC10B	10/01/11		SNF	"Reduced Physical Function , ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
PC10C	10/01/11		SNF	"Reduced Physical Function , ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
PC10D	10/01/11		SNF	"Reduced Physical Function , ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
PC110	10/01/10		SNF	"Reduced Physical Function , ADL Index 6-10/5-day or readmission return. "					
PC111	07/01/98		SNF	"Reduced Physical Function , ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
PC112	10/01/10		SNF	"Reduced Physical Function , ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
PC113	10/01/10		SNF	"Reduced Physical Function , ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
PC114	10/01/10		SNF	"Reduced Physical Function , ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
PC115	10/01/10		SNF	"Reduced Physical Function , ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
PC116	10/01/10		SNF	"Reduced Physical Function , ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
PC117	07/01/98		SNF	"Reduced Physical Function , ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
PC118 	10/01/00	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 9 - 10, not receiving nursing rehabilitation/OMRA replacing 5-day Medicare assessment"					
PC119	07/01/02	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 9 - 10, not receiving nursing rehabilitation/Special payment situation 5-day assessment"					
PC11A	10/01/11		SNF	"Reduced Physical Function , ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
PC11B	10/01/11		SNF	"Reduced Physical Function , ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
PC11C	10/01/11		SNF	"Reduced Physical Function , ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PC120	10/01/10		SNF	"Reduced Physical Function , ADL Index 6-10/14-day. "					
PC121	10/01/10		SNF	"Reduced Physical Function , ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
PC124	10/01/10		SNF	"Reduced Physical Function , ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
PC125	10/01/10		SNF	"Reduced Physical Function , ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
PC126	10/01/10		SNF	"Reduced Physical Function , ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
PC128	10/01/00	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 9 - 10, not receiving nursing rehabilitation/OMRA replacing 30-day Medicare assessment"					
PC129	07/01/02	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 9 - 10, not receiving nursing rehabilitation/Special payment situation 30-day assessment"					
PC12A	10/01/11		SNF	"Reduced Physical Function , ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
PC12B	10/01/11		SNF	"Reduced Physical Function , ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
PC12C	10/01/11		SNF	"Reduced Physical Function , ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PC12D	10/01/11		SNF	"Reduced Physical Function , ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PC130	07/01/98		SNF	"Reduced Physical Function , ADL Index 6-10/30-day. "					
PC131	07/01/98		SNF	"Reduced Physical Function , ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
PC132	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 9 - 10, not receiving nursing rehabilitation/[7/98 def.] SCSA or OMRA/ Medicare 30 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 30-day Medicare required assessment"					
PC133	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 9 - 10, not receiving nursing rehabilitation/[7/98 def.] SCSA or OMRA/ Medicare 60 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 60-day Medicare required assessment"					
PC134	07/01/98		SNF	"Reduced Physical Function , ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
PC135	07/01/98		SNF	"Reduced Physical Function , ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
PC136	10/01/10		SNF	"Reduced Physical Function , ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
PC137	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 9 - 10, not receiving nursing rehabilitation/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
PC138	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 9 - 10, not receiving nursing rehabilitation/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
PC139	07/01/02	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 9 - 10, not receiving nursing rehabilitation/Special payment situation 60-day assessment"					
PC13A	10/01/11		SNF	"Reduced Physical Function , ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
PC13B	10/01/11		SNF	"Reduced Physical Function , ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
PC13C	10/01/11		SNF	"Reduced Physical Function , ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PC13D	10/01/11		SNF	"Reduced Physical Function , ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PC140	07/01/98		SNF	"Reduced Physical Function , ADL Index 6-10/60-day. "					
PC141	07/01/98		SNF	"Reduced Physical Function , ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
PC142	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 9 - 10, not receiving nursing rehabilitation/Significant Correction of Prior Full Assessment/Medicare 30 Day Assessment "					
PC143	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 9 - 10, not receiving nursing rehabilitation/Significant Correction of Prior Full Assessment/Medicare 60 Day Assessment "					
PC144	07/01/98		SNF	"Reduced Physical Function , ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
PC145	07/01/98		SNF	"Reduced Physical Function , ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
PC146	10/01/10		SNF	"Reduced Physical Function , ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
PC147	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 9 - 10, not receiving nursing rehabilitation/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
PC148	10/01/00	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 9 - 10, not receiving nursing rehabilitation/OMRA replacing 90-day Medicare-required assessment"					
PC149	07/01/02	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 9 - 10, not receiving nursing rehabilitation/Special payment situation 90-day assessment"					
PC14A	10/01/11		SNF	"Reduced Physical Function , ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
PC14B	10/01/11		SNF	"Reduced Physical Function , ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
PC14C	10/01/11		SNF	"Reduced Physical Function , ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PC14D	10/01/11		SNF	"Reduced Physical Function , ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PC150	10/01/10		SNF	"Reduced Physical Function , ADL Index 6-10/90-day. "					
PC151	10/01/10		SNF	"Reduced Physical Function , ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
PC154	07/01/98		SNF	"Reduced Physical Function , ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
PC155	10/01/10		SNF	"Reduced Physical Function , ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
PC156	10/01/10		SNF	"Reduced Physical Function , ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
PC15A	10/01/11		SNF	"Reduced Physical Function , ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
PC15B	10/01/11		SNF	"Reduced Physical Function , ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
PC15C	10/01/11		SNF	"Reduced Physical Function , ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PC15D	10/01/11		SNF	"Reduced Physical Function , ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PC160	10/01/10		SNF	"Reduced Physical Function , ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following: SNF notified untimely of MSP denial, or 
SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
PC178	10/01/00	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 9 - 10, not receiving nursing rehabilitation/OMRA replacing 14-day Medicare-required assessment"					
PC179	07/01/02	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 9 - 10, not receiving nursing rehabilitation/Special payment situation 14-day assessment"					
PC18A	07/01/98		SNF	"Reduced Physical Function , ADL Index 6-10/TRICARE 120-day assessment "					
PC18B	07/01/98		SNF	"Reduced Physical Function , ADL Index 6-10/TRICARE 150-day assessment "					
PC18C	07/01/98		SNF	"Reduced Physical Function , ADL Index 6-10/TRICARE 180-day assessment "					
PC18D	07/01/98		SNF	"Reduced Physical Function , ADL Index 6-10/TRICARE 210-day assessment "					
PC18E	07/01/98		SNF	"Reduced Physical Function , ADL Index 6-10/TRICARE 240-day assessment "					
PC18F	07/01/98		SNF	"Reduced Physical Function , ADL Index 6-10/TRICARE 270-day assessment "					
PC18G	07/01/98		SNF	"Reduced Physical Function , ADL Index 6-10/TRICARE 300-day assessment "					
PC18H	07/01/98		SNF	"Reduced Physical Function , ADL Index 6-10/TRICARE 330-day assessment "					
PC18I	07/01/98		SNF	"Reduced Physical Function , ADL Index 6-10/TRICARE 360-day assessment "					
PC18X	07/01/98		SNF	"Reduced Physical Function , ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval "					
PC201	07/01/98		SNF	"Reduced Physical Function , ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA."					
PC202	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 9 - 10/Medicare 30 day assessment (Full)"					
PC203	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 9 - 10/Medicare 60 day assessment (Full)"					
PC204	07/01/98		SNF	"Reduced Physical Function , ADL Index 6-10/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA."					
PC205	07/01/98		SNF	"Reduced Physical Function , ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
PC206	10/01/10		SNF	"Reduced Physical Function , ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
PC207	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 9 - 10/Medicare 14 day assessment (Full or comprehensive)"					
PC208	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 9 - 10/Other Medicare Required Assessment (OMRA) "					
PC20A	10/01/11		SNF	"Reduced Physical Function , ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
PC20B	10/01/11		SNF	"Reduced Physical Function , ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
PC20C	10/01/11		SNF	"Reduced Physical Function , ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
PC20D	10/01/11		SNF	"Reduced Physical Function , ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
PC210	10/01/10		SNF	"Reduced Physical Function , ADL Index 6-10/5-day or readmission return. "					
PC211	07/01/98		SNF	"Reduced Physical Function , ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
PC212	10/01/10		SNF	"Reduced Physical Function , ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
PC213	10/01/10		SNF	"Reduced Physical Function , ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
PC214	10/01/10		SNF	"Reduced Physical Function , ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
PC215	10/01/10		SNF	"Reduced Physical Function , ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
PC216	10/01/10		SNF	"Reduced Physical Function , ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
PC217	07/01/98		SNF	"Reduced Physical Function , ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
PC218 	10/01/00	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 9 - 10/OMRA replacing 5-day Medicare assessment"					
PC219	07/01/02	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 9 - 10/Special payment situation 5-day assessment"					
PC21A	10/01/11		SNF	"Reduced Physical Function , ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
PC21B	10/01/11		SNF	"Reduced Physical Function , ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
PC21C	10/01/11		SNF	"Reduced Physical Function , ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PC220	10/01/10		SNF	"Reduced Physical Function , ADL Index 6-10/14-day. "					
PC221	10/01/10		SNF	"Reduced Physical Function , ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
PC224	10/01/10		SNF	"Reduced Physical Function , ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
PC225	10/01/10		SNF	"Reduced Physical Function , ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
PC226	10/01/10		SNF	"Reduced Physical Function , ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
PC228	10/01/00	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 9 - 10/OMRA replacing 30-day Medicare assessment"					
PC229	07/01/02	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 9 - 10/Special payment situation 30-day assessment"					
PC22A	10/01/11		SNF	"Reduced Physical Function , ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
PC22B	10/01/11		SNF	"Reduced Physical Function , ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
PC22C	10/01/11		SNF	"Reduced Physical Function , ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PC22D	10/01/11		SNF	"Reduced Physical Function , ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PC230	07/01/98		SNF	"Reduced Physical Function , ADL Index 6-10/30-day. "					
PC231	07/01/98		SNF	"Reduced Physical Function , ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
PC232	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 9 - 10/[7/98 def.] SCSA or OMRA/ Medicare 30 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 30-day Medicare required assessment"					
PC233	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 9 - 10/[7/98 def.] SCSA or OMRA/ Medicare 60 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 60-day Medicare required assessment"					
PC234	07/01/98		SNF	"Reduced Physical Function , ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
PC235	07/01/98		SNF	"Reduced Physical Function , ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
PC236	10/01/10		SNF	"Reduced Physical Function , ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
PC237	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 9 - 10/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
PC238	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 9 - 10/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
PC239	07/01/02	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 9 - 10/Special payment situation 60-day assessment"					
PC23A	10/01/11		SNF	"Reduced Physical Function , ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
PC23B	10/01/11		SNF	"Reduced Physical Function , ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
PC23C	10/01/11		SNF	"Reduced Physical Function , ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PC23D	10/01/11		SNF	"Reduced Physical Function , ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PC240	07/01/98		SNF	"Reduced Physical Function , ADL Index 6-10/60-day. "					
PC241	07/01/98		SNF	"Reduced Physical Function , ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
PC242	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 9 - 10/Significant Correction of Prior Full Assessment/Medicare 30 Day Assessment "					
PC243	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 9 - 10/Significant Correction of Prior Full Assessment/Medicare 60 Day Assessment "					
PC244	07/01/98		SNF	"Reduced Physical Function , ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
PC245	07/01/98		SNF	"Reduced Physical Function , ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
PC246	10/01/10		SNF	"Reduced Physical Function , ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
PC247	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 9 - 10/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
PC248	10/01/00	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 9 - 10/OMRA replacing 90-day Medicare-required assessment"					
PC249	07/01/02	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 9 - 10/Special payment situation 90-day assessment"					
PC24A	10/01/11		SNF	"Reduced Physical Function , ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
PC24B	10/01/11		SNF	"Reduced Physical Function , ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
PC24C	10/01/11		SNF	"Reduced Physical Function , ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PC24D	10/01/11		SNF	"Reduced Physical Function , ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PC250	10/01/10		SNF	"Reduced Physical Function , ADL Index 6-10/90-day. "					
PC251	10/01/10		SNF	"Reduced Physical Function , ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
PC254	07/01/98		SNF	"Reduced Physical Function , ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
PC255	10/01/10		SNF	"Reduced Physical Function , ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
PC256	10/01/10		SNF	"Reduced Physical Function , ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
PC25A	10/01/11		SNF	"Reduced Physical Function , ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
PC25B	10/01/11		SNF	"Reduced Physical Function , ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
PC25C	10/01/11		SNF	"Reduced Physical Function , ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PC25D	10/01/11		SNF	"Reduced Physical Function , ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PC260	10/01/10		SNF	"Reduced Physical Function , ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following: SNF notified untimely of MSP denial, or 
SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
PC278	10/01/00	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 9 - 10/OMRA replacing 14-day Medicare-required assessment"					
PC279	07/01/02	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 9 - 10/Special payment situation 14-day assessment"					
PC28A	07/01/98		SNF	"Reduced Physical Function , ADL Index 6-10/TRICARE 120-day assessment "					
PC28B	07/01/98		SNF	"Reduced Physical Function , ADL Index 6-10/TRICARE 150-day assessment "					
PC28C	07/01/98		SNF	"Reduced Physical Function , ADL Index 6-10/TRICARE 180-day assessment "					
PC28D	07/01/98		SNF	"Reduced Physical Function , ADL Index 6-10/TRICARE 210-day assessment "					
PC28E	07/01/98		SNF	"Reduced Physical Function , ADL Index 6-10/TRICARE 240-day assessment "					
PC28F	07/01/98		SNF	"Reduced Physical Function , ADL Index 6-10/TRICARE 270-day assessment "					
PC28G	07/01/98		SNF	"Reduced Physical Function , ADL Index 6-10/TRICARE 300-day assessment "					
PC28H	07/01/98		SNF	"Reduced Physical Function , ADL Index 6-10/TRICARE 330-day assessment "					
PC28I	07/01/98		SNF	"Reduced Physical Function , ADL Index 6-10/TRICARE 360-day assessment "					
PC28X	07/01/98		SNF	"Reduced Physical Function , ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval "					
PD101	07/01/98		SNF	"Reduced Physical Function , ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA."					
PD102	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 11 - 15, not receiving nursing rehabilitation/Medicare 30 day assessment (Full)"					
PD103	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 11 - 15, not receiving nursing rehabilitation/Medicare 60 day assessment (Full)"					
PD104	07/01/98		SNF	"Reduced Physical Function , ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA."					
PD105	07/01/98		SNF	"Reduced Physical Function , ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
PD106	10/01/10		SNF	"Reduced Physical Function , ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
PD107	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 11 - 15, not receiving nursing rehabilitation/Medicare 14 day assessment (Full or comprehensive)"					
PD108	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 11 - 15, not receiving nursing rehabilitation/Other Medicare Required Assessment (OMRA) "					
PD10A	10/01/11		SNF	"Reduced Physical Function , ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
PD10B	10/01/11		SNF	"Reduced Physical Function , ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
PD10C	10/01/11		SNF	"Reduced Physical Function , ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
PD10D	10/01/11		SNF	"Reduced Physical Function , ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
PD110	10/01/10		SNF	"Reduced Physical Function , ADL Index 11-14/5-day or readmission return. "					
PD111	07/01/98		SNF	"Reduced Physical Function , ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
PD112	10/01/10		SNF	"Reduced Physical Function , ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
PD113	10/01/10		SNF	"Reduced Physical Function , ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
PD114	10/01/10		SNF	"Reduced Physical Function , ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
PD115	10/01/10		SNF	"Reduced Physical Function , ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
PD116	10/01/10		SNF	"Reduced Physical Function , ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
PD117	07/01/98		SNF	"Reduced Physical Function , ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
PD118 	10/01/00	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 11 - 15, not receiving nursing rehabilitation/OMRA replacing 5-day Medicare assessment"					
PD119	07/01/02	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 11 - 15, not receiving nursing rehabilitation/Special payment situation 5-day assessment"					
PD11A	10/01/11		SNF	"Reduced Physical Function , ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
PD11B	10/01/11		SNF	"Reduced Physical Function , ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
PD11C	10/01/11		SNF	"Reduced Physical Function , ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PD120	10/01/10		SNF	"Reduced Physical Function , ADL Index 11-14/14-day. "					
PD121	10/01/10		SNF	"Reduced Physical Function , ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
PD124	10/01/10		SNF	"Reduced Physical Function , ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
PD125	10/01/10		SNF	"Reduced Physical Function , ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
PD126	10/01/10		SNF	"Reduced Physical Function , ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
PD128	10/01/00	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 11 - 15, not receiving nursing rehabilitation/OMRA replacing 30-day Medicare assessment"					
PD129	07/01/02	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 11 - 15, not receiving nursing rehabilitation/Special payment situation 30-day assessment"					
PD12A	10/01/11		SNF	"Reduced Physical Function , ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
PD12B	10/01/11		SNF	"Reduced Physical Function , ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
PD12C	10/01/11		SNF	"Reduced Physical Function , ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PD12D	10/01/11		SNF	"Reduced Physical Function , ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PD130	07/01/98		SNF	"Reduced Physical Function , ADL Index 11-14/30-day. "					
PD131	07/01/98		SNF	"Reduced Physical Function , ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
PD132	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 11 - 15, not receiving nursing rehabilitation/[7/98 def.] SCSA or OMRA/ Medicare 30 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 30-day Medicare required assessment"					
PD133	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 11 - 15, not receiving nursing rehabilitation/[7/98 def.] SCSA or OMRA/ Medicare 60 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 60-day Medicare required assessment"					
PD134	07/01/98		SNF	"Reduced Physical Function , ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
PD135	07/01/98		SNF	"Reduced Physical Function , ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
PD136	10/01/10		SNF	"Reduced Physical Function , ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
PD137	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 11 - 15, not receiving nursing rehabilitation/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
PD138	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 11 - 15, not receiving nursing rehabilitation/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
PD139	07/01/02	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 11 - 15, not receiving nursing rehabilitation/Special payment situation 60-day assessment"					
PD13A	10/01/11		SNF	"Reduced Physical Function , ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
PD13B	10/01/11		SNF	"Reduced Physical Function , ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
PD13C	10/01/11		SNF	"Reduced Physical Function , ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PD13D	10/01/11		SNF	"Reduced Physical Function , ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PD140	07/01/98		SNF	"Reduced Physical Function , ADL Index 11-14/60-day. "					
PD141	07/01/98		SNF	"Reduced Physical Function , ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
PD142	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 11 - 15, not receiving nursing rehabilitation/Significant Correction of Prior Full Assessment/Medicare 30 Day Assessment "					
PD143	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 11 - 15, not receiving nursing rehabilitation/Significant Correction of Prior Full Assessment/Medicare 60 Day Assessment "					
PD144	07/01/98		SNF	"Reduced Physical Function , ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
PD145	07/01/98		SNF	"Reduced Physical Function , ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
PD146	10/01/10		SNF	"Reduced Physical Function , ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
PD147	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 11 - 15, not receiving nursing rehabilitation/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
PD148	10/01/00	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 11 - 15, not receiving nursing rehabilitation/OMRA replacing 90-day Medicare-required assessment"					
PD149	07/01/02	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 11 - 15, not receiving nursing rehabilitation/Special payment situation 90-day assessment"					
PD14A	10/01/11		SNF	"Reduced Physical Function , ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
PD14B	10/01/11		SNF	"Reduced Physical Function , ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
PD14C	10/01/11		SNF	"Reduced Physical Function , ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PD14D	10/01/11		SNF	"Reduced Physical Function , ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PD150	10/01/10		SNF	"Reduced Physical Function , ADL Index 11-14/90-day. "					
PD151	10/01/10		SNF	"Reduced Physical Function , ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
PD154	07/01/98		SNF	"Reduced Physical Function , ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
PD155	10/01/10		SNF	"Reduced Physical Function , ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
PD156	10/01/10		SNF	"Reduced Physical Function , ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
PD15A	10/01/11		SNF	"Reduced Physical Function , ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
PD15B	10/01/11		SNF	"Reduced Physical Function , ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
PD15C	10/01/11		SNF	"Reduced Physical Function , ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PD15D	10/01/11		SNF	"Reduced Physical Function , ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PD160	10/01/10		SNF	"Reduced Physical Function , ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following: SNF notified untimely of MSP denial, or 
SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
PD178	10/01/00	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 11 - 15, not receiving nursing rehabilitation/OMRA replacing 14-day Medicare-required assessment"					
PD179	07/01/02	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 11 - 15, not receiving nursing rehabilitation/Special payment situation 14-day assessment"					
PD18A	07/01/98		SNF	"Reduced Physical Function , ADL Index 11-14/TRICARE 120-day assessment "					
PD18B	07/01/98		SNF	"Reduced Physical Function , ADL Index 11-14/TRICARE 150-day assessment "					
PD18C	07/01/98		SNF	"Reduced Physical Function , ADL Index 11-14/TRICARE 180-day assessment "					
PD18D	07/01/98		SNF	"Reduced Physical Function , ADL Index 11-14/TRICARE 210-day assessment "					
PD18E	07/01/98		SNF	"Reduced Physical Function , ADL Index 11-14/TRICARE 240-day assessment "					
PD18F	07/01/98		SNF	"Reduced Physical Function , ADL Index 11-14/TRICARE 270-day assessment "					
PD18G	07/01/98		SNF	"Reduced Physical Function , ADL Index 11-14/TRICARE 300-day assessment "					
PD18H	07/01/98		SNF	"Reduced Physical Function , ADL Index 11-14/TRICARE 330-day assessment "					
PD18I	07/01/98		SNF	"Reduced Physical Function , ADL Index 11-14/TRICARE 360-day assessment "					
PD18X	07/01/98		SNF	"Reduced Physical Function , ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval "					
PD201	07/01/98		SNF	"Reduced Physical Function , ADL Index 11-14/Stand-alone OBRA SCSA OR SCPA OR CCA."					
PD202	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 11 - 15/Medicare 30 day assessment (Full)"					
PD203	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 11 - 15/Medicare 60 day assessment (Full)"					
PD204	07/01/98		SNF	"Reduced Physical Function , ADL Index 11-14/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA."					
PD205	07/01/98		SNF	"Reduced Physical Function , ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
PD206	10/01/10		SNF	"Reduced Physical Function , ADL Index 11-14/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
PD207	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 11 - 15/Medicare 14 day assessment (Full or comprehensive)"					
PD208	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 11 - 15/Other Medicare Required Assessment (OMRA) "					
PD20A	10/01/11		SNF	"Reduced Physical Function , ADL Index 11-14/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
PD20B	10/01/11		SNF	"Reduced Physical Function , ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
PD20C	10/01/11		SNF	"Reduced Physical Function , ADL Index 11-14/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
PD20D	10/01/11		SNF	"Reduced Physical Function , ADL Index 11-14/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
PD210	10/01/10		SNF	"Reduced Physical Function , ADL Index 11-14/5-day or readmission return. "					
PD211	07/01/98		SNF	"Reduced Physical Function , ADL Index 11-14/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
PD212	10/01/10		SNF	"Reduced Physical Function , ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
PD213	10/01/10		SNF	"Reduced Physical Function , ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
PD214	10/01/10		SNF	"Reduced Physical Function , ADL Index 11-14/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
PD215	10/01/10		SNF	"Reduced Physical Function , ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
PD216	10/01/10		SNF	"Reduced Physical Function , ADL Index 11-14/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
PD217	07/01/98		SNF	"Reduced Physical Function , ADL Index 11-14/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
PD218 	10/01/00	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 11 - 15/OMRA replacing 5-day Medicare assessment"					
PD219	07/01/02	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 11 - 15/Special payment situation 5-day assessment"					
PD21A	10/01/11		SNF	"Reduced Physical Function , ADL Index 11-14/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
PD21B	10/01/11		SNF	"Reduced Physical Function , ADL Index 11-14/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
PD21C	10/01/11		SNF	"Reduced Physical Function , ADL Index 11-14/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PD220	10/01/10		SNF	"Reduced Physical Function , ADL Index 11-14/14-day. "					
PD221	10/01/10		SNF	"Reduced Physical Function , ADL Index 11-14/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
PD224	10/01/10		SNF	"Reduced Physical Function , ADL Index 11-14/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
PD225	10/01/10		SNF	"Reduced Physical Function , ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
PD226	10/01/10		SNF	"Reduced Physical Function , ADL Index 11-14/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
PD228	10/01/00	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 11 - 15/OMRA replacing 30-day Medicare assessment"					
PD229	07/01/02	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 11 - 15/Special payment situation 30-day assessment"					
PD22A	10/01/11		SNF	"Reduced Physical Function , ADL Index 11-14/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
PD22B	10/01/11		SNF	"Reduced Physical Function , ADL Index 11-14/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
PD22C	10/01/11		SNF	"Reduced Physical Function , ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PD22D	10/01/11		SNF	"Reduced Physical Function , ADL Index 11-14/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PD230	07/01/98		SNF	"Reduced Physical Function , ADL Index 11-14/30-day. "					
PD231	07/01/98		SNF	"Reduced Physical Function , ADL Index 11-14/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
PD232	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 11 - 15/[7/98 def.] SCSA or OMRA/ Medicare 30 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 30-day Medicare required assessment"					
PD233	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 11 - 15/[7/98 def.] SCSA or OMRA/ Medicare 60 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 60-day Medicare required assessment"					
PD234	07/01/98		SNF	"Reduced Physical Function , ADL Index 11-14/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
PD235	07/01/98		SNF	"Reduced Physical Function , ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
PD236	10/01/10		SNF	"Reduced Physical Function , ADL Index 11-14/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
PD237	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 11 - 15/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
PD238	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 11 - 15/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
PD239	07/01/02	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 11 - 15/Special payment situation 60-day assessment"					
PD23A	10/01/11		SNF	"Reduced Physical Function , ADL Index 11-14/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
PD23B	10/01/11		SNF	"Reduced Physical Function , ADL Index 11-14/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
PD23C	10/01/11		SNF	"Reduced Physical Function , ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PD23D	10/01/11		SNF	"Reduced Physical Function , ADL Index 11-14/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PD240	07/01/98		SNF	"Reduced Physical Function , ADL Index 11-14/60-day. "					
PD241	07/01/98		SNF	"Reduced Physical Function , ADL Index 11-14/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
PD242	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 11 - 15/Significant Correction of Prior Full Assessment/Medicare 30 Day Assessment "					
PD243	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 11 - 15/Significant Correction of Prior Full Assessment/Medicare 60 Day Assessment "					
PD244	07/01/98		SNF	"Reduced Physical Function , ADL Index 11-14/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
PD245	07/01/98		SNF	"Reduced Physical Function , ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
PD246	10/01/10		SNF	"Reduced Physical Function , ADL Index 11-14/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
PD247	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 11 - 15/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
PD248	10/01/00	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 11 - 15/OMRA replacing 90-day Medicare-required assessment"					
PD249	07/01/02	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 11 - 15/Special payment situation 90-day assessment"					
PD24A	10/01/11		SNF	"Reduced Physical Function , ADL Index 11-14/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
PD24B	10/01/11		SNF	"Reduced Physical Function , ADL Index 11-14/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
PD24C	10/01/11		SNF	"Reduced Physical Function , ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PD24D	10/01/11		SNF	"Reduced Physical Function , ADL Index 11-14/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PD250	10/01/10		SNF	"Reduced Physical Function , ADL Index 11-14/90-day. "					
PD251	10/01/10		SNF	"Reduced Physical Function , ADL Index 11-14/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
PD254	07/01/98		SNF	"Reduced Physical Function , ADL Index 11-14/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
PD255	10/01/10		SNF	"Reduced Physical Function , ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
PD256	10/01/10		SNF	"Reduced Physical Function , ADL Index 11-14/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
PD25A	10/01/11		SNF	"Reduced Physical Function , ADL Index 11-14/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
PD25B	10/01/11		SNF	"Reduced Physical Function , ADL Index 11-14/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
PD25C	10/01/11		SNF	"Reduced Physical Function , ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PD25D	10/01/11		SNF	"Reduced Physical Function , ADL Index 11-14/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PD260	10/01/10		SNF	"Reduced Physical Function , ADL Index 11-14/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following: SNF notified untimely of MSP denial, or 
SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
PD278	10/01/00	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 11 - 15/OMRA replacing 14-day Medicare-required assessment"					
PD279	07/01/02	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 11 - 15/Special payment situation 14-day assessment"					
PD28A	07/01/98		SNF	"Reduced Physical Function , ADL Index 11-14/TRICARE 120-day assessment "					
PD28B	07/01/98		SNF	"Reduced Physical Function , ADL Index 11-14/TRICARE 150-day assessment "					
PD28C	07/01/98		SNF	"Reduced Physical Function , ADL Index 11-14/TRICARE 180-day assessment "					
PD28D	07/01/98		SNF	"Reduced Physical Function , ADL Index 11-14/TRICARE 210-day assessment "					
PD28E	07/01/98		SNF	"Reduced Physical Function , ADL Index 11-14/TRICARE 240-day assessment "					
PD28F	07/01/98		SNF	"Reduced Physical Function , ADL Index 11-14/TRICARE 270-day assessment "					
PD28G	07/01/98		SNF	"Reduced Physical Function , ADL Index 11-14/TRICARE 300-day assessment "					
PD28H	07/01/98		SNF	"Reduced Physical Function , ADL Index 11-14/TRICARE 330-day assessment "					
PD28I	07/01/98		SNF	"Reduced Physical Function , ADL Index 11-14/TRICARE 360-day assessment "					
PD28X	07/01/98		SNF	"Reduced Physical Function , ADL Index 11-14/TRICARE Post 360-day assessments with 30-day interval "					
PE101	07/01/98		SNF	"Reduced Physical Function , ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA."					
PE102	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 16 - 18, not receiving nursing rehabilitation/Medicare 30 day assessment (Full)"					
PE103	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 16 - 18, not receiving nursing rehabilitation/Medicare 60 day assessment (Full)"					
PE104	07/01/98		SNF	"Reduced Physical Function , ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA."					
PE105	07/01/98		SNF	"Reduced Physical Function , ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
PE106	10/01/10		SNF	"Reduced Physical Function , ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
PE107	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 16 - 18, not receiving nursing rehabilitation/Medicare 14 day assessment (Full or comprehensive)"					
PE108	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 16 - 18, not receiving nursing rehabilitation/Other Medicare Required Assessment (OMRA) "					
PE10A	10/01/11		SNF	"Reduced Physical Function , ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
PE10B	10/01/11		SNF	"Reduced Physical Function , ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
PE10C	10/01/11		SNF	"Reduced Physical Function , ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
PE10D	10/01/11		SNF	"Reduced Physical Function , ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
PE110	10/01/10		SNF	"Reduced Physical Function , ADL Index 15-16/5-day or readmission return. "					
PE111	07/01/98		SNF	"Reduced Physical Function , ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
PE112	10/01/10		SNF	"Reduced Physical Function , ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
PE113	10/01/10		SNF	"Reduced Physical Function , ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
PE114	10/01/10		SNF	"Reduced Physical Function , ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
PE115	10/01/10		SNF	"Reduced Physical Function , ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
PE116	10/01/10		SNF	"Reduced Physical Function , ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
PE117	07/01/98		SNF	"Reduced Physical Function , ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
PE118 	10/01/00	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 16 - 18, not receiving nursing rehabilitation/OMRA replacing 5-day Medicare assessment"					
PE119	07/01/02	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 16 - 18, not receiving nursing rehabilitation/Special payment situation 5-day assessment"					
PE11A	10/01/11		SNF	"Reduced Physical Function , ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
PE11B	10/01/11		SNF	"Reduced Physical Function , ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
PE11C	10/01/11		SNF	"Reduced Physical Function , ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PE120	10/01/10		SNF	"Reduced Physical Function , ADL Index 15-16/14-day. "					
PE121	10/01/10		SNF	"Reduced Physical Function , ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
PE124	10/01/10		SNF	"Reduced Physical Function , ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
PE125	10/01/10		SNF	"Reduced Physical Function , ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
PE126	10/01/10		SNF	"Reduced Physical Function , ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
PE128	10/01/00	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 16 - 18, not receiving nursing rehabilitation/OMRA replacing 30-day Medicare assessment"					
PE129	07/01/02	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 16 - 18, not receiving nursing rehabilitation/Special payment situation 30-day assessment"					
PE12A	10/01/11		SNF	"Reduced Physical Function , ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
PE12B	10/01/11		SNF	"Reduced Physical Function , ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
PE12C	10/01/11		SNF	"Reduced Physical Function , ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PE12D	10/01/11		SNF	"Reduced Physical Function , ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PE130	07/01/98		SNF	"Reduced Physical Function , ADL Index 15-16/30-day. "					
PE131	07/01/98		SNF	"Reduced Physical Function , ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
PE132	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 16 - 18, not receiving nursing rehabilitation/[7/98 def.] SCSA or OMRA/ Medicare 30 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 30-day Medicare required assessment"					
PE133	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 16 - 18, not receiving nursing rehabilitation/[7/98 def.] SCSA or OMRA/ Medicare 60 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 60-day Medicare required assessment"					
PE134	07/01/98		SNF	"Reduced Physical Function , ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
PE135	07/01/98		SNF	"Reduced Physical Function , ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
PE136	10/01/10		SNF	"Reduced Physical Function , ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
PE137	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 16 - 18, not receiving nursing rehabilitation/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
PE138	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 16 - 18, not receiving nursing rehabilitation/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
PE139	07/01/02	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 16 - 18, not receiving nursing rehabilitation/Special payment situation 60-day assessment"					
PE13A	10/01/11		SNF	"Reduced Physical Function , ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
PE13B	10/01/11		SNF	"Reduced Physical Function , ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
PE13C	10/01/11		SNF	"Reduced Physical Function , ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PE13D	10/01/11		SNF	"Reduced Physical Function , ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PE140	07/01/98		SNF	"Reduced Physical Function , ADL Index 15-16/60-day. "					
PE141	07/01/98		SNF	"Reduced Physical Function , ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
PE142	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 16 - 18, not receiving nursing rehabilitation/Significant Correction of Prior Full Assessment/Medicare 30 Day Assessment "					
PE143	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 16 - 18, not receiving nursing rehabilitation/Significant Correction of Prior Full Assessment/Medicare 60 Day Assessment "					
PE144	07/01/98		SNF	"Reduced Physical Function , ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
PE145	07/01/98		SNF	"Reduced Physical Function , ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
PE146	10/01/10		SNF	"Reduced Physical Function , ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
PE147	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 16 - 18, not receiving nursing rehabilitation/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
PE148	10/01/00	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 16 - 18, not receiving nursing rehabilitation/OMRA replacing 90-day Medicare-required assessment"					
PE149	07/01/02	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 16 - 18, not receiving nursing rehabilitation/Special payment situation 90-day assessment"					
PE14A	10/01/11		SNF	"Reduced Physical Function , ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
PE14B	10/01/11		SNF	"Reduced Physical Function , ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
PE14C	10/01/11		SNF	"Reduced Physical Function , ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PE14D	10/01/11		SNF	"Reduced Physical Function , ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PE150	10/01/10		SNF	"Reduced Physical Function , ADL Index 15-16/90-day. "					
PE151	10/01/10		SNF	"Reduced Physical Function , ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
PE154	07/01/98		SNF	"Reduced Physical Function , ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
PE155	10/01/10		SNF	"Reduced Physical Function , ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
PE156	10/01/10		SNF	"Reduced Physical Function , ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
PE15A	10/01/11		SNF	"Reduced Physical Function , ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
PE15B	10/01/11		SNF	"Reduced Physical Function , ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
PE15C	10/01/11		SNF	"Reduced Physical Function , ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PE15D	10/01/11		SNF	"Reduced Physical Function , ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PE160	10/01/10		SNF	"Reduced Physical Function , ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following: SNF notified untimely of MSP denial, or 
SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
PE178	10/01/00	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 16 - 18, not receiving nursing rehabilitation/OMRA replacing 14-day Medicare-required assessment"					
PE179	07/01/02	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 16 - 18, not receiving nursing rehabilitation/Special payment situation 14-day assessment"					
PE18A	07/01/98		SNF	"Reduced Physical Function , ADL Index 15-16/TRICARE 120-day assessment "					
PE18B	07/01/98		SNF	"Reduced Physical Function , ADL Index 15-16/TRICARE 150-day assessment "					
PE18C	07/01/98		SNF	"Reduced Physical Function , ADL Index 15-16/TRICARE 180-day assessment "					
PE18D	07/01/98		SNF	"Reduced Physical Function , ADL Index 15-16/TRICARE 210-day assessment "					
PE18E	07/01/98		SNF	"Reduced Physical Function , ADL Index 15-16/TRICARE 240-day assessment "					
PE18F	07/01/98		SNF	"Reduced Physical Function , ADL Index 15-16/TRICARE 270-day assessment "					
PE18G	07/01/98		SNF	"Reduced Physical Function , ADL Index 15-16/TRICARE 300-day assessment "					
PE18H	07/01/98		SNF	"Reduced Physical Function , ADL Index 15-16/TRICARE 330-day assessment "					
PE18I	07/01/98		SNF	"Reduced Physical Function , ADL Index 15-16/TRICARE 360-day assessment "					
PE18X	07/01/98		SNF	"Reduced Physical Function , ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval "					
PE201	07/01/98		SNF	"Reduced Physical Function , ADL Index 15-16/Stand-alone OBRA SCSA OR SCPA OR CCA."					
PE202	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 16 - 18/Medicare 30 day assessment (Full)"					
PE203	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 16 - 18/Medicare 60 day assessment (Full)"					
PE204	07/01/98		SNF	"Reduced Physical Function , ADL Index 15-16/EOT OMRA OR EOT OMRA AND SCSA OR EOT OMRA AND SCPA OR EOT OMRA AND CCA."					
PE205	07/01/98		SNF	"Reduced Physical Function , ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
PE206	10/01/10		SNF	"Reduced Physical Function , ADL Index 15-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
PE207	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 16 - 18/Medicare 14 day assessment (Full or comprehensive)"					
PE208	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 16 - 18/Other Medicare Required Assessment (OMRA) "					
PE20A	10/01/11		SNF	"Reduced Physical Function , ADL Index 15-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
PE20B	10/01/11		SNF	"Reduced Physical Function , ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
PE20C	10/01/11		SNF	"Reduced Physical Function , ADL Index 15-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
PE20D	10/01/11		SNF	"Reduced Physical Function , ADL Index 15-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
PE210	10/01/10		SNF	"Reduced Physical Function , ADL Index 15-16/5-day or readmission return. "					
PE211	07/01/98		SNF	"Reduced Physical Function , ADL Index 15-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
PE212	10/01/10		SNF	"Reduced Physical Function , ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
PE213	10/01/10		SNF	"Reduced Physical Function , ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
PE214	10/01/10		SNF	"Reduced Physical Function , ADL Index 15-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
PE215	10/01/10		SNF	"Reduced Physical Function , ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
PE216	10/01/10		SNF	"Reduced Physical Function , ADL Index 15-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
PE217	07/01/98		SNF	"Reduced Physical Function , ADL Index 15-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
PE218 	10/01/00	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 16 - 18/OMRA replacing 5-day Medicare assessment"					
PE219	07/01/02	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 16 - 18/Special payment situation 5-day assessment"					
PE21A	10/01/11		SNF	"Reduced Physical Function , ADL Index 15-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
PE21B	10/01/11		SNF	"Reduced Physical Function , ADL Index 15-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
PE21C	10/01/11		SNF	"Reduced Physical Function , ADL Index 15-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PE220	10/01/10		SNF	"Reduced Physical Function , ADL Index 15-16/14-day. "					
PE221	10/01/10		SNF	"Reduced Physical Function , ADL Index 15-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
PE224	10/01/10		SNF	"Reduced Physical Function , ADL Index 15-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
PE225	10/01/10		SNF	"Reduced Physical Function , ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
PE226	10/01/10		SNF	"Reduced Physical Function , ADL Index 15-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
PE228	10/01/00	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 16 - 18/OMRA replacing 30-day Medicare assessment"					
PE229	07/01/02	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 16 - 18/Special payment situation 30-day assessment"					
PE22A	10/01/11		SNF	"Reduced Physical Function , ADL Index 15-16/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
PE22B	10/01/11		SNF	"Reduced Physical Function , ADL Index 15-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
PE22C	10/01/11		SNF	"Reduced Physical Function , ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PE22D	10/01/11		SNF	"Reduced Physical Function , ADL Index 15-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PE230	07/01/98		SNF	"Reduced Physical Function , ADL Index 15-16/30-day. "					
PE231	07/01/98		SNF	"Reduced Physical Function , ADL Index 15-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
PE232	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 16 - 18/[7/98 def.] SCSA or OMRA/ Medicare 30 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 30-day Medicare required assessment"					
PE233	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 16 - 18/[7/98 def.] SCSA or OMRA/ Medicare 60 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 60-day Medicare required assessment"					
PE234	07/01/98		SNF	"Reduced Physical Function , ADL Index 15-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
PE235	07/01/98		SNF	"Reduced Physical Function , ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
PE236	10/01/10		SNF	"Reduced Physical Function , ADL Index 15-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
PE237	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 16 - 18/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
PE238	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 16 - 18/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
PE239	07/01/02	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 16 - 18/Special payment situation 60-day assessment"					
PE23A	10/01/11		SNF	"Reduced Physical Function , ADL Index 15-16/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
PE23B	10/01/11		SNF	"Reduced Physical Function , ADL Index 15-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
PE23C	10/01/11		SNF	"Reduced Physical Function , ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PE23D	10/01/11		SNF	"Reduced Physical Function , ADL Index 15-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PE240	07/01/98		SNF	"Reduced Physical Function , ADL Index 15-16/60-day. "					
PE241	07/01/98		SNF	"Reduced Physical Function , ADL Index 15-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
PE242	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 16 - 18/Significant Correction of Prior Full Assessment/Medicare 30 Day Assessment "					
PE243	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 16 - 18/Significant Correction of Prior Full Assessment/Medicare 60 Day Assessment "					
PE244	07/01/98		SNF	"Reduced Physical Function , ADL Index 15-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
PE245	07/01/98		SNF	"Reduced Physical Function , ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
PE246	10/01/10		SNF	"Reduced Physical Function , ADL Index 15-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
PE247	07/01/98	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 16 - 18/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
PE248	10/01/00	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 16 - 18/OMRA replacing 90-day Medicare-required assessment"					
PE249	07/01/02	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 16 - 18/Special payment situation 90-day assessment"					
PE24A	10/01/11		SNF	"Reduced Physical Function , ADL Index 15-16/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
PE24B	10/01/11		SNF	"Reduced Physical Function , ADL Index 15-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
PE24C	10/01/11		SNF	"Reduced Physical Function , ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PE24D	10/01/11		SNF	"Reduced Physical Function , ADL Index 15-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PE250	10/01/10		SNF	"Reduced Physical Function , ADL Index 15-16/90-day. "					
PE251	10/01/10		SNF	"Reduced Physical Function , ADL Index 15-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
PE254	07/01/98		SNF	"Reduced Physical Function , ADL Index 15-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
PE255	10/01/10		SNF	"Reduced Physical Function , ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
PE256	10/01/10		SNF	"Reduced Physical Function , ADL Index 15-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
PE25A	10/01/11		SNF	"Reduced Physical Function , ADL Index 15-16/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
PE25B	10/01/11		SNF	"Reduced Physical Function , ADL Index 15-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
PE25C	10/01/11		SNF	"Reduced Physical Function , ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PE25D	10/01/11		SNF	"Reduced Physical Function , ADL Index 15-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
PE260	10/01/10		SNF	"Reduced Physical Function , ADL Index 15-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following: SNF notified untimely of MSP denial, or 
SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
PE278	10/01/00	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 16 - 18/OMRA replacing 14-day Medicare-required assessment"					
PE279	07/01/02	* 09/30/10	SNF	"Physical Function Reduced, ADL Index 16 - 18/Special payment situation 14-day assessment"					
PE28A	07/01/98		SNF	"Reduced Physical Function , ADL Index 15-16/TRICARE 120-day assessment "					
PE28B	07/01/98		SNF	"Reduced Physical Function , ADL Index 15-16/TRICARE 150-day assessment "					
PE28C	07/01/98		SNF	"Reduced Physical Function , ADL Index 15-16/TRICARE 180-day assessment "					
PE28D	07/01/98		SNF	"Reduced Physical Function , ADL Index 15-16/TRICARE 210-day assessment "					
PE28E	07/01/98		SNF	"Reduced Physical Function , ADL Index 15-16/TRICARE 240-day assessment "					
PE28F	07/01/98		SNF	"Reduced Physical Function , ADL Index 15-16/TRICARE 270-day assessment "					
PE28G	07/01/98		SNF	"Reduced Physical Function , ADL Index 15-16/TRICARE 300-day assessment "					
PE28H	07/01/98		SNF	"Reduced Physical Function , ADL Index 15-16/TRICARE 330-day assessment "					
PE28I	07/01/98		SNF	"Reduced Physical Function , ADL Index 15-16/TRICARE 360-day assessment "					
PE28X	07/01/98		SNF	"Reduced Physical Function , ADL Index 15-16/TRICARE Post 360-day assessments with 30-day interval "					
RHA01	07/01/98		SNF	"High Rehab , ADL Index 0-5/Stand-alone OBRA SCSA OR SCPA OR CCA."					
RHA02	07/01/98		SNF	"High Rehab , ADL Index 0-5/Stand-alone SOT OMRA (not Medicare short stay)."					
RHA03	07/01/98		SNF	"High Rehab , ADL Index 0-5/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA."					
RHA04	07/01/98	* 09/30/10	SNF	"Rehabilitation, High, ADL Index 4-7/Medicare 90 day assessment (Full)"					
RHA05	07/01/98		SNF	"High Rehab , ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RHA06	10/01/10		SNF	"High Rehab , ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RHA07	07/01/98		SNF	"High Rehab , ADL Index 0-5/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA. "					
RHA08	07/01/98	* 09/30/10	SNF	"Rehabilitation, High, ADL Index 4-7/Other Medicare Required Assessment (OMRA) "					
RHA0A	10/01/11		SNF	"High Rehab , ADL Index 0-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
RHA0B	10/01/11		SNF	"High Rehab , ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
RHA0C	10/01/11		SNF	"High Rehab , ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
RHA0D	10/01/11		SNF	"High Rehab , ADL Index 0-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
RHA10	10/01/10		SNF	"High Rehab , ADL Index 0-5/5-day or readmission return. "					
RHA11	07/01/98		SNF	"High Rehab , ADL Index 0-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
RHA12	10/01/10		SNF	"High Rehab , ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
RHA13	10/01/10		SNF	"High Rehab , ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
RHA14	10/01/10		SNF	"High Rehab , ADL Index 0-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
RHA15	10/01/10		SNF	"High Rehab , ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RHA16	10/01/10		SNF	"High Rehab , ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
RHA17	07/01/98		SNF	"High Rehab , ADL Index 0-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
RHA18 	10/01/00	* 09/30/10	SNF	"Rehabilitation, High, ADL Index 4-7/OMRA replacing 5-day Medicare assessment"					
RHA19	07/01/02	* 09/30/10	SNF	"Rehabilitation, High, ADL Index 4-7/Special payment situation 5-day assessment"					
RHA1A	10/01/11		SNF	"High Rehab , ADL Index 0-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RHA1B	10/01/11		SNF	"High Rehab , ADL Index 0-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RHA1C	10/01/11		SNF	"High Rehab , ADL Index 0-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RHA20	10/01/10		SNF	"High Rehab , ADL Index 0-5/14-day. "					
RHA21	10/01/10		SNF	"High Rehab , ADL Index 0-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
RHA22	10/01/10		SNF	"High Rehab , ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay)."					
RHA23	10/01/10		SNF	"High Rehab , ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND CCA. "					
RHA24	10/01/10		SNF	"High Rehab , ADL Index 0-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
RHA25	10/01/10		SNF	"High Rehab , ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
RHA26	10/01/10		SNF	"High Rehab , ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RHA28	10/01/00	* 09/30/10	SNF	"Rehabilitation, High, ADL Index 4-7/OMRA replacing 30-day Medicare assessment"					
RHA29	07/01/02	* 09/30/10	SNF	"Rehabilitation, High, ADL Index 4-7/Special payment situation 30-day assessment"					
RHA2A	10/01/11		SNF	"High Rehab , ADL Index 0-5/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RHA2B	10/01/11		SNF	"High Rehab , ADL Index 0-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RHA2C	10/01/11		SNF	"High Rehab , ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RHA2D	10/01/11		SNF	"High Rehab , ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RHA30	07/01/98		SNF	"High Rehab , ADL Index 0-5/30-day. "					
RHA31	07/01/98		SNF	"High Rehab , ADL Index 0-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
RHA32	07/01/98		SNF	"High Rehab , ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay)."					
RHA33	07/01/98		SNF	"High Rehab , ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND CCA."					
RHA34	07/01/98		SNF	"High Rehab , ADL Index 0-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
RHA35	07/01/98		SNF	"High Rehab , ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RHA36	10/01/10		SNF	"High Rehab , ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
RHA37	07/01/98	* 09/30/10	SNF	"Rehabilitation, High, ADL Index 4-7/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
RHA38	07/01/98	* 09/30/10	SNF	"Rehabilitation, High, ADL Index 4-7/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
RHA39	07/01/02	* 09/30/10	SNF	"Rehabilitation, High, ADL Index 4-7/Special payment situation 60-day assessment"					
RHA3A	10/01/11		SNF	"High Rehab , ADL Index 0-5/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RHA3B	10/01/11		SNF	"High Rehab , ADL Index 0-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RHA3C	10/01/11		SNF	"High Rehab , ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RHA3D	10/01/11		SNF	"High Rehab , ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RHA40	07/01/98		SNF	"High Rehab , ADL Index 0-5/60-day. "					
RHA41	07/01/98		SNF	"High Rehab , ADL Index 0-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
RHA42	07/01/98		SNF	"High Rehab , ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay)."					
RHA43	07/01/98		SNF	"High Rehab , ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) AND CCA."					
RHA44	07/01/98		SNF	"High Rehab , ADL Index 0-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
RHA45	07/01/98		SNF	"High Rehab , ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RHA46	10/01/10		SNF	"High Rehab , ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
RHA47	07/01/98	* 09/30/10	SNF	"Rehabilitation, High, ADL Index 4-7/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
RHA48	10/01/00	* 09/30/10	SNF	"Rehabilitation, High, ADL Index 4-7/OMRA replacing 90-day Medicare-required assessment"					
RHA49	07/01/02	* 09/30/10	SNF	"Rehabilitation, High, ADL Index 4-7/Special payment situation 90-day assessment"					
RHA4A	10/01/11		SNF	"High Rehab , ADL Index 0-5/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RHA4B	10/01/11		SNF	"High Rehab , ADL Index 0-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RHA4C	10/01/11		SNF	"High Rehab , ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RHA4D	10/01/11		SNF	"High Rehab , ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RHA50	10/01/10		SNF	"High Rehab , ADL Index 0-5/90-day. "					
RHA51	10/01/10		SNF	"High Rehab , ADL Index 0-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
RHA52	10/01/10		SNF	"High Rehab , ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay)."					
RHA53	10/01/10		SNF	"High Rehab , ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND CCA. "					
RHA54	07/01/98		SNF	"High Rehab , ADL Index 0-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
RHA55	10/01/10		SNF	"High Rehab , ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RHA56	10/01/10		SNF	"High Rehab , ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RHA5A	10/01/11		SNF	"High Rehab , ADL Index 0-5/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RHA5B	10/01/11		SNF	"High Rehab , ADL Index 0-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RHA5C	10/01/11		SNF	"High Rehab , ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RHA5D	10/01/11		SNF	"High Rehab , ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RHA60	10/01/10		SNF	"High Rehab , ADL Index 0-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following:  SNF notified untimely of MSP denial, or 
 SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
RHA78	10/01/00	* 09/30/10	SNF	"Rehabilitation, High, ADL Index 4-7/OMRA replacing 14-day Medicare-required assessment"					
RHA79	07/01/02	* 09/30/10	SNF	"Rehabilitation, High, ADL Index 4-7/Special payment situation 14-day assessment"					
RHA8A	07/01/98		SNF	"High Rehab , ADL Index 0-5/TRICARE 120-day assessment "					
RHA8B	07/01/98		SNF	"High Rehab , ADL Index 0-5/TRICARE 150-day assessment "					
RHA8C	07/01/98		SNF	"High Rehab , ADL Index 0-5/TRICARE 180-day assessment "					
RHA8D	07/01/98		SNF	"High Rehab , ADL Index 0-5/TRICARE 210-day assessment "					
RHA8E	07/01/98		SNF	"High Rehab , ADL Index 0-5/TRICARE 240-day assessment "					
RHA8F	07/01/98		SNF	"High Rehab , ADL Index 0-5/TRICARE 270-day assessment "					
RHA8G	07/01/98		SNF	"High Rehab , ADL Index 0-5/TRICARE 300-day assessment "					
RHA8H	07/01/98		SNF	"High Rehab , ADL Index 0-5/TRICARE 330-day assessment "					
RHA8I	07/01/98		SNF	"High Rehab , ADL Index 0-5/TRICARE 360-day assessment "					
RHA8X	07/01/98		SNF	"High Rehab , ADL Index 0-5/TRICARE Post 360-day assessments with 30-day interval "					
RHB01	07/01/98		SNF	"High Rehab , ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA."					
RHB02	07/01/98		SNF	"High Rehab , ADL Index 6-10/Stand-alone SOT OMRA (not Medicare short stay)."					
RHB03	07/01/98		SNF	"High Rehab , ADL Index 6-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA."					
RHB04	07/01/98	* 09/30/10	SNF	"Rehabilitation, High, ADL Index 8-12/Medicare 90 day assessment (Full)"					
RHB05	07/01/98		SNF	"High Rehab , ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RHB06	10/01/10		SNF	"High Rehab , ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RHB07	07/01/98		SNF	"High Rehab , ADL Index 6-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA. "					
RHB08	07/01/98	* 09/30/10	SNF	"Rehabilitation, High, ADL Index 8-12/Other Medicare Required Assessment (OMRA) "					
RHB0A	10/01/11		SNF	"High Rehab , ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
RHB0B	10/01/11		SNF	"High Rehab , ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
RHB0C	10/01/11		SNF	"High Rehab , ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
RHB0D	10/01/11		SNF	"High Rehab , ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
RHB10	10/01/10		SNF	"High Rehab , ADL Index 6-10/5-day or readmission return. "					
RHB11	07/01/98		SNF	"High Rehab , ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
RHB12	10/01/10		SNF	"High Rehab , ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
RHB13	10/01/10		SNF	"High Rehab , ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
RHB14	10/01/10		SNF	"High Rehab , ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
RHB15	10/01/10		SNF	"High Rehab , ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RHB16	10/01/10		SNF	"High Rehab , ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
RHB17	07/01/98		SNF	"High Rehab , ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
RHB18 	10/01/00	* 09/30/10	SNF	"Rehabilitation, High, ADL Index 8-12/OMRA replacing 5-day Medicare assessment"					
RHB19	07/01/02	* 09/30/10	SNF	"Rehabilitation, High, ADL Index 8-12/Special payment situation 5-day assessment"					
RHB1A	10/01/11		SNF	"High Rehab , ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RHB1B	10/01/11		SNF	"High Rehab , ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RHB1C	10/01/11		SNF	"High Rehab , ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RHB20	10/01/10		SNF	"High Rehab , ADL Index 6-10/14-day. "					
RHB21	10/01/10		SNF	"High Rehab , ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
RHB22	10/01/10		SNF	"High Rehab , ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay)."					
RHB23	10/01/10		SNF	"High Rehab , ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND CCA. "					
RHB24	10/01/10		SNF	"High Rehab , ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
RHB25	10/01/10		SNF	"High Rehab , ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
RHB26	10/01/10		SNF	"High Rehab , ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RHB28	10/01/00	* 09/30/10	SNF	"Rehabilitation, High, ADL Index 8-12/OMRA replacing 30-day Medicare assessment"					
RHB29	07/01/02	* 09/30/10	SNF	"Rehabilitation, High, ADL Index 8-12/Special payment situation 30-day assessment"					
RHB2A	10/01/11		SNF	"High Rehab , ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RHB2B	10/01/11		SNF	"High Rehab , ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RHB2C	10/01/11		SNF	"High Rehab , ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RHB2D	10/01/11		SNF	"High Rehab , ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RHB30	07/01/98		SNF	"High Rehab , ADL Index 6-10/30-day. "					
RHB31	07/01/98		SNF	"High Rehab , ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
RHB32	07/01/98		SNF	"High Rehab , ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay)."					
RHB33	07/01/98		SNF	"High Rehab , ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND CCA."					
RHB34	07/01/98		SNF	"High Rehab , ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
RHB35	07/01/98		SNF	"High Rehab , ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RHB36	10/01/10		SNF	"High Rehab , ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
RHB37	07/01/98	* 09/30/10	SNF	"Rehabilitation, High, ADL Index 8-12/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
RHB38	07/01/98	* 09/30/10	SNF	"Rehabilitation, High, ADL Index 8-12/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
RHB39	07/01/02	* 09/30/10	SNF	"Rehabilitation, High, ADL Index 8-12/Special payment situation 60-day assessment"					
RHB3A	10/01/11		SNF	"High Rehab , ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RHB3B	10/01/11		SNF	"High Rehab , ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RHB3C	10/01/11		SNF	"High Rehab , ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RHB3D	10/01/11		SNF	"High Rehab , ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RHB40	07/01/98		SNF	"High Rehab , ADL Index 6-10/60-day. "					
RHB41	07/01/98		SNF	"High Rehab , ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
RHB42	07/01/98		SNF	"High Rehab , ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay)."					
RHB43	07/01/98		SNF	"High Rehab , ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) AND CCA."					
RHB44	07/01/98		SNF	"High Rehab , ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
RHB45	07/01/98		SNF	"High Rehab , ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RHB46	10/01/10		SNF	"High Rehab , ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
RHB47	07/01/98	* 09/30/10	SNF	"Rehabilitation, High, ADL Index 8-12/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
RHB48	10/01/00	* 09/30/10	SNF	"Rehabilitation, High, ADL Index 8-12/OMRA replacing 90-day Medicare-required assessment"					
RHB49	07/01/02	* 09/30/10	SNF	"Rehabilitation, High, ADL Index 8-12/Special payment situation 90-day assessment"					
RHB4A	10/01/11		SNF	"High Rehab , ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RHB4B	10/01/11		SNF	"High Rehab , ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RHB4C	10/01/11		SNF	"High Rehab , ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RHB4D	10/01/11		SNF	"High Rehab , ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RHB50	10/01/10		SNF	"High Rehab , ADL Index 6-10/90-day. "					
RHB51	10/01/10		SNF	"High Rehab , ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
RHB52	10/01/10		SNF	"High Rehab , ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay)."					
RHB53	10/01/10		SNF	"High Rehab , ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND CCA. "					
RHB54	07/01/98		SNF	"High Rehab , ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
RHB55	10/01/10		SNF	"High Rehab , ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RHB56	10/01/10		SNF	"High Rehab , ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RHB5A	10/01/11		SNF	"High Rehab , ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RHB5B	10/01/11		SNF	"High Rehab , ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RHB5C	10/01/11		SNF	"High Rehab , ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RHB5D	10/01/11		SNF	"High Rehab , ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RHB60	10/01/10		SNF	"High Rehab , ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following:  SNF notified untimely of MSP denial, or 
 SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
RHB78	10/01/00	* 09/30/10	SNF	"Rehabilitation, High, ADL Index 8-12/OMRA replacing 14-day Medicare-required assessment"					
RHB79	07/01/02	* 09/30/10	SNF	"Rehabilitation, High, ADL Index 8-12/Special payment situation 14-day assessment"					
RHB8A	07/01/98		SNF	"High Rehab , ADL Index 6-10/TRICARE 120-day assessment "					
RHB8B	07/01/98		SNF	"High Rehab , ADL Index 6-10/TRICARE 150-day assessment "					
RHB8C	07/01/98		SNF	"High Rehab , ADL Index 6-10/TRICARE 180-day assessment "					
RHB8D	07/01/98		SNF	"High Rehab , ADL Index 6-10/TRICARE 210-day assessment "					
RHB8E	07/01/98		SNF	"High Rehab , ADL Index 6-10/TRICARE 240-day assessment "					
RHB8F	07/01/98		SNF	"High Rehab , ADL Index 6-10/TRICARE 270-day assessment "					
RHB8G	07/01/98		SNF	"High Rehab , ADL Index 6-10/TRICARE 300-day assessment "					
RHB8H	07/01/98		SNF	"High Rehab , ADL Index 6-10/TRICARE 330-day assessment "					
RHB8I	07/01/98		SNF	"High Rehab , ADL Index 6-10/TRICARE 360-day assessment "					
RHB8X	07/01/98		SNF	"High Rehab , ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval "					
RHC01	07/01/98		SNF	"High Rehab , ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA."					
RHC02	07/01/98		SNF	"High Rehab , ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay)."					
RHC03	07/01/98		SNF	"High Rehab , ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA."					
RHC04	07/01/98	* 09/30/10	SNF	"Rehabilitation, High, ADL Index 13-18/Medicare 90 day assessment (Full)"					
RHC05	07/01/98		SNF	"High Rehab , ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RHC06	10/01/10		SNF	"High Rehab , ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RHC07	07/01/98		SNF	"High Rehab , ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA. "					
RHC08	07/01/98	* 09/30/10	SNF	"Rehabilitation, High, ADL Index 13-18/Other Medicare Required Assessment (OMRA) "					
RHC0A	10/01/11		SNF	"High Rehab , ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
RHC0B	10/01/11		SNF	"High Rehab , ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
RHC0C	10/01/11		SNF	"High Rehab , ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
RHC0D	10/01/11		SNF	"High Rehab , ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
RHC10	10/01/10		SNF	"High Rehab , ADL Index 11-16/5-day or readmission return. "					
RHC11	07/01/98		SNF	"High Rehab , ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
RHC12	10/01/10		SNF	"High Rehab , ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
RHC13	10/01/10		SNF	"High Rehab , ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
RHC14	10/01/10		SNF	"High Rehab , ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
RHC15	10/01/10		SNF	"High Rehab , ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RHC16	10/01/10		SNF	"High Rehab , ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
RHC17	07/01/98		SNF	"High Rehab , ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
RHC18 	10/01/00	* 09/30/10	SNF	"Rehabilitation, High, ADL Index 13-18/OMRA replacing 5-day Medicare assessment"					
RHC19	07/01/02	* 09/30/10	SNF	"Rehabilitation, High, ADL Index 13-18/Special payment situation 5-day assessment"					
RHC1A	10/01/11		SNF	"High Rehab , ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RHC1B	10/01/11		SNF	"High Rehab , ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RHC1C	10/01/11		SNF	"High Rehab , ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RHC20	10/01/10		SNF	"High Rehab , ADL Index 11-16/14-day. "					
RHC21	10/01/10		SNF	"High Rehab , ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
RHC22	10/01/10		SNF	"High Rehab , ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay)."					
RHC23	10/01/10		SNF	"High Rehab , ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND CCA. "					
RHC24	10/01/10		SNF	"High Rehab , ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
RHC25	10/01/10		SNF	"High Rehab , ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
RHC26	10/01/10		SNF	"High Rehab , ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RHC28	10/01/00	* 09/30/10	SNF	"Rehabilitation, High, ADL Index 13-18/OMRA replacing 30-day Medicare assessment"					
RHC29	07/01/02	* 09/30/10	SNF	"Rehabilitation, High, ADL Index 13-18/Special payment situation 30-day assessment"					
RHC2A	10/01/11		SNF	"High Rehab , ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RHC2B	10/01/11		SNF	"High Rehab , ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RHC2C	10/01/11		SNF	"High Rehab , ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RHC2D	10/01/11		SNF	"High Rehab , ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RHC30	07/01/98		SNF	"High Rehab , ADL Index 11-16/30-day. "					
RHC31	07/01/98		SNF	"High Rehab , ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
RHC32	07/01/98		SNF	"High Rehab , ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay)."					
RHC33	07/01/98		SNF	"High Rehab , ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND CCA."					
RHC34	07/01/98		SNF	"High Rehab , ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
RHC35	07/01/98		SNF	"High Rehab , ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RHC36	10/01/10		SNF	"High Rehab , ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
RHC37	07/01/98	* 09/30/10	SNF	"Rehabilitation, High, ADL Index 13-18/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
RHC38	07/01/98	* 09/30/10	SNF	"Rehabilitation, High, ADL Index 13-18/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
RHC39	07/01/02	* 09/30/10	SNF	"Rehabilitation, High, ADL Index 13-18/Special payment situation 60-day assessment"					
RHC3A	10/01/11		SNF	"High Rehab , ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RHC3B	10/01/11		SNF	"High Rehab , ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RHC3C	10/01/11		SNF	"High Rehab , ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RHC3D	10/01/11		SNF	"High Rehab , ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RHC40	07/01/98		SNF	"High Rehab , ADL Index 11-16/60-day. "					
RHC41	07/01/98		SNF	"High Rehab , ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
RHC42	07/01/98		SNF	"High Rehab , ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay)."					
RHC43	07/01/98		SNF	"High Rehab , ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) AND CCA."					
RHC44	07/01/98		SNF	"High Rehab , ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
RHC45	07/01/98		SNF	"High Rehab , ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RHC46	10/01/10		SNF	"High Rehab , ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
RHC47	07/01/98	* 09/30/10	SNF	"Rehabilitation, High, ADL Index 13-18/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
RHC48	10/01/00	* 09/30/10	SNF	"Rehabilitation, High, ADL Index 13-18/OMRA replacing 90-day Medicare-required assessment"					
RHC49	07/01/02	* 09/30/10	SNF	"Rehabilitation, High, ADL Index 13-18/Special payment situation 90-day assessment"					
RHC4A	10/01/11		SNF	"High Rehab , ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RHC4B	10/01/11		SNF	"High Rehab , ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RHC4C	10/01/11		SNF	"High Rehab , ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RHC4D	10/01/11		SNF	"High Rehab , ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RHC50	10/01/10		SNF	"High Rehab , ADL Index 11-16/90-day. "					
RHC51	10/01/10		SNF	"High Rehab , ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
RHC52	10/01/10		SNF	"High Rehab , ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay)."					
RHC53	10/01/10		SNF	"High Rehab , ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND CCA. "					
RHC54	07/01/98		SNF	"High Rehab , ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
RHC55	10/01/10		SNF	"High Rehab , ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RHC56	10/01/10		SNF	"High Rehab , ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RHC5A	10/01/11		SNF	"High Rehab , ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RHC5B	10/01/11		SNF	"High Rehab , ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RHC5C	10/01/11		SNF	"High Rehab , ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RHC5D	10/01/11		SNF	"High Rehab , ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RHC60	10/01/10		SNF	"High Rehab , ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following:  SNF notified untimely of MSP denial, or 
 SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
RHC78	10/01/00	* 09/30/10	SNF	"Rehabilitation, High, ADL Index 13-18/OMRA replacing 14-day Medicare-required assessment"					
RHC79	07/01/02	* 09/30/10	SNF	"Rehabilitation, High, ADL Index 13-18/Special payment situation 14-day assessment"					
RHC8A	07/01/98		SNF	"High Rehab , ADL Index 11-16/TRICARE 120-day assessment "					
RHC8B	07/01/98		SNF	"High Rehab , ADL Index 11-16/TRICARE 150-day assessment "					
RHC8C	07/01/98		SNF	"High Rehab , ADL Index 11-16/TRICARE 180-day assessment "					
RHC8D	07/01/98		SNF	"High Rehab , ADL Index 11-16/TRICARE 210-day assessment "					
RHC8E	07/01/98		SNF	"High Rehab , ADL Index 11-16/TRICARE 240-day assessment "					
RHC8F	07/01/98		SNF	"High Rehab , ADL Index 11-16/TRICARE 270-day assessment "					
RHC8G	07/01/98		SNF	"High Rehab , ADL Index 11-16/TRICARE 300-day assessment "					
RHC8H	07/01/98		SNF	"High Rehab , ADL Index 11-16/TRICARE 330-day assessment "					
RHC8I	07/01/98		SNF	"High Rehab , ADL Index 11-16/TRICARE 360-day assessment "					
RHC8X	07/01/98		SNF	"High Rehab , ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval "					
RHL01	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 2-10/Stand-alone OBRA SCSA OR SCPA OR CCA."					
RHL02	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 2-10/Stand-alone SOT OMRA (not Medicare short stay)."					
RHL03	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 2-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA."					
RHL04	01/01/06	* 09/30/10	SNF	"Rehabilitation, High, plus Extensive Services, Low, ADL Index 7-12/Medicare 90 day assessment (Full)"					
RHL05	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RHL06	10/01/10		SNF	"High Rehab plus Extensive , ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RHL07	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 2-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA. "					
RHL08	01/01/06	* 09/30/10	SNF	"Rehabilitation, High, plus Extensive Services, Low, ADL Index 7-12/Other Medicare Required Assessment (OMRA) "					
RHL0A	10/01/11		SNF	"High Rehab plus Extensive , ADL Index 2-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
RHL0B	10/01/11		SNF	"High Rehab plus Extensive , ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
RHL0C	10/01/11		SNF	"High Rehab plus Extensive , ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
RHL0D	10/01/11		SNF	"High Rehab plus Extensive , ADL Index 2-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
RHL10	10/01/10		SNF	"High Rehab plus Extensive , ADL Index 2-10/5-day or readmission return. "					
RHL11	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 2-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
RHL12	10/01/10		SNF	"High Rehab plus Extensive , ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
RHL13	10/01/10		SNF	"High Rehab plus Extensive , ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
RHL14	10/01/10		SNF	"High Rehab plus Extensive , ADL Index 2-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
RHL15	10/01/10		SNF	"High Rehab plus Extensive , ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RHL16	10/01/10		SNF	"High Rehab plus Extensive , ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
RHL17	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 2-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
RHL18 	01/01/06	* 09/30/10	SNF	"Rehabilitation, High, plus Extensive Services, Low, ADL Index 7-12/OMRA replacing 5-day Medicare assessment"					
RHL19	01/01/06	* 09/30/10	SNF	"Rehabilitation, High, plus Extensive Services, Low, ADL Index 7-12/Special payment situation 5-day assessment"					
RHL1A	10/01/11		SNF	"High Rehab plus Extensive , ADL Index 2-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RHL1B	10/01/11		SNF	"High Rehab plus Extensive , ADL Index 2-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RHL1C	10/01/11		SNF	"High Rehab plus Extensive , ADL Index 2-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RHL20	10/01/10		SNF	"High Rehab plus Extensive , ADL Index 2-10/14-day. "					
RHL21	10/01/10		SNF	"High Rehab plus Extensive , ADL Index 2-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
RHL22	10/01/10		SNF	"High Rehab plus Extensive , ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay)."					
RHL23	10/01/10		SNF	"High Rehab plus Extensive , ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND CCA. "					
RHL24	10/01/10		SNF	"High Rehab plus Extensive , ADL Index 2-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
RHL25	10/01/10		SNF	"High Rehab plus Extensive , ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
RHL26	10/01/10		SNF	"High Rehab plus Extensive , ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RHL28	01/01/06	* 09/30/10	SNF	"Rehabilitation, High, plus Extensive Services, Low, ADL Index 7-12/OMRA replacing 30-day Medicare assessment"					
RHL29	01/01/06	* 09/30/10	SNF	"Rehabilitation, High, plus Extensive Services, Low, ADL Index 7-12/Special payment situation 30-day assessment"					
RHL2A	10/01/11		SNF	"High Rehab plus Extensive , ADL Index 2-10/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RHL2B	10/01/11		SNF	"High Rehab plus Extensive , ADL Index 2-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RHL2C	10/01/11		SNF	"High Rehab plus Extensive , ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RHL2D	10/01/11		SNF	"High Rehab plus Extensive , ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RHL30	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 2-10/30-day. "					
RHL31	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 2-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
RHL32	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay)."					
RHL33	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND CCA."					
RHL34	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 2-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
RHL35	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RHL36	10/01/10		SNF	"High Rehab plus Extensive , ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
RHL37	01/01/06	* 09/30/10	SNF	"Rehabilitation, High, plus Extensive Services, Low, ADL Index 7-12/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
RHL38	01/01/06	* 09/30/10	SNF	"Rehabilitation, High, plus Extensive Services, Low, ADL Index 7-12/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
RHL39	01/01/06	* 09/30/10	SNF	"Rehabilitation, High, plus Extensive Services, Low, ADL Index 7-12/Special payment situation 60-day assessment"					
RHL3A	10/01/11		SNF	"High Rehab plus Extensive , ADL Index 2-10/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RHL3B	10/01/11		SNF	"High Rehab plus Extensive , ADL Index 2-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RHL3C	10/01/11		SNF	"High Rehab plus Extensive , ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RHL3D	10/01/11		SNF	"High Rehab plus Extensive , ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RHL40	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 2-10/60-day. "					
RHL41	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 2-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
RHL42	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay)."					
RHL43	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) AND CCA."					
RHL44	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 2-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
RHL45	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RHL46	10/01/10		SNF	"High Rehab plus Extensive , ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
RHL47	01/01/06	* 09/30/10	SNF	"Rehabilitation, High, plus Extensive Services, Low, ADL Index 7-12/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
RHL48	01/01/06	* 09/30/10	SNF	"Rehabilitation, High, plus Extensive Services, Low, ADL Index 7-12/OMRA replacing 90-day Medicare-required assessment"					
RHL49	01/01/06	* 09/30/10	SNF	"Rehabilitation, High, plus Extensive Services, Low, ADL Index 7-12/Special payment situation 90-day assessment"					
RHL4A	10/01/11		SNF	"High Rehab plus Extensive , ADL Index 2-10/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RHL4B	10/01/11		SNF	"High Rehab plus Extensive , ADL Index 2-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RHL4C	10/01/11		SNF	"High Rehab plus Extensive , ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RHL4D	10/01/11		SNF	"High Rehab plus Extensive , ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RHL50	10/01/10		SNF	"High Rehab plus Extensive , ADL Index 2-10/90-day. "					
RHL51	10/01/10		SNF	"High Rehab plus Extensive , ADL Index 2-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
RHL52	10/01/10		SNF	"High Rehab plus Extensive , ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay)."					
RHL53	10/01/10		SNF	"High Rehab plus Extensive , ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND CCA. "					
RHL54	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 2-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
RHL55	10/01/10		SNF	"High Rehab plus Extensive , ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RHL56	10/01/10		SNF	"High Rehab plus Extensive , ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RHL5A	10/01/11		SNF	"High Rehab plus Extensive , ADL Index 2-10/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RHL5B	10/01/11		SNF	"High Rehab plus Extensive , ADL Index 2-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RHL5C	10/01/11		SNF	"High Rehab plus Extensive , ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RHL5D	10/01/11		SNF	"High Rehab plus Extensive , ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RHL60	10/01/10		SNF	"High Rehab plus Extensive , ADL Index 2-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following:  SNF notified untimely of MSP denial, or 
 SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
RHL78	01/01/06	* 09/30/10	SNF	"Rehabilitation, High, plus Extensive Services, Low, ADL Index 7-12/OMRA replacing 14-day Medicare-required assessment"					
RHL79	01/01/06	* 09/30/10	SNF	"Rehabilitation, High, plus Extensive Services, Low, ADL Index 7-12/Special payment situation 14-day assessment"					
RHL8A	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 2-10/TRICARE 120-day assessment "					
RHL8B	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 2-10/TRICARE 150-day assessment "					
RHL8C	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 2-10/TRICARE 180-day assessment "					
RHL8D	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 2-10/TRICARE 210-day assessment "					
RHL8E	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 2-10/TRICARE 240-day assessment "					
RHL8F	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 2-10/TRICARE 270-day assessment "					
RHL8G	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 2-10/TRICARE 300-day assessment "					
RHL8H	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 2-10/TRICARE 330-day assessment "					
RHL8I	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 2-10/TRICARE 360-day assessment "					
RHL8X	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 2-10/TRICARE Post 360-day assessments with 30-day interval "					
RHX01	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA."					
RHX02	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay)."					
RHX03	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA."					
RHX04	01/01/06	* 09/30/10	SNF	"Rehabilitation, High, plus Extensive Services, High, ADL Index 13-18/Medicare 90 day assessment (Full)"					
RHX05	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RHX06	10/01/10		SNF	"High Rehab plus Extensive , ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RHX07	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA. "					
RHX08	01/01/06	* 09/30/10	SNF	"Rehabilitation, High, plus Extensive Services, High, ADL Index 13-18/Other Medicare Required Assessment (OMRA) "					
RHX0A	10/01/11		SNF	"High Rehab plus Extensive , ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
RHX0B	10/01/11		SNF	"High Rehab plus Extensive , ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
RHX0C	10/01/11		SNF	"High Rehab plus Extensive , ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
RHX0D	10/01/11		SNF	"High Rehab plus Extensive , ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
RHX10	10/01/10		SNF	"High Rehab plus Extensive , ADL Index 11-16/5-day or readmission return. "					
RHX11	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
RHX12	10/01/10		SNF	"High Rehab plus Extensive , ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
RHX13	10/01/10		SNF	"High Rehab plus Extensive , ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
RHX14	10/01/10		SNF	"High Rehab plus Extensive , ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
RHX15	10/01/10		SNF	"High Rehab plus Extensive , ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RHX16	10/01/10		SNF	"High Rehab plus Extensive , ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
RHX17	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
RHX18 	01/01/06	* 09/30/10	SNF	"Rehabilitation, High, plus Extensive Services, High, ADL Index 13-18/OMRA replacing 5-day Medicare assessment"					
RHX19	01/01/06	* 09/30/10	SNF	"Rehabilitation, High, plus Extensive Services, High, ADL Index 13-18/Special payment situation 5-day assessment"					
RHX1A	10/01/11		SNF	"High Rehab plus Extensive , ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RHX1B	10/01/11		SNF	"High Rehab plus Extensive , ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RHX1C	10/01/11		SNF	"High Rehab plus Extensive , ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RHX20	10/01/10		SNF	"High Rehab plus Extensive , ADL Index 11-16/14-day. "					
RHX21	10/01/10		SNF	"High Rehab plus Extensive , ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
RHX22	10/01/10		SNF	"High Rehab plus Extensive , ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay)."					
RHX23	10/01/10		SNF	"High Rehab plus Extensive , ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND CCA. "					
RHX24	10/01/10		SNF	"High Rehab plus Extensive , ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
RHX25	10/01/10		SNF	"High Rehab plus Extensive , ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
RHX26	10/01/10		SNF	"High Rehab plus Extensive , ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RHX28	01/01/06	* 09/30/10	SNF	"Rehabilitation, High, plus Extensive Services, High, ADL Index 13-18/OMRA replacing 30-day Medicare assessment"					
RHX29	01/01/06	* 09/30/10	SNF	"Rehabilitation, High, plus Extensive Services, High, ADL Index 13-18/Special payment situation 30-day assessment"					
RHX2A	10/01/11		SNF	"High Rehab plus Extensive , ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RHX2B	10/01/11		SNF	"High Rehab plus Extensive , ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RHX2C	10/01/11		SNF	"High Rehab plus Extensive , ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RHX2D	10/01/11		SNF	"High Rehab plus Extensive , ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RHX30	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 11-16/30-day. "					
RHX31	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
RHX32	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay)."					
RHX33	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND CCA."					
RHX34	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
RHX35	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RHX36	10/01/10		SNF	"High Rehab plus Extensive , ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
RHX37	01/01/06	* 09/30/10	SNF	"Rehabilitation, High, plus Extensive Services, High, ADL Index 13-18/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
RHX38	01/01/06	* 09/30/10	SNF	"Rehabilitation, High, plus Extensive Services, High, ADL Index 13-18/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
RHX39	01/01/06	* 09/30/10	SNF	"Rehabilitation, High, plus Extensive Services, High, ADL Index 13-18/Special payment situation 60-day assessment"					
RHX3A	10/01/11		SNF	"High Rehab plus Extensive , ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RHX3B	10/01/11		SNF	"High Rehab plus Extensive , ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RHX3C	10/01/11		SNF	"High Rehab plus Extensive , ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RHX3D	10/01/11		SNF	"High Rehab plus Extensive , ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RHX40	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 11-16/60-day. "					
RHX41	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
RHX42	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay)."					
RHX43	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) AND CCA."					
RHX44	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
RHX45	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RHX46	10/01/10		SNF	"High Rehab plus Extensive , ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
RHX47	01/01/06	* 09/30/10	SNF	"Rehabilitation, High, plus Extensive Services, High, ADL Index 13-18/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
RHX48	01/01/06	* 09/30/10	SNF	"Rehabilitation, High, plus Extensive Services, High, ADL Index 13-18/OMRA replacing 90-day Medicare-required assessment"					
RHX49	01/01/06	* 09/30/10	SNF	"Rehabilitation, High, plus Extensive Services, High, ADL Index 13-18/Special payment situation 90-day assessment"					
RHX4A	10/01/11		SNF	"High Rehab plus Extensive , ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RHX4B	10/01/11		SNF	"High Rehab plus Extensive , ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RHX4C	10/01/11		SNF	"High Rehab plus Extensive , ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RHX4D	10/01/11		SNF	"High Rehab plus Extensive , ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RHX50	10/01/10		SNF	"High Rehab plus Extensive , ADL Index 11-16/90-day. "					
RHX51	10/01/10		SNF	"High Rehab plus Extensive , ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
RHX52	10/01/10		SNF	"High Rehab plus Extensive , ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay)."					
RHX53	10/01/10		SNF	"High Rehab plus Extensive , ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND CCA. "					
RHX54	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
RHX55	10/01/10		SNF	"High Rehab plus Extensive , ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RHX56	10/01/10		SNF	"High Rehab plus Extensive , ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RHX5A	10/01/11		SNF	"High Rehab plus Extensive , ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RHX5B	10/01/11		SNF	"High Rehab plus Extensive , ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RHX5C	10/01/11		SNF	"High Rehab plus Extensive , ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RHX5D	10/01/11		SNF	"High Rehab plus Extensive , ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RHX60	10/01/10		SNF	"High Rehab plus Extensive , ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following:  SNF notified untimely of MSP denial, or 
 SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
RHX78	01/01/06	* 09/30/10	SNF	"Rehabilitation, High, plus Extensive Services, High, ADL Index 13-18/OMRA replacing 14-day Medicare-required assessment"					
RHX79	01/01/06	* 09/30/10	SNF	"Rehabilitation, High, plus Extensive Services, High, ADL Index 13-18/Special payment situation 14-day assessment"					
RHX8A	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 11-16/TRICARE 120-day assessment "					
RHX8B	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 11-16/TRICARE 150-day assessment "					
RHX8C	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 11-16/TRICARE 180-day assessment "					
RHX8D	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 11-16/TRICARE 210-day assessment "					
RHX8E	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 11-16/TRICARE 240-day assessment "					
RHX8F	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 11-16/TRICARE 270-day assessment "					
RHX8G	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 11-16/TRICARE 300-day assessment "					
RHX8H	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 11-16/TRICARE 330-day assessment "					
RHX8I	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 11-16/TRICARE 360-day assessment "					
RHX8X	07/01/98		SNF	"High Rehab plus Extensive , ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval "					
RLA01	07/01/98		SNF	"Low Rehab, ADL Index 0-10/Stand-alone OBRA SCSA OR SCPA OR CCA."					
RLA02	07/01/98		SNF	"Low Rehab, ADL Index 0-10/Stand-alone SOT OMRA (not Medicare short stay)."					
RLA03	07/01/98		SNF	"Low Rehab, ADL Index 0-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA."					
RLA04	07/01/98	* 09/30/10	SNF	"Rehabilitation, Low, ADL Index 4-13/Medicare 90 day assessment (Full)"					
RLA05	07/01/98		SNF	"Low Rehab, ADL Index 0-10/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RLA06	10/01/10		SNF	"Low Rehab, ADL Index 0-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RLA07	07/01/98		SNF	"Low Rehab, ADL Index 0-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA. "					
RLA08	07/01/98	* 09/30/10	SNF	"Rehabilitation, Low, ADL Index 4-13/Other Medicare Required Assessment (OMRA) "					
RLA0A	10/01/11		SNF	"Low Rehab, ADL Index 0-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
RLA0B	10/01/11		SNF	"Low Rehab, ADL Index 0-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
RLA0C	10/01/11		SNF	"Low Rehab, ADL Index 0-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
RLA0D	10/01/11		SNF	"Low Rehab, ADL Index 0-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
RLA10	10/01/10		SNF	"Low Rehab, ADL Index 0-10/5-day or readmission return. "					
RLA11	07/01/98		SNF	"Low Rehab, ADL Index 0-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
RLA12	10/01/10		SNF	"Low Rehab, ADL Index 0-10/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
RLA13	10/01/10		SNF	"Low Rehab, ADL Index 0-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
RLA14	10/01/10		SNF	"Low Rehab, ADL Index 0-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
RLA15	10/01/10		SNF	"Low Rehab, ADL Index 0-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RLA16	10/01/10		SNF	"Low Rehab, ADL Index 0-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
RLA17	07/01/98		SNF	"Low Rehab, ADL Index 0-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
RLA18 	10/01/00	* 09/30/10	SNF	"Rehabilitation, Low, ADL Index 4-13/OMRA replacing 5-day Medicare assessment"					
RLA19	07/01/02	* 09/30/10	SNF	"Rehabilitation, Low, ADL Index 4-13/Special payment situation 5-day assessment"					
RLA1A	10/01/11		SNF	"Low Rehab, ADL Index 0-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RLA1B	10/01/11		SNF	"Low Rehab, ADL Index 0-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RLA1C	10/01/11		SNF	"Low Rehab, ADL Index 0-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RLA20	10/01/10		SNF	"Low Rehab, ADL Index 0-10/14-day. "					
RLA21	10/01/10		SNF	"Low Rehab, ADL Index 0-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
RLA22	10/01/10		SNF	"Low Rehab, ADL Index 0-10/14-day AND SOT OMRA (not Medicare short stay)."					
RLA23	10/01/10		SNF	"Low Rehab, ADL Index 0-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND CCA. "					
RLA24	10/01/10		SNF	"Low Rehab, ADL Index 0-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
RLA25	10/01/10		SNF	"Low Rehab, ADL Index 0-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
RLA26	10/01/10		SNF	"Low Rehab, ADL Index 0-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RLA28	10/01/00	* 09/30/10	SNF	"Rehabilitation, Low, ADL Index 4-13/OMRA replacing 30-day Medicare assessment"					
RLA29	07/01/02	* 09/30/10	SNF	"Rehabilitation, Low, ADL Index 4-13/Special payment situation 30-day assessment"					
RLA2A	10/01/11		SNF	"Low Rehab, ADL Index 0-10/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RLA2B	10/01/11		SNF	"Low Rehab, ADL Index 0-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RLA2C	10/01/11		SNF	"Low Rehab, ADL Index 0-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RLA2D	10/01/11		SNF	"Low Rehab, ADL Index 0-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RLA30	07/01/98		SNF	"Low Rehab, ADL Index 0-10/30-day. "					
RLA31	07/01/98		SNF	"Low Rehab, ADL Index 0-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
RLA32	07/01/98		SNF	"Low Rehab, ADL Index 0-10/30-day AND SOT OMRA (not Medicare short stay)."					
RLA33	07/01/98		SNF	"Low Rehab, ADL Index 0-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND CCA."					
RLA34	07/01/98		SNF	"Low Rehab, ADL Index 0-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
RLA35	07/01/98		SNF	"Low Rehab, ADL Index 0-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RLA36	10/01/10		SNF	"Low Rehab, ADL Index 0-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
RLA37	07/01/98	* 09/30/10	SNF	"Rehabilitation, Low, ADL Index 4-13/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
RLA38	07/01/98	* 09/30/10	SNF	"Rehabilitation, Low, ADL Index 4-13/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
RLA39	07/01/02	* 09/30/10	SNF	"Rehabilitation, Low, ADL Index 4-13/Special payment situation 60-day assessment"					
RLA3A	10/01/11		SNF	"Low Rehab, ADL Index 0-10/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RLA3B	10/01/11		SNF	"Low Rehab, ADL Index 0-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RLA3C	10/01/11		SNF	"Low Rehab, ADL Index 0-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RLA3D	10/01/11		SNF	"Low Rehab, ADL Index 0-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RLA40	07/01/98		SNF	"Low Rehab, ADL Index 0-10/60-day. "					
RLA41	07/01/98		SNF	"Low Rehab, ADL Index 0-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
RLA42	07/01/98		SNF	"Low Rehab, ADL Index 0-10/60-day AND SOT OMRA (not Medicare short stay)."					
RLA43	07/01/98		SNF	"Low Rehab, ADL Index 0-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) AND CCA."					
RLA44	07/01/98		SNF	"Low Rehab, ADL Index 0-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
RLA45	07/01/98		SNF	"Low Rehab, ADL Index 0-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RLA46	10/01/10		SNF	"Low Rehab, ADL Index 0-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
RLA47	07/01/98	* 09/30/10	SNF	"Rehabilitation, Low, ADL Index 4-13/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
RLA48	10/01/00	* 09/30/10	SNF	"Rehabilitation, Low, ADL Index 4-13/OMRA replacing 90-day Medicare-required assessment"					
RLA49	07/01/02	* 09/30/10	SNF	"Rehabilitation, Low, ADL Index 4-13/Special payment situation 90-day assessment"					
RLA4A	10/01/11		SNF	"Low Rehab, ADL Index 0-10/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RLA4B	10/01/11		SNF	"Low Rehab, ADL Index 0-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RLA4C	10/01/11		SNF	"Low Rehab, ADL Index 0-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RLA4D	10/01/11		SNF	"Low Rehab, ADL Index 0-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RLA50	10/01/10		SNF	"Low Rehab, ADL Index 0-10/90-day. "					
RLA51	10/01/10		SNF	"Low Rehab, ADL Index 0-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
RLA52	10/01/10		SNF	"Low Rehab, ADL Index 0-10/90-day AND SOT OMRA (not Medicare short stay)."					
RLA53	10/01/10		SNF	"Low Rehab, ADL Index 0-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND CCA. "					
RLA54	07/01/98		SNF	"Low Rehab, ADL Index 0-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
RLA55	10/01/10		SNF	"Low Rehab, ADL Index 0-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RLA56	10/01/10		SNF	"Low Rehab, ADL Index 0-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RLA5A	10/01/11		SNF	"Low Rehab, ADL Index 0-10/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RLA5B	10/01/11		SNF	"Low Rehab, ADL Index 0-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RLA5C	10/01/11		SNF	"Low Rehab, ADL Index 0-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RLA5D	10/01/11		SNF	"Low Rehab, ADL Index 0-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RLA60	10/01/10		SNF	"Low Rehab, ADL Index 0-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following:  SNF notified untimely of MSP denial, or 
 SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
RLA78	10/01/00	* 09/30/10	SNF	"Rehabilitation, Low, ADL Index 4-13/OMRA replacing 14-day Medicare-required assessment"					
RLA79	07/01/02	* 09/30/10	SNF	"Rehabilitation, Low, ADL Index 4-13/Special payment situation 14-day assessment"					
RLA8A	07/01/98		SNF	"Low Rehab, ADL Index 0-10/TRICARE 120-day assessment "					
RLA8B	07/01/98		SNF	"Low Rehab, ADL Index 0-10/TRICARE 150-day assessment "					
RLA8C	07/01/98		SNF	"Low Rehab, ADL Index 0-10/TRICARE 180-day assessment "					
RLA8D	07/01/98		SNF	"Low Rehab, ADL Index 0-10/TRICARE 210-day assessment "					
RLA8E	07/01/98		SNF	"Low Rehab, ADL Index 0-10/TRICARE 240-day assessment "					
RLA8F	07/01/98		SNF	"Low Rehab, ADL Index 0-10/TRICARE 270-day assessment "					
RLA8G	07/01/98		SNF	"Low Rehab, ADL Index 0-10/TRICARE 300-day assessment "					
RLA8H	07/01/98		SNF	"Low Rehab, ADL Index 0-10/TRICARE 330-day assessment "					
RLA8I	07/01/98		SNF	"Low Rehab, ADL Index 0-10/TRICARE 360-day assessment "					
RLA8X	07/01/98		SNF	"Low Rehab, ADL Index 0-10/TRICARE Post 360-day assessments with 30-day interval "					
RLB01	07/01/98		SNF	"Low Rehab, ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA."					
RLB02	07/01/98		SNF	"Low Rehab, ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay)."					
RLB03	07/01/98		SNF	"Low Rehab, ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA."					
RLB05	07/01/98		SNF	"Low Rehab, ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RLB06	10/01/10		SNF	"Low Rehab, ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RLB07	07/01/98		SNF	"Low Rehab, ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA. "					
RLB08	07/01/98	* 09/30/10	SNF	"Rehabilitation, Low, ADL Index 14-18/Other Medicare Required Assessment (OMRA) "					
RLB0A	10/01/11		SNF	"Low Rehab, ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
RLB0B	10/01/11		SNF	"Low Rehab, ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
RLB0C	10/01/11		SNF	"Low Rehab, ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
RLB0D	10/01/11		SNF	"Low Rehab, ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
RLB10	10/01/10		SNF	"Low Rehab, ADL Index 11-16/5-day or readmission return. "					
RLB11	07/01/98		SNF	"Low Rehab, ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
RLB12	10/01/10		SNF	"Low Rehab, ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
RLB13	10/01/10		SNF	"Low Rehab, ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
RLB14	10/01/10		SNF	"Low Rehab, ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
RLB15	10/01/10		SNF	"Low Rehab, ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RLB16	10/01/10		SNF	"Low Rehab, ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
RLB17	07/01/98		SNF	"Low Rehab, ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
RLB18 	10/01/00	* 09/30/10	SNF	"Rehabilitation, Low, ADL Index 14-18/OMRA replacing 5-day Medicare assessment"					
RLB19	07/01/02	* 09/30/10	SNF	"Rehabilitation, Low, ADL Index 14-18/Special payment situation 5-day assessment"					
RLB1A	10/01/11		SNF	"Low Rehab, ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RLB1B	10/01/11		SNF	"Low Rehab, ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RLB1C	10/01/11		SNF	"Low Rehab, ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RLB20	10/01/10		SNF	"Low Rehab, ADL Index 11-16/14-day. "					
RLB21	10/01/10		SNF	"Low Rehab, ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
RLB22	10/01/10		SNF	"Low Rehab, ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay)."					
RLB23	10/01/10		SNF	"Low Rehab, ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND CCA. "					
RLB24	10/01/10		SNF	"Low Rehab, ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
RLB25	10/01/10		SNF	"Low Rehab, ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
RLB26	10/01/10		SNF	"Low Rehab, ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RLB28	10/01/00	* 09/30/10	SNF	"Rehabilitation, Low, ADL Index 14-18/OMRA replacing 30-day Medicare assessment"					
RLB29	07/01/02	* 09/30/10	SNF	"Rehabilitation, Low, ADL Index 14-18/Special payment situation 30-day assessment"					
RLB2A	10/01/11		SNF	"Low Rehab, ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RLB2B	10/01/11		SNF	"Low Rehab, ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RLB2C	10/01/11		SNF	"Low Rehab, ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RLB2D	10/01/11		SNF	"Low Rehab, ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RLB30	07/01/98		SNF	"Low Rehab, ADL Index 11-16/30-day. "					
RLB31	07/01/98		SNF	"Low Rehab, ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
RLB32	07/01/98		SNF	"Low Rehab, ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay)."					
RLB33	07/01/98		SNF	"Low Rehab, ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND CCA."					
RLB34	07/01/98		SNF	"Low Rehab, ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
RLB35	07/01/98		SNF	"Low Rehab, ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RLB36	10/01/10		SNF	"Low Rehab, ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
RLB37	07/01/98	* 09/30/10	SNF	"Rehabilitation, Low, ADL Index 14-18/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
RLB38	07/01/98	* 09/30/10	SNF	"Rehabilitation, Low, ADL Index 14-18/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
RLB39	07/01/02	* 09/30/10	SNF	"Rehabilitation, Low, ADL Index 14-18/Special payment situation 60-day assessment"					
RLB3A	10/01/11		SNF	"Low Rehab, ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RLB3B	10/01/11		SNF	"Low Rehab, ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RLB3C	10/01/11		SNF	"Low Rehab, ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RLB3D	10/01/11		SNF	"Low Rehab, ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RLB40	07/01/98		SNF	"Low Rehab, ADL Index 11-16/60-day. "					
RLB41	07/01/98		SNF	"Low Rehab, ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
RLB42	07/01/98		SNF	"Low Rehab, ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay)."					
RLB43	07/01/98		SNF	"Low Rehab, ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) AND CCA."					
RLB44	07/01/98		SNF	"Low Rehab, ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
RLB45	07/01/98		SNF	"Low Rehab, ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RLB46	10/01/10		SNF	"Low Rehab, ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
RLB47	07/01/98	* 09/30/10	SNF	"Rehabilitation, Low, ADL Index 14-18/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
RLB48	10/01/00	* 09/30/10	SNF	"Rehabilitation, Low, ADL Index 14-18/OMRA replacing 90-day Medicare-required assessment"					
RLB49	07/01/02	* 09/30/10	SNF	"Rehabilitation, Low, ADL Index 14-18/Special payment situation 90-day assessment"					
RLB4A	10/01/11		SNF	"Low Rehab, ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RLB4B	10/01/11		SNF	"Low Rehab, ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RLB4C	10/01/11		SNF	"Low Rehab, ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RLB4D	10/01/11		SNF	"Low Rehab, ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RLB50	10/01/10		SNF	"Low Rehab, ADL Index 11-16/90-day. "					
RLB51	10/01/10		SNF	"Low Rehab, ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
RLB52	10/01/10		SNF	"Low Rehab, ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay)."					
RLB53	10/01/10		SNF	"Low Rehab, ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND CCA. "					
RLB54	07/01/98		SNF	"Low Rehab, ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
RLB55	10/01/10		SNF	"Low Rehab, ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RLB56	10/01/10		SNF	"Low Rehab, ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RLB5A	10/01/11		SNF	"Low Rehab, ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RLB5B	10/01/11		SNF	"Low Rehab, ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RLB5C	10/01/11		SNF	"Low Rehab, ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RLB5D	10/01/11		SNF	"Low Rehab, ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RLB60	10/01/10		SNF	"Low Rehab, ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following:  SNF notified untimely of MSP denial, or 
 SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
RLB78	10/01/00	* 09/30/10	SNF	"Rehabilitation, Low, ADL Index 14-18/OMRA replacing 14-day Medicare-required assessment"					
RLB79	07/01/02	* 09/30/10	SNF	"Rehabilitation, Low, ADL Index 14-18/Special payment situation 14-day assessment"					
RLB8A	07/01/98		SNF	"Low Rehab, ADL Index 11-16/TRICARE 120-day assessment "					
RLB8B	07/01/98		SNF	"Low Rehab, ADL Index 11-16/TRICARE 150-day assessment "					
RLB8C	07/01/98		SNF	"Low Rehab, ADL Index 11-16/TRICARE 180-day assessment "					
RLB8D	07/01/98		SNF	"Low Rehab, ADL Index 11-16/TRICARE 210-day assessment "					
RLB8E	07/01/98		SNF	"Low Rehab, ADL Index 11-16/TRICARE 240-day assessment "					
RLB8F	07/01/98		SNF	"Low Rehab, ADL Index 11-16/TRICARE 270-day assessment "					
RLB8G	07/01/98		SNF	"Low Rehab, ADL Index 11-16/TRICARE 300-day assessment "					
RLB8H	07/01/98		SNF	"Low Rehab, ADL Index 11-16/TRICARE 330-day assessment "					
RLB8I	07/01/98		SNF	"Low Rehab, ADL Index 11-16/TRICARE 360-day assessment "					
RLB8X	07/01/98		SNF	"Low Rehab, ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval "					
RLX01	07/01/98		SNF	"Low Rehab plus Extensive , ADL Index 2-16/Stand-alone OBRA SCSA OR SCPA OR CCA."					
RLX02	07/01/98		SNF	"Low Rehab plus Extensive , ADL Index 2-16/Stand-alone SOT OMRA (not Medicare short stay)."					
RLX03	07/01/98		SNF	"Low Rehab plus Extensive , ADL Index 2-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA."					
RLX04	01/01/06	* 09/30/10	SNF	"Rehabilitation, Low, plus Extensive Services, ADL Index 7-18/Medicare 90 day assessment (Full)"					
RLX05	07/01/98		SNF	"Low Rehab plus Extensive , ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RLX06	10/01/10		SNF	"Low Rehab plus Extensive , ADL Index 2-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RLX07	07/01/98		SNF	"Low Rehab plus Extensive , ADL Index 2-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA. "					
RLX08	01/01/06	* 09/30/10	SNF	"Rehabilitation, Low, plus Extensive Services, ADL Index 7-18/Other Medicare Required Assessment (OMRA) "					
RLX0A	10/01/11		SNF	"Low Rehab plus Extensive , ADL Index 2-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
RLX0B	10/01/11		SNF	"Low Rehab plus Extensive , ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
RLX0C	10/01/11		SNF	"Low Rehab plus Extensive , ADL Index 2-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
RLX0D	10/01/11		SNF	"Low Rehab plus Extensive , ADL Index 2-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
RLX10	10/01/10		SNF	"Low Rehab plus Extensive , ADL Index 2-16/5-day or readmission return. "					
RLX11	07/01/98		SNF	"Low Rehab plus Extensive , ADL Index 2-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
RLX12	10/01/10		SNF	"Low Rehab plus Extensive , ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
RLX13	10/01/10		SNF	"Low Rehab plus Extensive , ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
RLX14	10/01/10		SNF	"Low Rehab plus Extensive , ADL Index 2-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
RLX15	10/01/10		SNF	"Low Rehab plus Extensive , ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RLX16	10/01/10		SNF	"Low Rehab plus Extensive , ADL Index 2-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
RLX17	07/01/98		SNF	"Low Rehab plus Extensive , ADL Index 2-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
RLX18 	01/01/06	* 09/30/10	SNF	"Rehabilitation, Low, plus Extensive Services, ADL Index 7-18/OMRA replacing 5-day Medicare assessment"					
RLX19	01/01/06	* 09/30/10	SNF	"Rehabilitation, Low, plus Extensive Services, ADL Index 7-18/Special payment situation 5-day assessment"					
RLX1A	10/01/11		SNF	"Low Rehab plus Extensive , ADL Index 2-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RLX1B	10/01/11		SNF	"Low Rehab plus Extensive , ADL Index 2-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RLX1C	10/01/11		SNF	"Low Rehab plus Extensive , ADL Index 2-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RLX20	10/01/10		SNF	"Low Rehab plus Extensive , ADL Index 2-16/14-day. "					
RLX21	10/01/10		SNF	"Low Rehab plus Extensive , ADL Index 2-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
RLX22	10/01/10		SNF	"Low Rehab plus Extensive , ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay)."					
RLX23	10/01/10		SNF	"Low Rehab plus Extensive , ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND CCA. "					
RLX24	10/01/10		SNF	"Low Rehab plus Extensive , ADL Index 2-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
RLX25	10/01/10		SNF	"Low Rehab plus Extensive , ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
RLX26	10/01/10		SNF	"Low Rehab plus Extensive , ADL Index 2-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RLX28	01/01/06	* 09/30/10	SNF	"Rehabilitation, Low, plus Extensive Services, ADL Index 7-18/OMRA replacing 30-day Medicare assessment"					
RLX29	01/01/06	* 09/30/10	SNF	"Rehabilitation, Low, plus Extensive Services, ADL Index 7-18/Special payment situation 30-day assessment"					
RLX2A	10/01/11		SNF	"Low Rehab plus Extensive , ADL Index 2-16/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RLX2B	10/01/11		SNF	"Low Rehab plus Extensive , ADL Index 2-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RLX2C	10/01/11		SNF	"Low Rehab plus Extensive , ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RLX2D	10/01/11		SNF	"Low Rehab plus Extensive , ADL Index 2-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RLX30	07/01/98		SNF	"Low Rehab plus Extensive , ADL Index 2-16/30-day. "					
RLX31	07/01/98		SNF	"Low Rehab plus Extensive , ADL Index 2-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
RLX32	07/01/98		SNF	"Low Rehab plus Extensive , ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay)."					
RLX33	07/01/98		SNF	"Low Rehab plus Extensive , ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND CCA."					
RLX34	07/01/98		SNF	"Low Rehab plus Extensive , ADL Index 2-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
RLX35	07/01/98		SNF	"Low Rehab plus Extensive , ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RLX36	10/01/10		SNF	"Low Rehab plus Extensive , ADL Index 2-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
RLX37	01/01/06	* 09/30/10	SNF	"Rehabilitation, Low, plus Extensive Services, ADL Index 7-18/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
RLX38	01/01/06	* 09/30/10	SNF	"Rehabilitation, Low, plus Extensive Services, ADL Index 7-18/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
RLX39	01/01/06	* 09/30/10	SNF	"Rehabilitation, Low, plus Extensive Services, ADL Index 7-18/Special payment situation 60-day assessment"					
RLX3A	10/01/11		SNF	"Low Rehab plus Extensive , ADL Index 2-16/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RLX3B	10/01/11		SNF	"Low Rehab plus Extensive , ADL Index 2-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RLX3C	10/01/11		SNF	"Low Rehab plus Extensive , ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RLX3D	10/01/11		SNF	"Low Rehab plus Extensive , ADL Index 2-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RLX40	07/01/98		SNF	"Low Rehab plus Extensive , ADL Index 2-16/60-day. "					
RLX41	07/01/98		SNF	"Low Rehab plus Extensive , ADL Index 2-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
RLX42	07/01/98		SNF	"Low Rehab plus Extensive , ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay)."					
RLX43	07/01/98		SNF	"Low Rehab plus Extensive , ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) AND CCA."					
RLX44	07/01/98		SNF	"Low Rehab plus Extensive , ADL Index 2-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
RLX45	07/01/98		SNF	"Low Rehab plus Extensive , ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RLX46	10/01/10		SNF	"Low Rehab plus Extensive , ADL Index 2-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
RLX47	01/01/06	* 09/30/10	SNF	"Rehabilitation, Low, plus Extensive Services, ADL Index 7-18/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
RLX48	01/01/06	* 09/30/10	SNF	"Rehabilitation, Low, plus Extensive Services, ADL Index 7-18/OMRA replacing 90-day Medicare-required assessment"					
RLX49	01/01/06	* 09/30/10	SNF	"Rehabilitation, Low, plus Extensive Services, ADL Index 7-18/Special payment situation 90-day assessment"					
RLX4A	10/01/11		SNF	"Low Rehab plus Extensive , ADL Index 2-16/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RLX4B	10/01/11		SNF	"Low Rehab plus Extensive , ADL Index 2-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RLX4C	10/01/11		SNF	"Low Rehab plus Extensive , ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RLX4D	10/01/11		SNF	"Low Rehab plus Extensive , ADL Index 2-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RLX50	10/01/10		SNF	"Low Rehab plus Extensive , ADL Index 2-16/90-day. "					
RLX51	10/01/10		SNF	"Low Rehab plus Extensive , ADL Index 2-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
RLX52	10/01/10		SNF	"Low Rehab plus Extensive , ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay)."					
RLX53	10/01/10		SNF	"Low Rehab plus Extensive , ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND CCA. "					
RLX54	07/01/98		SNF	"Low Rehab plus Extensive , ADL Index 2-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
RLX55	10/01/10		SNF	"Low Rehab plus Extensive , ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RLX56	10/01/10		SNF	"Low Rehab plus Extensive , ADL Index 2-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RLX5A	10/01/11		SNF	"Low Rehab plus Extensive , ADL Index 2-16/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RLX5B	10/01/11		SNF	"Low Rehab plus Extensive , ADL Index 2-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RLX5C	10/01/11		SNF	"Low Rehab plus Extensive , ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RLX5D	10/01/11		SNF	"Low Rehab plus Extensive , ADL Index 2-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RLX60	10/01/10		SNF	"Low Rehab plus Extensive , ADL Index 2-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following:  SNF notified untimely of MSP denial, or 
 SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
RLX78	01/01/06	* 09/30/10	SNF	"Rehabilitation, Low, plus Extensive Services, ADL Index 7-18/OMRA replacing 14-day Medicare-required assessment"					
RLX79	01/01/06	* 09/30/10	SNF	"Rehabilitation, Low, plus Extensive Services, ADL Index 7-18/Special payment situation 14-day assessment"					
RLX8A	07/01/98		SNF	"Low Rehab plus Extensive , ADL Index 2-16/TRICARE 120-day assessment "					
RLX8B	07/01/98		SNF	"Low Rehab plus Extensive , ADL Index 2-16/TRICARE 150-day assessment "					
RLX8C	07/01/98		SNF	"Low Rehab plus Extensive , ADL Index 2-16/TRICARE 180-day assessment "					
RLX8D	07/01/98		SNF	"Low Rehab plus Extensive , ADL Index 2-16/TRICARE 210-day assessment "					
RLX8E	07/01/98		SNF	"Low Rehab plus Extensive , ADL Index 2-16/TRICARE 240-day assessment "					
RLX8F	07/01/98		SNF	"Low Rehab plus Extensive , ADL Index 2-16/TRICARE 270-day assessment "					
RLX8G	07/01/98		SNF	"Low Rehab plus Extensive , ADL Index 2-16/TRICARE 300-day assessment "					
RLX8H	07/01/98		SNF	"Low Rehab plus Extensive , ADL Index 2-16/TRICARE 330-day assessment "					
RLX8I	07/01/98		SNF	"Low Rehab plus Extensive , ADL Index 2-16/TRICARE 360-day assessment "					
RLX8X	07/01/98		SNF	"Low Rehab plus Extensive , ADL Index 2-16/TRICARE Post 360-day assessments with 30-day interval "					
RMA01	07/01/98		SNF	"Medium Rehab , ADL Index 0-5/Stand-alone OBRA SCSA OR SCPA OR CCA."					
RMA02	07/01/98		SNF	"Medium Rehab , ADL Index 0-5/Stand-alone SOT OMRA (not Medicare short stay)."					
RMA03	07/01/98		SNF	"Medium Rehab , ADL Index 0-5/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA."					
RMA04	07/01/98	* 09/30/10	SNF	"Rehabilitation, Medium, ADL Index 4-7/Medicare 90 day assessment (Full)"					
RMA05	07/01/98		SNF	"Medium Rehab , ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RMA06	10/01/10		SNF	"Medium Rehab , ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RMA07	07/01/98		SNF	"Medium Rehab , ADL Index 0-5/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA. "					
RMA08	07/01/98	* 09/30/10	SNF	"Rehabilitation, Medium, ADL Index 4-7/Other Medicare Required Assessment (OMRA) "					
RMA0A	10/01/11		SNF	"Medium Rehab , ADL Index 0-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
RMA0B	10/01/11		SNF	"Medium Rehab , ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
RMA0C	10/01/11		SNF	"Medium Rehab , ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
RMA0D	10/01/11		SNF	"Medium Rehab , ADL Index 0-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
RMA10	10/01/10		SNF	"Medium Rehab , ADL Index 0-5/5-day or readmission return. "					
RMA11	07/01/98		SNF	"Medium Rehab , ADL Index 0-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
RMA12	10/01/10		SNF	"Medium Rehab , ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
RMA13	10/01/10		SNF	"Medium Rehab , ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
RMA14	10/01/10		SNF	"Medium Rehab , ADL Index 0-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
RMA15	10/01/10		SNF	"Medium Rehab , ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RMA16	10/01/10		SNF	"Medium Rehab , ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
RMA17	07/01/98		SNF	"Medium Rehab , ADL Index 0-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
RMA18 	10/01/00	* 09/30/10	SNF	"Rehabilitation, Medium, ADL Index 4-7/OMRA replacing 5-day Medicare assessment"					
RMA19	07/01/02	* 09/30/10	SNF	"Rehabilitation, Medium, ADL Index 4-7/Special payment situation 5-day assessment"					
RMA1A	10/01/11		SNF	"Medium Rehab , ADL Index 0-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RMA1B	10/01/11		SNF	"Medium Rehab , ADL Index 0-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RMA1C	10/01/11		SNF	"Medium Rehab , ADL Index 0-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RMA20	10/01/10		SNF	"Medium Rehab , ADL Index 0-5/14-day. "					
RMA21	10/01/10		SNF	"Medium Rehab , ADL Index 0-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
RMA22	10/01/10		SNF	"Medium Rehab , ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay)."					
RMA23	10/01/10		SNF	"Medium Rehab , ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND CCA. "					
RMA24	10/01/10		SNF	"Medium Rehab , ADL Index 0-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
RMA25	10/01/10		SNF	"Medium Rehab , ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
RMA26	10/01/10		SNF	"Medium Rehab , ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RMA28	10/01/00	* 09/30/10	SNF	"Rehabilitation, Medium, ADL Index 4-7/OMRA replacing 30-day Medicare assessment"					
RMA29	07/01/02	* 09/30/10	SNF	"Rehabilitation, Medium, ADL Index 4-7/Special payment situation 30-day assessment"					
RMA2A	10/01/11		SNF	"Medium Rehab , ADL Index 0-5/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RMA2B	10/01/11		SNF	"Medium Rehab , ADL Index 0-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RMA2C	10/01/11		SNF	"Medium Rehab , ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RMA2D	10/01/11		SNF	"Medium Rehab , ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RMA30	07/01/98		SNF	"Medium Rehab , ADL Index 0-5/30-day. "					
RMA31	07/01/98		SNF	"Medium Rehab , ADL Index 0-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
RMA32	07/01/98		SNF	"Medium Rehab , ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay)."					
RMA33	07/01/98		SNF	"Medium Rehab , ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND CCA."					
RMA34	07/01/98		SNF	"Medium Rehab , ADL Index 0-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
RMA35	07/01/98		SNF	"Medium Rehab , ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RMA36	10/01/10		SNF	"Medium Rehab , ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
RMA37	07/01/98	* 09/30/10	SNF	"Rehabilitation, Medium, ADL Index 4-7/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
RMA38	07/01/98	* 09/30/10	SNF	"Rehabilitation, Medium, ADL Index 4-7/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
RMA39	07/01/02	* 09/30/10	SNF	"Rehabilitation, Medium, ADL Index 4-7/Special payment situation 60-day assessment"					
RMA3A	10/01/11		SNF	"Medium Rehab , ADL Index 0-5/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RMA3B	10/01/11		SNF	"Medium Rehab , ADL Index 0-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RMA3C	10/01/11		SNF	"Medium Rehab , ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RMA3D	10/01/11		SNF	"Medium Rehab , ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RMA40	07/01/98		SNF	"Medium Rehab , ADL Index 0-5/60-day. "					
RMA41	07/01/98		SNF	"Medium Rehab , ADL Index 0-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
RMA42	07/01/98		SNF	"Medium Rehab , ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay)."					
RMA43	07/01/98		SNF	"Medium Rehab , ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) AND CCA."					
RMA44	07/01/98		SNF	"Medium Rehab , ADL Index 0-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
RMA45	07/01/98		SNF	"Medium Rehab , ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RMA46	10/01/10		SNF	"Medium Rehab , ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
RMA47	07/01/98	* 09/30/10	SNF	"Rehabilitation, Medium, ADL Index 4-7/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
RMA48	10/01/00	* 09/30/10	SNF	"Rehabilitation, Medium, ADL Index 4-7/OMRA replacing 90-day Medicare-required assessment"					
RMA49	07/01/02	* 09/30/10	SNF	"Rehabilitation, Medium, ADL Index 4-7/Special payment situation 90-day assessment"					
RMA4A	10/01/11		SNF	"Medium Rehab , ADL Index 0-5/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RMA4B	10/01/11		SNF	"Medium Rehab , ADL Index 0-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RMA4C	10/01/11		SNF	"Medium Rehab , ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RMA4D	10/01/11		SNF	"Medium Rehab , ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RMA50	10/01/10		SNF	"Medium Rehab , ADL Index 0-5/90-day. "					
RMA51	10/01/10		SNF	"Medium Rehab , ADL Index 0-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
RMA52	10/01/10		SNF	"Medium Rehab , ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay)."					
RMA53	10/01/10		SNF	"Medium Rehab , ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND CCA. "					
RMA54	07/01/98		SNF	"Medium Rehab , ADL Index 0-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
RMA55	10/01/10		SNF	"Medium Rehab , ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RMA56	10/01/10		SNF	"Medium Rehab , ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RMA5A	10/01/11		SNF	"Medium Rehab , ADL Index 0-5/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RMA5B	10/01/11		SNF	"Medium Rehab , ADL Index 0-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RMA5C	10/01/11		SNF	"Medium Rehab , ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RMA5D	10/01/11		SNF	"Medium Rehab , ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RMA60	10/01/10		SNF	"Medium Rehab , ADL Index 0-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following:  SNF notified untimely of MSP denial, or 
 SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
RMA78	10/01/00	* 09/30/10	SNF	"Rehabilitation, Medium, ADL Index 4-7/OMRA replacing 14-day Medicare-required assessment"					
RMA79	07/01/02	* 09/30/10	SNF	"Rehabilitation, Medium, ADL Index 4-7/Special payment situation 14-day assessment"					
RMA8A	07/01/98		SNF	"Medium Rehab , ADL Index 0-5/TRICARE 120-day assessment "					
RMA8B	07/01/98		SNF	"Medium Rehab , ADL Index 0-5/TRICARE 150-day assessment "					
RMA8C	07/01/98		SNF	"Medium Rehab , ADL Index 0-5/TRICARE 180-day assessment "					
RMA8D	07/01/98		SNF	"Medium Rehab , ADL Index 0-5/TRICARE 210-day assessment "					
RMA8E	07/01/98		SNF	"Medium Rehab , ADL Index 0-5/TRICARE 240-day assessment "					
RMA8F	07/01/98		SNF	"Medium Rehab , ADL Index 0-5/TRICARE 270-day assessment "					
RMA8G	07/01/98		SNF	"Medium Rehab , ADL Index 0-5/TRICARE 300-day assessment "					
RMA8H	07/01/98		SNF	"Medium Rehab , ADL Index 0-5/TRICARE 330-day assessment "					
RMA8I	07/01/98		SNF	"Medium Rehab , ADL Index 0-5/TRICARE 360-day assessment "					
RMA8X	07/01/98		SNF	"Medium Rehab , ADL Index 0-5/TRICARE Post 360-day assessments with 30-day interval "					
RMB01	07/01/98		SNF	"Medium Rehab , ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA."					
RMB02	07/01/98		SNF	"Medium Rehab , ADL Index 6-10/Stand-alone SOT OMRA (not Medicare short stay)."					
RMB03	07/01/98		SNF	"Medium Rehab , ADL Index 6-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA."					
RMB04	07/01/98	* 09/30/10	SNF	"Rehabilitation, Medium, ADL Index 8-14/Medicare 90 day assessment (Full)"					
RMB05	07/01/98		SNF	"Medium Rehab , ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RMB06	10/01/10		SNF	"Medium Rehab , ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RMB07	07/01/98		SNF	"Medium Rehab , ADL Index 6-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA. "					
RMB08	07/01/98	* 09/30/10	SNF	"Rehabilitation, Medium, ADL Index 8-14/Other Medicare Required Assessment (OMRA) "					
RMB0A	10/01/11		SNF	"Medium Rehab , ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
RMB0B	10/01/11		SNF	"Medium Rehab , ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
RMB0C	10/01/11		SNF	"Medium Rehab , ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
RMB0D	10/01/11		SNF	"Medium Rehab , ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
RMB10	10/01/10		SNF	"Medium Rehab , ADL Index 6-10/5-day or readmission return. "					
RMB11	07/01/98		SNF	"Medium Rehab , ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
RMB12	10/01/10		SNF	"Medium Rehab , ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
RMB13	10/01/10		SNF	"Medium Rehab , ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
RMB14	10/01/10		SNF	"Medium Rehab , ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
RMB15	10/01/10		SNF	"Medium Rehab , ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RMB16	10/01/10		SNF	"Medium Rehab , ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
RMB17	07/01/98		SNF	"Medium Rehab , ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
RMB18 	10/01/00	* 09/30/10	SNF	"Rehabilitation, Medium, ADL Index 8-14/OMRA replacing 5-day Medicare assessment"					
RMB19	07/01/02	* 09/30/10	SNF	"Rehabilitation, Medium, ADL Index 8-14/Special payment situation 5-day assessment"					
RMB1A	10/01/11		SNF	"Medium Rehab , ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RMB1B	10/01/11		SNF	"Medium Rehab , ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RMB1C	10/01/11		SNF	"Medium Rehab , ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RMB20	10/01/10		SNF	"Medium Rehab , ADL Index 6-10/14-day. "					
RMB21	10/01/10		SNF	"Medium Rehab , ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
RMB22	10/01/10		SNF	"Medium Rehab , ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay)."					
RMB23	10/01/10		SNF	"Medium Rehab , ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND CCA. "					
RMB24	10/01/10		SNF	"Medium Rehab , ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
RMB25	10/01/10		SNF	"Medium Rehab , ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
RMB26	10/01/10		SNF	"Medium Rehab , ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RMB28	10/01/00	* 09/30/10	SNF	"Rehabilitation, Medium, ADL Index 8-14/OMRA replacing 30-day Medicare assessment"					
RMB29	07/01/02	* 09/30/10	SNF	"Rehabilitation, Medium, ADL Index 8-14/Special payment situation 30-day assessment"					
RMB2A	10/01/11		SNF	"Medium Rehab , ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RMB2B	10/01/11		SNF	"Medium Rehab , ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RMB2C	10/01/11		SNF	"Medium Rehab , ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RMB2D	10/01/11		SNF	"Medium Rehab , ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RMB30	07/01/98		SNF	"Medium Rehab , ADL Index 6-10/30-day. "					
RMB31	07/01/98		SNF	"Medium Rehab , ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
RMB32	07/01/98		SNF	"Medium Rehab , ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay)."					
RMB33	07/01/98		SNF	"Medium Rehab , ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND CCA."					
RMB34	07/01/98		SNF	"Medium Rehab , ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
RMB35	07/01/98		SNF	"Medium Rehab , ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RMB36	10/01/10		SNF	"Medium Rehab , ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
RMB37	07/01/98	* 09/30/10	SNF	"Rehabilitation, Medium, ADL Index 8-14/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
RMB38	07/01/98	* 09/30/10	SNF	"Rehabilitation, Medium, ADL Index 8-14/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
RMB39	07/01/02	* 09/30/10	SNF	"Rehabilitation, Medium, ADL Index 8-14/Special payment situation 60-day assessment"					
RMB3A	10/01/11		SNF	"Medium Rehab , ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RMB3B	10/01/11		SNF	"Medium Rehab , ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RMB3C	10/01/11		SNF	"Medium Rehab , ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RMB3D	10/01/11		SNF	"Medium Rehab , ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RMB40	07/01/98		SNF	"Medium Rehab , ADL Index 6-10/60-day. "					
RMB41	07/01/98		SNF	"Medium Rehab , ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
RMB42	07/01/98		SNF	"Medium Rehab , ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay)."					
RMB43	07/01/98		SNF	"Medium Rehab , ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) AND CCA."					
RMB44	07/01/98		SNF	"Medium Rehab , ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
RMB45	07/01/98		SNF	"Medium Rehab , ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RMB46	10/01/10		SNF	"Medium Rehab , ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
RMB47	07/01/98	* 09/30/10	SNF	"Rehabilitation, Medium, ADL Index 8-14/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
RMB48	10/01/00	* 09/30/10	SNF	"Rehabilitation, Medium, ADL Index 8-14/OMRA replacing 90-day Medicare-required assessment"					
RMB49	07/01/02	* 09/30/10	SNF	"Rehabilitation, Medium, ADL Index 8-14/Special payment situation 90-day assessment"					
RMB4A	10/01/11		SNF	"Medium Rehab , ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RMB4B	10/01/11		SNF	"Medium Rehab , ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RMB4C	10/01/11		SNF	"Medium Rehab , ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RMB4D	10/01/11		SNF	"Medium Rehab , ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RMB50	10/01/10		SNF	"Medium Rehab , ADL Index 6-10/90-day. "					
RMB51	10/01/10		SNF	"Medium Rehab , ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
RMB52	10/01/10		SNF	"Medium Rehab , ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay)."					
RMB53	10/01/10		SNF	"Medium Rehab , ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND CCA. "					
RMB54	07/01/98		SNF	"Medium Rehab , ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
RMB55	10/01/10		SNF	"Medium Rehab , ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RMB56	10/01/10		SNF	"Medium Rehab , ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RMB5A	10/01/11		SNF	"Medium Rehab , ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RMB5B	10/01/11		SNF	"Medium Rehab , ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RMB5C	10/01/11		SNF	"Medium Rehab , ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RMB5D	10/01/11		SNF	"Medium Rehab , ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RMB60	10/01/10		SNF	"Medium Rehab , ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following:  SNF notified untimely of MSP denial, or 
 SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
RMB78	10/01/00	* 09/30/10	SNF	"Rehabilitation, Medium, ADL Index 8-14/OMRA replacing 14-day Medicare-required assessment"					
RMB79	07/01/02	* 09/30/10	SNF	"Rehabilitation, Medium, ADL Index 8-14/Special payment situation 14-day assessment"					
RMB8A	07/01/98		SNF	"Medium Rehab , ADL Index 6-10/TRICARE 120-day assessment "					
RMB8B	07/01/98		SNF	"Medium Rehab , ADL Index 6-10/TRICARE 150-day assessment "					
RMB8C	07/01/98		SNF	"Medium Rehab , ADL Index 6-10/TRICARE 180-day assessment "					
RMB8D	07/01/98		SNF	"Medium Rehab , ADL Index 6-10/TRICARE 210-day assessment "					
RMB8E	07/01/98		SNF	"Medium Rehab , ADL Index 6-10/TRICARE 240-day assessment "					
RMB8F	07/01/98		SNF	"Medium Rehab , ADL Index 6-10/TRICARE 270-day assessment "					
RMB8G	07/01/98		SNF	"Medium Rehab , ADL Index 6-10/TRICARE 300-day assessment "					
RMB8H	07/01/98		SNF	"Medium Rehab , ADL Index 6-10/TRICARE 330-day assessment "					
RMB8I	07/01/98		SNF	"Medium Rehab , ADL Index 6-10/TRICARE 360-day assessment "					
RMB8X	07/01/98		SNF	"Medium Rehab , ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval "					
RMC01	07/01/98		SNF	"Medium Rehab , ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA."					
RMC02	07/01/98		SNF	"Medium Rehab , ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay)."					
RMC03	07/01/98		SNF	"Medium Rehab , ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA."					
RMC04	07/01/98	* 09/30/10	SNF	"Rehabilitation, Medium, ADL Index 15-18/Medicare 90 day assessment (Full)"					
RMC05	07/01/98		SNF	"Medium Rehab , ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RMC06	10/01/10		SNF	"Medium Rehab , ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RMC07	07/01/98		SNF	"Medium Rehab , ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA. "					
RMC08	07/01/98	* 09/30/10	SNF	"Rehabilitation, Medium, ADL Index 15-18/Other Medicare Required Assessment (OMRA) "					
RMC0A	10/01/11		SNF	"Medium Rehab , ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
RMC0B	10/01/11		SNF	"Medium Rehab , ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
RMC0C	10/01/11		SNF	"Medium Rehab , ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
RMC0D	10/01/11		SNF	"Medium Rehab , ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
RMC10	10/01/10		SNF	"Medium Rehab , ADL Index 11-16/5-day or readmission return. "					
RMC11	07/01/98		SNF	"Medium Rehab , ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
RMC12	10/01/10		SNF	"Medium Rehab , ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
RMC13	10/01/10		SNF	"Medium Rehab , ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
RMC14	10/01/10		SNF	"Medium Rehab , ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
RMC15	10/01/10		SNF	"Medium Rehab , ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RMC16	10/01/10		SNF	"Medium Rehab , ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
RMC17	07/01/98		SNF	"Medium Rehab , ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
RMC18 	10/01/00	* 09/30/10	SNF	"Rehabilitation, Medium, ADL Index 15-18/OMRA replacing 5-day Medicare assessment"					
RMC19	07/01/02	* 09/30/10	SNF	"Rehabilitation, Medium, ADL Index 15-18/Special payment situation 5-day assessment"					
RMC1A	10/01/11		SNF	"Medium Rehab , ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RMC1B	10/01/11		SNF	"Medium Rehab , ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RMC1C	10/01/11		SNF	"Medium Rehab , ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RMC20	10/01/10		SNF	"Medium Rehab , ADL Index 11-16/14-day. "					
RMC21	10/01/10		SNF	"Medium Rehab , ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
RMC22	10/01/10		SNF	"Medium Rehab , ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay)."					
RMC23	10/01/10		SNF	"Medium Rehab , ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND CCA. "					
RMC24	10/01/10		SNF	"Medium Rehab , ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
RMC25	10/01/10		SNF	"Medium Rehab , ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
RMC26	10/01/10		SNF	"Medium Rehab , ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RMC28	10/01/00	* 09/30/10	SNF	"Rehabilitation, Medium, ADL Index 15-18/OMRA replacing 30-day Medicare assessment"					
RMC29	07/01/02	* 09/30/10	SNF	"Rehabilitation, Medium, ADL Index 15-18/Special payment situation 30-day assessment"					
RMC2A	10/01/11		SNF	"Medium Rehab , ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RMC2B	10/01/11		SNF	"Medium Rehab , ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RMC2C	10/01/11		SNF	"Medium Rehab , ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RMC2D	10/01/11		SNF	"Medium Rehab , ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RMC30	07/01/98		SNF	"Medium Rehab , ADL Index 11-16/30-day. "					
RMC31	07/01/98		SNF	"Medium Rehab , ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
RMC32	07/01/98		SNF	"Medium Rehab , ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay)."					
RMC33	07/01/98		SNF	"Medium Rehab , ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND CCA."					
RMC34	07/01/98		SNF	"Medium Rehab , ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
RMC35	07/01/98		SNF	"Medium Rehab , ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RMC36	10/01/10		SNF	"Medium Rehab , ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
RMC37	07/01/98	* 09/30/10	SNF	"Rehabilitation, Medium, ADL Index 15-18/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
RMC38	07/01/98	* 09/30/10	SNF	"Rehabilitation, Medium, ADL Index 15-18/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
RMC39	07/01/02	* 09/30/10	SNF	"Rehabilitation, Medium, ADL Index 15-18/Special payment situation 60-day assessment"					
RMC3A	10/01/11		SNF	"Medium Rehab , ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RMC3B	10/01/11		SNF	"Medium Rehab , ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RMC3C	10/01/11		SNF	"Medium Rehab , ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RMC3D	10/01/11		SNF	"Medium Rehab , ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RMC40	07/01/98		SNF	"Medium Rehab , ADL Index 11-16/60-day. "					
RMC41	07/01/98		SNF	"Medium Rehab , ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
RMC42	07/01/98		SNF	"Medium Rehab , ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay)."					
RMC43	07/01/98		SNF	"Medium Rehab , ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) AND CCA."					
RMC44	07/01/98		SNF	"Medium Rehab , ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
RMC45	07/01/98		SNF	"Medium Rehab , ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RMC46	10/01/10		SNF	"Medium Rehab , ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
RMC47	07/01/98	* 09/30/10	SNF	"Rehabilitation, Medium, ADL Index 15-18/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
RMC48	10/01/00	* 09/30/10	SNF	"Rehabilitation, Medium, ADL Index 15-18/OMRA replacing 90-day Medicare-required assessment"					
RMC49	07/01/02	* 09/30/10	SNF	"Rehabilitation, Medium, ADL Index 15-18/Special payment situation 90-day assessment"					
RMC4A	10/01/11		SNF	"Medium Rehab , ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RMC4B	10/01/11		SNF	"Medium Rehab , ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RMC4C	10/01/11		SNF	"Medium Rehab , ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RMC4D	10/01/11		SNF	"Medium Rehab , ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RMC50	10/01/10		SNF	"Medium Rehab , ADL Index 11-16/90-day. "					
RMC51	10/01/10		SNF	"Medium Rehab , ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
RMC52	10/01/10		SNF	"Medium Rehab , ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay)."					
RMC53	10/01/10		SNF	"Medium Rehab , ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND CCA. "					
RMC54	07/01/98		SNF	"Medium Rehab , ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
RMC55	10/01/10		SNF	"Medium Rehab , ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RMC56	10/01/10		SNF	"Medium Rehab , ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RMC5A	10/01/11		SNF	"Medium Rehab , ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RMC5B	10/01/11		SNF	"Medium Rehab , ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RMC5C	10/01/11		SNF	"Medium Rehab , ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RMC5D	10/01/11		SNF	"Medium Rehab , ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RMC60	10/01/10		SNF	"Medium Rehab , ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following:  SNF notified untimely of MSP denial, or 
 SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
RMC78	10/01/00	* 09/30/10	SNF	"Rehabilitation, Medium, ADL Index 15-18/OMRA replacing 14-day Medicare-required assessment"					
RMC79	07/01/02	* 09/30/10	SNF	"Rehabilitation, Medium, ADL Index 15-18/Special payment situation 14-day assessment"					
RMC8A	07/01/98		SNF	"Medium Rehab , ADL Index 11-16/TRICARE 120-day assessment "					
RMC8B	07/01/98		SNF	"Medium Rehab , ADL Index 11-16/TRICARE 150-day assessment "					
RMC8C	07/01/98		SNF	"Medium Rehab , ADL Index 11-16/TRICARE 180-day assessment "					
RMC8D	07/01/98		SNF	"Medium Rehab , ADL Index 11-16/TRICARE 210-day assessment "					
RMC8E	07/01/98		SNF	"Medium Rehab , ADL Index 11-16/TRICARE 240-day assessment "					
RMC8F	07/01/98		SNF	"Medium Rehab , ADL Index 11-16/TRICARE 270-day assessment "					
RMC8G	07/01/98		SNF	"Medium Rehab , ADL Index 11-16/TRICARE 300-day assessment "					
RMC8H	07/01/98		SNF	"Medium Rehab , ADL Index 11-16/TRICARE 330-day assessment "					
RMC8I	07/01/98		SNF	"Medium Rehab , ADL Index 11-16/TRICARE 360-day assessment "					
RMC8X	07/01/98		SNF	"Medium Rehab , ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval "					
RML01	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/Stand-alone OBRA SCSA OR SCPA OR CCA."					
RML02	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/Stand-alone SOT OMRA (not Medicare short stay)."					
RML03	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA."					
RML04	01/01/06	* 09/30/10	SNF	"Rehabilitation, Medium, plus Extensive Services, Low, ADL Index 7-14/Medicare 90 day assessment (Full)"					
RML05	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RML06	10/01/10		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RML07	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA. "					
RML08	01/01/06	* 09/30/10	SNF	"Rehabilitation, Medium, plus Extensive Services, Low, ADL Index 7-14/Other Medicare Required Assessment (OMRA) "					
RML0A	10/01/11		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
RML0B	10/01/11		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
RML0C	10/01/11		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
RML0D	10/01/11		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
RML10	10/01/10		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/5-day or readmission return. "					
RML11	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
RML12	10/01/10		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
RML13	10/01/10		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
RML14	10/01/10		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
RML15	10/01/10		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RML16	10/01/10		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
RML17	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
RML18 	01/01/06	* 09/30/10	SNF	"Rehabilitation, Medium, plus Extensive Services, Low, ADL Index 7-14/OMRA replacing 5-day Medicare assessment"					
RML19	01/01/06	* 09/30/10	SNF	"Rehabilitation, Medium, plus Extensive Services, Low, ADL Index 7-14/Special payment situation 5-day assessment"					
RML1A	10/01/11		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RML1B	10/01/11		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RML1C	10/01/11		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RML20	10/01/10		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/14-day. "					
RML21	10/01/10		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
RML22	10/01/10		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay)."					
RML23	10/01/10		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND CCA. "					
RML24	10/01/10		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
RML25	10/01/10		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
RML26	10/01/10		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RML28	01/01/06	* 09/30/10	SNF	"Rehabilitation, Medium, plus Extensive Services, Low, ADL Index 7-14/OMRA replacing 30-day Medicare assessment"					
RML29	01/01/06	* 09/30/10	SNF	"Rehabilitation, Medium, plus Extensive Services, Low, ADL Index 7-14/Special payment situation 30-day assessment"					
RML2A	10/01/11		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RML2B	10/01/11		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RML2C	10/01/11		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RML2D	10/01/11		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RML30	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/30-day. "					
RML31	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
RML32	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay)."					
RML33	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND CCA."					
RML34	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
RML35	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RML36	10/01/10		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
RML37	01/01/06	* 09/30/10	SNF	"Rehabilitation, Medium, plus Extensive Services, Low, ADL Index 7-14/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
RML38	01/01/06	* 09/30/10	SNF	"Rehabilitation, Medium, plus Extensive Services, Low, ADL Index 7-14/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
RML39	01/01/06	* 09/30/10	SNF	"Rehabilitation, Medium, plus Extensive Services, Low, ADL Index 7-14/Special payment situation 60-day assessment"					
RML3A	10/01/11		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RML3B	10/01/11		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RML3C	10/01/11		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RML3D	10/01/11		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RML40	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/60-day. "					
RML41	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
RML42	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay)."					
RML43	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) AND CCA."					
RML44	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
RML45	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RML46	10/01/10		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
RML47	01/01/06	* 09/30/10	SNF	"Rehabilitation, Medium, plus Extensive Services, Low, ADL Index 7-14/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
RML48	01/01/06	* 09/30/10	SNF	"Rehabilitation, Medium, plus Extensive Services, Low, ADL Index 7-14/OMRA replacing 90-day Medicare-required assessment"					
RML49	01/01/06	* 09/30/10	SNF	"Rehabilitation, Medium, plus Extensive Services, Low, ADL Index 7-14/Special payment situation 90-day assessment"					
RML4A	10/01/11		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RML4B	10/01/11		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RML4C	10/01/11		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RML4D	10/01/11		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RML50	10/01/10		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/90-day. "					
RML51	10/01/10		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
RML52	10/01/10		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay)."					
RML53	10/01/10		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND CCA. "					
RML54	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
RML55	10/01/10		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RML56	10/01/10		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RML5A	10/01/11		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RML5B	10/01/11		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RML5C	10/01/11		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RML5D	10/01/11		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RML60	10/01/10		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following:  SNF notified untimely of MSP denial, or 
 SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
RML78	01/01/06	* 09/30/10	SNF	"Rehabilitation, Medium, plus Extensive Services, Low, ADL Index 7-14/OMRA replacing 14-day Medicare-required assessment"					
RML79	01/01/06	* 09/30/10	SNF	"Rehabilitation, Medium, plus Extensive Services, Low, ADL Index 7-14/Special payment situation 14-day assessment"					
RML8A	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/TRICARE 120-day assessment "					
RML8B	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/TRICARE 150-day assessment "					
RML8C	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/TRICARE 180-day assessment "					
RML8D	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/TRICARE 210-day assessment "					
RML8E	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/TRICARE 240-day assessment "					
RML8F	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/TRICARE 270-day assessment "					
RML8G	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/TRICARE 300-day assessment "					
RML8H	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/TRICARE 330-day assessment "					
RML8I	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/TRICARE 360-day assessment "					
RML8X	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 2-10/TRICARE Post 360-day assessments with 30-day interval "					
RMX01	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA."					
RMX02	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay)."					
RMX03	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA."					
RMX04	01/01/06	* 09/30/10	SNF	"Rehabilitation, Medium, plus Extensive Services, High, ADL Index 15-18/Medicare 90 day assessment (Full)"					
RMX05	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RMX06	10/01/10		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RMX07	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA. "					
RMX08	01/01/06	* 09/30/10	SNF	"Rehabilitation, Medium, plus Extensive Services, High, ADL Index 15-18/Other Medicare Required Assessment (OMRA) "					
RMX0A	10/01/11		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
RMX0B	10/01/11		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
RMX0C	10/01/11		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
RMX0D	10/01/11		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
RMX10	10/01/10		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/5-day or readmission return. "					
RMX11	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
RMX12	10/01/10		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
RMX13	10/01/10		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
RMX14	10/01/10		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
RMX15	10/01/10		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RMX16	10/01/10		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
RMX17	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
RMX18 	01/01/06	* 09/30/10	SNF	"Rehabilitation, Medium, plus Extensive Services, High, ADL Index 15-18/OMRA replacing 5-day Medicare assessment"					
RMX19	01/01/06	* 09/30/10	SNF	"Rehabilitation, Medium, plus Extensive Services, High, ADL Index 15-18/Special payment situation 5-day assessment"					
RMX1A	10/01/11		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RMX1B	10/01/11		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RMX1C	10/01/11		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RMX20	10/01/10		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/14-day. "					
RMX21	10/01/10		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
RMX22	10/01/10		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay)."					
RMX23	10/01/10		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND CCA. "					
RMX24	10/01/10		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
RMX25	10/01/10		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
RMX26	10/01/10		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RMX28	01/01/06	* 09/30/10	SNF	"Rehabilitation, Medium, plus Extensive Services, High, ADL Index 15-187/OMRA replacing 30-day Medicare assessment"					
RMX29	01/01/06	* 09/30/10	SNF	"Rehabilitation, Medium, plus Extensive Services, High, ADL Index 15-18/Special payment situation 30-day assessment"					
RMX2A	10/01/11		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RMX2B	10/01/11		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RMX2C	10/01/11		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RMX2D	10/01/11		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RMX30	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/30-day. "					
RMX31	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
RMX32	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay)."					
RMX33	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND CCA."					
RMX34	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
RMX35	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RMX36	10/01/10		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
RMX37	01/01/06	* 09/30/10	SNF	"Rehabilitation, Medium, plus Extensive Services, High, ADL Index 15-18/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
RMX38	01/01/06	* 09/30/10	SNF	"Rehabilitation, Medium, plus Extensive Services, High, ADL Index 15-18/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
RMX39	01/01/06	* 09/30/10	SNF	"Rehabilitation, Medium, plus Extensive Services, High, ADL Index 15-18/Special payment situation 60-day assessment"					
RMX3A	10/01/11		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RMX3B	10/01/11		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RMX3C	10/01/11		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RMX3D	10/01/11		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RMX40	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/60-day. "					
RMX41	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
RMX42	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay)."					
RMX43	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) AND CCA."					
RMX44	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
RMX45	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RMX46	10/01/10		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
RMX47	01/01/06	* 09/30/10	SNF	"Rehabilitation, Medium, plus Extensive Services, High, ADL Index 15-18/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
RMX48	01/01/06	* 09/30/10	SNF	"Rehabilitation, Medium, plus Extensive Services, High, ADL Index 15-18/OMRA replacing 90-day Medicare-required assessment"					
RMX49	01/01/06	* 09/30/10	SNF	"Rehabilitation, Medium, plus Extensive Services, High, ADL Index 15-18/Special payment situation 90-day assessment"					
RMX4A	10/01/11		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RMX4B	10/01/11		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RMX4C	10/01/11		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RMX4D	10/01/11		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RMX50	10/01/10		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/90-day. "					
RMX51	10/01/10		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
RMX52	10/01/10		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay)."					
RMX53	10/01/10		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND CCA. "					
RMX54	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
RMX55	10/01/10		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RMX56	10/01/10		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RMX5A	10/01/11		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RMX5B	10/01/11		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RMX5C	10/01/11		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RMX5D	10/01/11		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RMX60	10/01/10		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following:  SNF notified untimely of MSP denial, or 
 SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
RMX78	01/01/06	* 09/30/10	SNF	"Rehabilitation, Medium, plus Extensive Services, High, ADL Index 15-18/OMRA replacing 14-day Medicare-required assessment"					
RMX79	01/01/06	* 09/30/10	SNF	"Rehabilitation, Medium, plus Extensive Services, High, ADL Index 15-18/Special payment situation 14-day assessment"					
RMX8A	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/TRICARE 120-day assessment "					
RMX8B	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/TRICARE 150-day assessment "					
RMX8C	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/TRICARE 180-day assessment "					
RMX8D	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/TRICARE 210-day assessment "					
RMX8E	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/TRICARE 240-day assessment "					
RMX8F	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/TRICARE 270-day assessment "					
RMX8G	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/TRICARE 300-day assessment "					
RMX8H	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/TRICARE 330-day assessment "					
RMX8I	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/TRICARE 360-day assessment "					
RMX8X	07/01/98		SNF	"Medium Rehab plus Extensive, ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval "					
RUA01	07/01/98		SNF	"Ultra High Rehab , ADL Index 0-5/Stand-alone OBRA SCSA OR SCPA OR CCA."					
RUA02	07/01/98		SNF	"Ultra High Rehab , ADL Index 0-5/Stand-alone SOT OMRA (not Medicare short stay)."					
RUA03	07/01/98		SNF	"Ultra High Rehab , ADL Index 0-5/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA."					
RUA04	07/01/98	* 09/30/10	SNF	"Rehabilitation, Ultra High, ADL Index 4-8/Medicare 90 day assessment (Full)"					
RUA05	07/01/98		SNF	"Ultra High Rehab , ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RUA06	10/01/10		SNF	"Ultra High Rehab , ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RUA07	07/01/98		SNF	"Ultra High Rehab , ADL Index 0-5/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA. "					
RUA08	07/01/98	* 09/30/10	SNF	"Rehabilitation, Ultra High, ADL Index 4-8/Other Medicare Required Assessment (OMRA) "					
RUA0A	10/01/11		SNF	"Ultra High Rehab , ADL Index 0-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
RUA0B	10/01/11		SNF	"Ultra High Rehab , ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
RUA0C	10/01/11		SNF	"Ultra High Rehab , ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
RUA0D	10/01/11		SNF	"Ultra High Rehab , ADL Index 0-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
RUA10	10/01/10		SNF	"Ultra High Rehab , ADL Index 0-5/5-day or readmission return. "					
RUA11	07/01/98		SNF	"Ultra High Rehab , ADL Index 0-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
RUA12	10/01/10		SNF	"Ultra High Rehab , ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
RUA13	10/01/10		SNF	"Ultra High Rehab , ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
RUA14	10/01/10		SNF	"Ultra High Rehab , ADL Index 0-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
RUA15	10/01/10		SNF	"Ultra High Rehab , ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RUA16	10/01/10		SNF	"Ultra High Rehab , ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
RUA17	07/01/98		SNF	"Ultra High Rehab , ADL Index 0-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
RUA18 	10/01/00	* 09/30/10	SNF	"Rehabilitation, Ultra High, ADL Index 4-8/OMRA replacing 5-day Medicare assessment"					
RUA19	07/01/02	* 09/30/10	SNF	"Rehabilitation, Ultra High, ADL Index 4-8/Special payment situation 5-day assessment"					
RUA1A	10/01/11		SNF	"Ultra High Rehab , ADL Index 0-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RUA1B	10/01/11		SNF	"Ultra High Rehab , ADL Index 0-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RUA1C	10/01/11		SNF	"Ultra High Rehab , ADL Index 0-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RUA20	10/01/10		SNF	"Ultra High Rehab , ADL Index 0-5/14-day. "					
RUA21	10/01/10		SNF	"Ultra High Rehab , ADL Index 0-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
RUA22	10/01/10		SNF	"Ultra High Rehab , ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay)."					
RUA23	10/01/10		SNF	"Ultra High Rehab , ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND CCA. "					
RUA24	10/01/10		SNF	"Ultra High Rehab , ADL Index 0-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
RUA25	10/01/10		SNF	"Ultra High Rehab , ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
RUA26	10/01/10		SNF	"Ultra High Rehab , ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RUA28	10/01/00	* 09/30/10	SNF	"Rehabilitation, Ultra High, ADL Index 4-8/OMRA replacing 30-day Medicare assessment"					
RUA29	07/01/02	* 09/30/10	SNF	"Rehabilitation, Ultra High, ADL Index 4-8/Special payment situation 30-day assessment"					
RUA2A	10/01/11		SNF	"Ultra High Rehab , ADL Index 0-5/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RUA2B	10/01/11		SNF	"Ultra High Rehab , ADL Index 0-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RUA2C	10/01/11		SNF	"Ultra High Rehab , ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RUA2D	10/01/11		SNF	"Ultra High Rehab , ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RUA30	07/01/98		SNF	"Ultra High Rehab , ADL Index 0-5/30-day. "					
RUA31	07/01/98		SNF	"Ultra High Rehab , ADL Index 0-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
RUA32	07/01/98		SNF	"Ultra High Rehab , ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay)."					
RUA33	07/01/98		SNF	"Ultra High Rehab , ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND CCA."					
RUA34	07/01/98		SNF	"Ultra High Rehab , ADL Index 0-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
RUA35	07/01/98		SNF	"Ultra High Rehab , ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RUA36	10/01/10		SNF	"Ultra High Rehab , ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
RUA37	07/01/98	* 09/30/10	SNF	"Rehabilitation, Ultra High, ADL Index 4-8/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
RUA38	07/01/98	* 09/30/10	SNF	"Rehabilitation, Ultra High, ADL Index 4-8/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
RUA39	07/01/02	* 09/30/10	SNF	"Rehabilitation, Ultra High, ADL Index 4-8/Special payment situation 60-day assessment"					
RUA3A	10/01/11		SNF	"Ultra High Rehab , ADL Index 0-5/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RUA3B	10/01/11		SNF	"Ultra High Rehab , ADL Index 0-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RUA3C	10/01/11		SNF	"Ultra High Rehab , ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RUA3D	10/01/11		SNF	"Ultra High Rehab , ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RUA40	07/01/98		SNF	"Ultra High Rehab , ADL Index 0-5/60-day. "					
RUA41	07/01/98		SNF	"Ultra High Rehab , ADL Index 0-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
RUA42	07/01/98		SNF	"Ultra High Rehab , ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay)."					
RUA43	07/01/98		SNF	"Ultra High Rehab , ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) AND CCA."					
RUA44	07/01/98		SNF	"Ultra High Rehab , ADL Index 0-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
RUA45	07/01/98		SNF	"Ultra High Rehab , ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RUA46	10/01/10		SNF	"Ultra High Rehab , ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
RUA47	07/01/98	* 09/30/10	SNF	"Rehabilitation, Ultra High, ADL Index 4-8/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
RUA48	10/01/00	* 09/30/10	SNF	"Rehabilitation, Ultra High, ADL Index 4-8/OMRA replacing 90-day Medicare-required assessment"					
RUA49	07/01/02	* 09/30/10	SNF	"Rehabilitation, Ultra High, ADL Index 4-8/Special payment situation 90-day assessment"					
RUA4A	10/01/11		SNF	"Ultra High Rehab , ADL Index 0-5/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RUA4B	10/01/11		SNF	"Ultra High Rehab , ADL Index 0-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RUA4C	10/01/11		SNF	"Ultra High Rehab , ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RUA4D	10/01/11		SNF	"Ultra High Rehab , ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RUA50	10/01/10		SNF	"Ultra High Rehab , ADL Index 0-5/90-day. "					
RUA51	10/01/10		SNF	"Ultra High Rehab , ADL Index 0-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
RUA52	10/01/10		SNF	"Ultra High Rehab , ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay)."					
RUA53	10/01/10		SNF	"Ultra High Rehab , ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND CCA. "					
RUA54	07/01/98		SNF	"Ultra High Rehab , ADL Index 0-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
RUA55	10/01/10		SNF	"Ultra High Rehab , ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RUA56	10/01/10		SNF	"Ultra High Rehab , ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RUA5A	10/01/11		SNF	"Ultra High Rehab , ADL Index 0-5/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RUA5B	10/01/11		SNF	"Ultra High Rehab , ADL Index 0-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RUA5C	10/01/11		SNF	"Ultra High Rehab , ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RUA5D	10/01/11		SNF	"Ultra High Rehab , ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RUA60	10/01/10		SNF	"Ultra High Rehab , ADL Index 0-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following:  SNF notified untimely of MSP denial, or 
 SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
RUA78	10/01/00	* 09/30/10	SNF	"Rehabilitation, Ultra High, ADL Index 4-8/OMRA replacing 14-day Medicare-required assessment"					
RUA79	07/01/02	* 09/30/10	SNF	"Rehabilitation, Ultra High, ADL Index 4-8/Special payment situation 14-day assessment"					
RUA8A	07/01/98		SNF	"Ultra High Rehab , ADL Index 0-5/TRICARE 120-day assessment "					
RUA8B	07/01/98		SNF	"Ultra High Rehab , ADL Index 0-5/TRICARE 150-day assessment "					
RUA8C	07/01/98		SNF	"Ultra High Rehab , ADL Index 0-5/TRICARE 180-day assessment "					
RUA8D	07/01/98		SNF	"Ultra High Rehab , ADL Index 0-5/TRICARE 210-day assessment "					
RUA8E	07/01/98		SNF	"Ultra High Rehab , ADL Index 0-5/TRICARE 240-day assessment "					
RUA8F	07/01/98		SNF	"Ultra High Rehab , ADL Index 0-5/TRICARE 270-day assessment "					
RUA8G	07/01/98		SNF	"Ultra High Rehab , ADL Index 0-5/TRICARE 300-day assessment "					
RUA8H	07/01/98		SNF	"Ultra High Rehab , ADL Index 0-5/TRICARE 330-day assessment "					
RUA8I	07/01/98		SNF	"Ultra High Rehab , ADL Index 0-5/TRICARE 360-day assessment "					
RUA8X	07/01/98		SNF	"Ultra High Rehab , ADL Index 0-5/TRICARE Post 360-day assessments with 30-day interval "					
RUB01	07/01/98		SNF	"Ultra High Rehab , ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA."					
RUB02	07/01/98		SNF	"Ultra High Rehab , ADL Index 6-10/Stand-alone SOT OMRA (not Medicare short stay)."					
RUB03	07/01/98		SNF	"Ultra High Rehab , ADL Index 6-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA."					
RUB04	07/01/98	* 09/30/10	SNF	"Rehabilitation, Ultra High, ADL Index 9-15/Medicare 90 day assessment (Full)"					
RUB05	07/01/98		SNF	"Ultra High Rehab , ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RUB06	10/01/10		SNF	"Ultra High Rehab , ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RUB07	07/01/98		SNF	"Ultra High Rehab , ADL Index 6-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA. "					
RUB08	07/01/98	* 09/30/10	SNF	"Rehabilitation, Ultra High, ADL Index 9-15/Other Medicare Required Assessment (OMRA) "					
RUB0A	10/01/11		SNF	"Ultra High Rehab , ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
RUB0B	10/01/11		SNF	"Ultra High Rehab , ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
RUB0C	10/01/11		SNF	"Ultra High Rehab , ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
RUB0D	10/01/11		SNF	"Ultra High Rehab , ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
RUB10	10/01/10		SNF	"Ultra High Rehab , ADL Index 6-10/5-day or readmission return. "					
RUB11	07/01/98		SNF	"Ultra High Rehab , ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
RUB12	10/01/10		SNF	"Ultra High Rehab , ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
RUB13	10/01/10		SNF	"Ultra High Rehab , ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
RUB14	10/01/10		SNF	"Ultra High Rehab , ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
RUB15	10/01/10		SNF	"Ultra High Rehab , ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RUB16	10/01/10		SNF	"Ultra High Rehab , ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
RUB17	07/01/98		SNF	"Ultra High Rehab , ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
RUB18 	10/01/00	* 09/30/10	SNF	"Rehabilitation, Ultra High, ADL Index 9-15/OMRA replacing 5-day Medicare assessment"					
RUB19	07/01/02	* 09/30/10	SNF	"Rehabilitation, Ultra High, ADL Index 9-15/Special payment situation 5-day assessment"					
RUB1A	10/01/11		SNF	"Ultra High Rehab , ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RUB1B	10/01/11		SNF	"Ultra High Rehab , ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RUB1C	10/01/11		SNF	"Ultra High Rehab , ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RUB20	10/01/10		SNF	"Ultra High Rehab , ADL Index 6-10/14-day. "					
RUB21	10/01/10		SNF	"Ultra High Rehab , ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
RUB22	10/01/10		SNF	"Ultra High Rehab , ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay)."					
RUB23	10/01/10		SNF	"Ultra High Rehab , ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND CCA. "					
RUB24	10/01/10		SNF	"Ultra High Rehab , ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
RUB25	10/01/10		SNF	"Ultra High Rehab , ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
RUB26	10/01/10		SNF	"Ultra High Rehab , ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RUB28	10/01/00	* 09/30/10	SNF	"Rehabilitation, Ultra High, ADL Index 9-15/OMRA replacing 30-day Medicare assessment"					
RUB29	07/01/02	* 09/30/10	SNF	"Rehabilitation, Ultra High, ADL Index 9-15/Special payment situation 30-day assessment"					
RUB2A	10/01/11		SNF	"Ultra High Rehab , ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RUB2B	10/01/11		SNF	"Ultra High Rehab , ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RUB2C	10/01/11		SNF	"Ultra High Rehab , ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RUB2D	10/01/11		SNF	"Ultra High Rehab , ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RUB30	07/01/98		SNF	"Ultra High Rehab , ADL Index 6-10/30-day. "					
RUB31	07/01/98		SNF	"Ultra High Rehab , ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
RUB32	07/01/98		SNF	"Ultra High Rehab , ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay)."					
RUB33	07/01/98		SNF	"Ultra High Rehab , ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND CCA."					
RUB34	07/01/98		SNF	"Ultra High Rehab , ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
RUB35	07/01/98		SNF	"Ultra High Rehab , ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RUB36	10/01/10		SNF	"Ultra High Rehab , ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
RUB37	07/01/98	* 09/30/10	SNF	"Rehabilitation, Ultra High, ADL Index 9-15/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
RUB38	07/01/98	* 09/30/10	SNF	"Rehabilitation, Ultra High, ADL Index 9-15/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
RUB39	07/01/02	* 09/30/10	SNF	"Rehabilitation, Ultra High, ADL Index 9-15/Special payment situation 60-day assessment"					
RUB3A	10/01/11		SNF	"Ultra High Rehab , ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RUB3B	10/01/11		SNF	"Ultra High Rehab , ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RUB3C	10/01/11		SNF	"Ultra High Rehab , ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RUB3D	10/01/11		SNF	"Ultra High Rehab , ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RUB40	07/01/98		SNF	"Ultra High Rehab , ADL Index 6-10/60-day. "					
RUB41	07/01/98		SNF	"Ultra High Rehab , ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
RUB42	07/01/98		SNF	"Ultra High Rehab , ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay)."					
RUB43	07/01/98		SNF	"Ultra High Rehab , ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) AND CCA."					
RUB44	07/01/98		SNF	"Ultra High Rehab , ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
RUB45	07/01/98		SNF	"Ultra High Rehab , ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RUB46	10/01/10		SNF	"Ultra High Rehab , ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
RUB47	07/01/98	* 09/30/10	SNF	"Rehabilitation, Ultra High, ADL Index 9-15/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
RUB48	10/01/00	* 09/30/10	SNF	"Rehabilitation, Ultra High, ADL Index 9-15/OMRA replacing 90-day Medicare-required assessment"					
RUB49	07/01/02	* 09/30/10	SNF	"Rehabilitation, Ultra High, ADL Index 9-15/Special payment situation 90-day assessment"					
RUB4A	10/01/11		SNF	"Ultra High Rehab , ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RUB4B	10/01/11		SNF	"Ultra High Rehab , ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RUB4C	10/01/11		SNF	"Ultra High Rehab , ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RUB4D	10/01/11		SNF	"Ultra High Rehab , ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RUB50	10/01/10		SNF	"Ultra High Rehab , ADL Index 6-10/90-day. "					
RUB51	10/01/10		SNF	"Ultra High Rehab , ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
RUB52	10/01/10		SNF	"Ultra High Rehab , ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay)."					
RUB53	10/01/10		SNF	"Ultra High Rehab , ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND CCA. "					
RUB54	07/01/98		SNF	"Ultra High Rehab , ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
RUB55	10/01/10		SNF	"Ultra High Rehab , ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RUB56	10/01/10		SNF	"Ultra High Rehab , ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RUB5A	10/01/11		SNF	"Ultra High Rehab , ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RUB5B	10/01/11		SNF	"Ultra High Rehab , ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RUB5C	10/01/11		SNF	"Ultra High Rehab , ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RUB5D	10/01/11		SNF	"Ultra High Rehab , ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RUB60	10/01/10		SNF	"Ultra High Rehab , ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following:  SNF notified untimely of MSP denial, or 
 SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
RUB78	10/01/00	* 09/30/10	SNF	"Rehabilitation, Ultra High, ADL Index 9-15/OMRA replacing 14-day Medicare-required assessment"					
RUB79	07/01/02	* 09/30/10	SNF	"Rehabilitation, Ultra High, ADL Index 9-15/Special payment situation 14-day assessment"					
RUB8A	07/01/98		SNF	"Ultra High Rehab , ADL Index 6-10/TRICARE 120-day assessment "					
RUB8B	07/01/98		SNF	"Ultra High Rehab , ADL Index 6-10/TRICARE 150-day assessment "					
RUB8C	07/01/98		SNF	"Ultra High Rehab , ADL Index 6-10/TRICARE 180-day assessment "					
RUB8D	07/01/98		SNF	"Ultra High Rehab , ADL Index 6-10/TRICARE 210-day assessment "					
RUB8E	07/01/98		SNF	"Ultra High Rehab , ADL Index 6-10/TRICARE 240-day assessment "					
RUB8F	07/01/98		SNF	"Ultra High Rehab , ADL Index 6-10/TRICARE 270-day assessment "					
RUB8G	07/01/98		SNF	"Ultra High Rehab , ADL Index 6-10/TRICARE 300-day assessment "					
RUB8H	07/01/98		SNF	"Ultra High Rehab , ADL Index 6-10/TRICARE 330-day assessment "					
RUB8I	07/01/98		SNF	"Ultra High Rehab , ADL Index 6-10/TRICARE 360-day assessment "					
RUB8X	07/01/98		SNF	"Ultra High Rehab , ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval "					
RUC01	07/01/98		SNF	"Ultra High Rehab , ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA."					
RUC02	07/01/98		SNF	"Ultra High Rehab , ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay)."					
RUC03	07/01/98		SNF	"Ultra High Rehab , ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA."					
RUC04	07/01/98	* 09/30/10	SNF	"Rehabilitation, Ultra High, ADL Index 16-18/Medicare 90 day assessment (Full)"					
RUC05	07/01/98		SNF	"Ultra High Rehab , ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RUC06	10/01/10		SNF	"Ultra High Rehab , ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RUC07	07/01/98		SNF	"Ultra High Rehab , ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA. "					
RUC08	07/01/98	* 09/30/10	SNF	"Rehabilitation, Ultra High, ADL Index 16-18/Other Medicare Required Assessment (OMRA) "					
RUC0A	10/01/11		SNF	"Ultra High Rehab , ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
RUC0B	10/01/11		SNF	"Ultra High Rehab , ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
RUC0C	10/01/11		SNF	"Ultra High Rehab , ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
RUC0D	10/01/11		SNF	"Ultra High Rehab , ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
RUC10	10/01/10		SNF	"Ultra High Rehab , ADL Index 11-16/5-day or readmission return. "					
RUC11	07/01/98		SNF	"Ultra High Rehab , ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
RUC12	10/01/10		SNF	"Ultra High Rehab , ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
RUC13	10/01/10		SNF	"Ultra High Rehab , ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
RUC14	10/01/10		SNF	"Ultra High Rehab , ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
RUC15	10/01/10		SNF	"Ultra High Rehab , ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RUC16	10/01/10		SNF	"Ultra High Rehab , ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
RUC17	07/01/98		SNF	"Ultra High Rehab , ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
RUC18 	10/01/00	* 09/30/10	SNF	"Rehabilitation, Ultra High, ADL Index 16-18/OMRA replacing 5-day Medicare assessment"					
RUC19	07/01/02	* 09/30/10	SNF	"Rehabilitation, Ultra High, ADL Index 16-18/Special payment situation 5-day assessment"					
RUC1A	10/01/11		SNF	"Ultra High Rehab , ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RUC1B	10/01/11		SNF	"Ultra High Rehab , ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RUC1C	10/01/11		SNF	"Ultra High Rehab , ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RUC20	10/01/10		SNF	"Ultra High Rehab , ADL Index 11-16/14-day. "					
RUC21	10/01/10		SNF	"Ultra High Rehab , ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
RUC22	10/01/10		SNF	"Ultra High Rehab , ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay)."					
RUC23	10/01/10		SNF	"Ultra High Rehab , ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND CCA. "					
RUC24	10/01/10		SNF	"Ultra High Rehab , ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
RUC25	10/01/10		SNF	"Ultra High Rehab , ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
RUC26	10/01/10		SNF	"Ultra High Rehab , ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RUC28	10/01/00	* 09/30/10	SNF	"Rehabilitation, Ultra High, ADL Index 16-18/OMRA replacing 30-day Medicare assessment"					
RUC29	07/01/02	* 09/30/10	SNF	"Rehabilitation, Ultra High, ADL Index 16-18/Special payment situation 30-day assessment"					
RUC2A	10/01/11		SNF	"Ultra High Rehab , ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RUC2B	10/01/11		SNF	"Ultra High Rehab , ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RUC2C	10/01/11		SNF	"Ultra High Rehab , ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RUC2D	10/01/11		SNF	"Ultra High Rehab , ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RUC30	07/01/98		SNF	"Ultra High Rehab , ADL Index 11-16/30-day. "					
RUC31	07/01/98		SNF	"Ultra High Rehab , ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
RUC32	07/01/98		SNF	"Ultra High Rehab , ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay)."					
RUC33	07/01/98		SNF	"Ultra High Rehab , ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND CCA."					
RUC34	07/01/98		SNF	"Ultra High Rehab , ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
RUC35	07/01/98		SNF	"Ultra High Rehab , ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RUC36	10/01/10		SNF	"Ultra High Rehab , ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
RUC37	07/01/98	* 09/30/10	SNF	"Rehabilitation, Ultra High, ADL Index 16-18/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
RUC38	07/01/98	* 09/30/10	SNF	"Rehabilitation, Ultra High, ADL Index 16-18/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
RUC39	07/01/02	* 09/30/10	SNF	"Rehabilitation, Ultra High, ADL Index 16-18/Special payment situation 60-day assessment"					
RUC3A	10/01/11		SNF	"Ultra High Rehab , ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RUC3B	10/01/11		SNF	"Ultra High Rehab , ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RUC3C	10/01/11		SNF	"Ultra High Rehab , ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RUC3D	10/01/11		SNF	"Ultra High Rehab , ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RUC40	07/01/98		SNF	"Ultra High Rehab , ADL Index 11-16/60-day. "					
RUC41	07/01/98		SNF	"Ultra High Rehab , ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
RUC42	07/01/98		SNF	"Ultra High Rehab , ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay)."					
RUC43	07/01/98		SNF	"Ultra High Rehab , ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) AND CCA."					
RUC44	07/01/98		SNF	"Ultra High Rehab , ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
RUC45	07/01/98		SNF	"Ultra High Rehab , ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RUC46	10/01/10		SNF	"Ultra High Rehab , ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
RUC47	07/01/98	* 09/30/10	SNF	"Rehabilitation, Ultra High, ADL Index 16-18/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
RUC48	10/01/00	* 09/30/10	SNF	"Rehabilitation, Ultra High, ADL Index 16-18/OMRA replacing 90-day Medicare-required assessment"					
RUC49	07/01/02	* 09/30/10	SNF	"Rehabilitation, Ultra High, ADL Index 16-18/Special payment situation 90-day assessment"					
RUC4A	10/01/11		SNF	"Ultra High Rehab , ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RUC4B	10/01/11		SNF	"Ultra High Rehab , ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RUC4C	10/01/11		SNF	"Ultra High Rehab , ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RUC4D	10/01/11		SNF	"Ultra High Rehab , ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RUC50	10/01/10		SNF	"Ultra High Rehab , ADL Index 11-16/90-day. "					
RUC51	10/01/10		SNF	"Ultra High Rehab , ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
RUC52	10/01/10		SNF	"Ultra High Rehab , ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay)."					
RUC53	10/01/10		SNF	"Ultra High Rehab , ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND CCA. "					
RUC54	07/01/98		SNF	"Ultra High Rehab , ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
RUC55	10/01/10		SNF	"Ultra High Rehab , ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RUC56	10/01/10		SNF	"Ultra High Rehab , ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RUC5A	10/01/11		SNF	"Ultra High Rehab , ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RUC5B	10/01/11		SNF	"Ultra High Rehab , ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RUC5C	10/01/11		SNF	"Ultra High Rehab , ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RUC5D	10/01/11		SNF	"Ultra High Rehab , ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RUC60	10/01/10		SNF	"Ultra High Rehab , ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following:  SNF notified untimely of MSP denial, or 
 SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
RUC78	10/01/00	* 09/30/10	SNF	"Rehabilitation, Ultra High, ADL Index 16-18/OMRA replacing 14-day Medicare-required assessment"					
RUC79	07/01/02	* 09/30/10	SNF	"Rehabilitation, Ultra High, ADL Index 16-18/Special payment situation 14-day assessment"					
RUC8A	07/01/98		SNF	"Ultra High Rehab , ADL Index 11-16/TRICARE 120-day assessment "					
RUC8B	07/01/98		SNF	"Ultra High Rehab , ADL Index 11-16/TRICARE 150-day assessment "					
RUC8C	07/01/98		SNF	"Ultra High Rehab , ADL Index 11-16/TRICARE 180-day assessment "					
RUC8D	07/01/98		SNF	"Ultra High Rehab , ADL Index 11-16/TRICARE 210-day assessment "					
RUC8E	07/01/98		SNF	"Ultra High Rehab , ADL Index 11-16/TRICARE 240-day assessment "					
RUC8F	07/01/98		SNF	"Ultra High Rehab , ADL Index 11-16/TRICARE 270-day assessment "					
RUC8G	07/01/98		SNF	"Ultra High Rehab , ADL Index 11-16/TRICARE 300-day assessment "					
RUC8H	07/01/98		SNF	"Ultra High Rehab , ADL Index 11-16/TRICARE 330-day assessment "					
RUC8I	07/01/98		SNF	"Ultra High Rehab , ADL Index 11-16/TRICARE 360-day assessment "					
RUC8X	07/01/98		SNF	"Ultra High Rehab , ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval "					
RUL01	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/Stand-alone OBRA SCSA OR SCPA OR CCA."					
RUL02	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/Stand-alone SOT OMRA (not Medicare short stay)."					
RUL03	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA."					
RUL04	01/01/06	* 09/30/10	SNF	"Rehabilitation, Ultra High, plus Extensive Services, Low, ADL Index 7-15/Medicare 90 day assessment (Full)"					
RUL05	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RUL06	10/01/10		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RUL07	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA. "					
RUL08	01/01/06	* 09/30/10	SNF	"Rehabilitation, Ultra High, plus Extensive Services, Low, ADL Index 7-15/Other Medicare Required Assessment (OMRA) "					
RUL0A	10/01/11		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
RUL0B	10/01/11		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
RUL0C	10/01/11		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
RUL0D	10/01/11		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
RUL10	10/01/10		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/5-day or readmission return. "					
RUL11	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
RUL12	10/01/10		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
RUL13	10/01/10		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
RUL14	10/01/10		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
RUL15	10/01/10		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RUL16	10/01/10		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
RUL17	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
RUL18 	01/01/06	* 09/30/10	SNF	"Rehabilitation, Ultra High, plus Extensive Services, Low, ADL Index 7-15/OMRA replacing 5-day Medicare assessment"					
RUL19	01/01/06	* 09/30/10	SNF	"Rehabilitation, Ultra High, plus Extensive Services, Low, ADL Index 7-15/Special payment situation 5-day assessment"					
RUL1A	10/01/11		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RUL1B	10/01/11		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RUL1C	10/01/11		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RUL20	10/01/10		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/14-day. "					
RUL21	10/01/10		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
RUL22	10/01/10		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay)."					
RUL23	10/01/10		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND CCA. "					
RUL24	10/01/10		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
RUL25	10/01/10		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
RUL26	10/01/10		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RUL28	01/01/06	* 09/30/10	SNF	"Rehabilitation, Ultra High, plus Extensive Services, Low, ADL Index 7-15/OMRA replacing 30-day Medicare assessment"					
RUL29	01/01/06	* 09/30/10	SNF	"Rehabilitation, Ultra High, plus Extensive Services, Low, ADL Index 7-15/Special payment situation 30-day assessment"					
RUL2A	10/01/11		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RUL2B	10/01/11		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RUL2C	10/01/11		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RUL2D	10/01/11		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RUL30	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/30-day. "					
RUL31	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
RUL32	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay)."					
RUL33	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND CCA."					
RUL34	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
RUL35	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RUL36	10/01/10		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
RUL37	01/01/06	* 09/30/10	SNF	"Rehabilitation, Ultra High, plus Extensive Services, Low, ADL Index 7-15/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
RUL38	01/01/06	* 09/30/10	SNF	"Rehabilitation, Ultra High, plus Extensive Services, Low, ADL Index 7-15/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
RUL39	01/01/06	* 09/30/10	SNF	"Rehabilitation, Ultra High, plus Extensive Services, Low, ADL Index 7-15/Special payment situation 60-day assessment"					
RUL3A	10/01/11		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RUL3B	10/01/11		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RUL3C	10/01/11		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RUL3D	10/01/11		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RUL40	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/60-day. "					
RUL41	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
RUL42	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay)."					
RUL43	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) AND CCA."					
RUL44	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
RUL45	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RUL46	10/01/10		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
RUL47	01/01/06	* 09/30/10	SNF	"Rehabilitation, Ultra High, plus Extensive Services, Low, ADL Index 7-15/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
RUL48	01/01/06	* 09/30/10	SNF	"Rehabilitation, Ultra High, plus Extensive Services, Low, ADL Index 7-15/OMRA replacing 90-day Medicare-required assessment"					
RUL49	01/01/06	* 09/30/10	SNF	"Rehabilitation, Ultra High, plus Extensive Services, Low, ADL Index 7-15/Special payment situation 90-day assessment"					
RUL4A	10/01/11		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RUL4B	10/01/11		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RUL4C	10/01/11		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RUL4D	10/01/11		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RUL50	10/01/10		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/90-day. "					
RUL51	10/01/10		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
RUL52	10/01/10		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay)."					
RUL53	10/01/10		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND CCA. "					
RUL54	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
RUL55	10/01/10		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RUL56	10/01/10		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RUL5A	10/01/11		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RUL5B	10/01/11		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RUL5C	10/01/11		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RUL5D	10/01/11		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RUL60	10/01/10		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following:  SNF notified untimely of MSP denial, or 
 SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
RUL78	01/01/06	* 09/30/10	SNF	"Rehabilitation, Ultra High, plus Extensive Services, Low, ADL Index 7-15/OMRA replacing 14-day Medicare-required assessment"					
RUL79	01/01/06	* 09/30/10	SNF	"Rehabilitation, Ultra High, plus Extensive Services, Low, ADL Index 7-15/Special payment situation 14-day assessment"					
RUL8A	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/TRICARE 120-day assessment "					
RUL8B	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/TRICARE 150-day assessment "					
RUL8C	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/TRICARE 180-day assessment "					
RUL8D	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/TRICARE 210-day assessment "					
RUL8E	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/TRICARE 240-day assessment "					
RUL8F	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/TRICARE 270-day assessment "					
RUL8G	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/TRICARE 300-day assessment "					
RUL8H	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/TRICARE 330-day assessment "					
RUL8I	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/TRICARE 360-day assessment "					
RUL8X	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 2-10/TRICARE Post 360-day assessments with 30-day interval "					
RUX01	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA."					
RUX02	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay)."					
RUX03	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA."					
RUX04	01/01/06	* 09/30/10	SNF	"Rehabilitation, Ultra High, plus Extensive Services, High, ADL Index 16-18/Medicare 90 day assessment (Full)"					
RUX05	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RUX06	10/01/10		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RUX07	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA. "					
RUX08	01/01/06	* 09/30/10	SNF	"Rehabilitation, Ultra High, plus Extensive Services, High, ADL Index 16-18/Other Medicare Required Assessment (OMRA) "					
RUX0A	10/01/11		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
RUX0B	10/01/11		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
RUX0C	10/01/11		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
RUX0D	10/01/11		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
RUX10	10/01/10		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/5-day or readmission return. "					
RUX11	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
RUX12	10/01/10		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
RUX13	10/01/10		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
RUX14	10/01/10		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
RUX15	10/01/10		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RUX16	10/01/10		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
RUX17	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
RUX18 	01/01/06	* 09/30/10	SNF	"Rehabilitation, Ultra High, plus Extensive Services, High, ADL Index 16-18/OMRA replacing 5-day Medicare assessment"					
RUX19	01/01/06	* 09/30/10	SNF	"Rehabilitation, Ultra High, plus Extensive Services, High, ADL Index 16-18/Special payment situation 5-day assessment"					
RUX1A	10/01/11		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RUX1B	10/01/11		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RUX1C	10/01/11		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RUX20	10/01/10		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/14-day. "					
RUX21	10/01/10		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
RUX22	10/01/10		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay)."					
RUX23	10/01/10		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND CCA. "					
RUX24	10/01/10		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
RUX25	10/01/10		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
RUX26	10/01/10		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RUX28	01/01/06	* 09/30/10	SNF	"Rehabilitation, Ultra High, plus Extensive Services, High, ADL Index 16-18/OMRA replacing 30-day Medicare assessment"					
RUX29	01/01/06	* 09/30/10	SNF	"Rehabilitation, Ultra High, plus Extensive Services, High, ADL Index 16-18/Special payment situation 30-day assessment"					
RUX2A	10/01/11		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RUX2B	10/01/11		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RUX2C	10/01/11		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RUX2D	10/01/11		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RUX30	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/30-day. "					
RUX31	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
RUX32	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay)."					
RUX33	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND CCA."					
RUX34	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
RUX35	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RUX36	10/01/10		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
RUX37	01/01/06	* 09/30/10	SNF	"Rehabilitation, Ultra High, plus Extensive Services, High, ADL Index 16-18/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
RUX38	01/01/06	* 09/30/10	SNF	"Rehabilitation, Ultra High, plus Extensive Services, High, ADL Index 16-18/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
RUX39	01/01/06	* 09/30/10	SNF	"Rehabilitation, Ultra High, plus Extensive Services, High, ADL Index 16-18/Special payment situation 60-day assessment"					
RUX3A	10/01/11		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RUX3B	10/01/11		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RUX3C	10/01/11		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RUX3D	10/01/11		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RUX40	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/60-day. "					
RUX41	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
RUX42	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay)."					
RUX43	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) AND CCA."					
RUX44	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
RUX45	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RUX46	10/01/10		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
RUX47	01/01/06	* 09/30/10	SNF	"Rehabilitation, Ultra High, plus Extensive Services, High, ADL Index 16-18/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
RUX48	01/01/06	* 09/30/10	SNF	"Rehabilitation, Ultra High, plus Extensive Services, High, ADL Index 16-18/OMRA replacing 90-day Medicare-required assessment"					
RUX49	01/01/06	* 09/30/10	SNF	"Rehabilitation, Ultra High, plus Extensive Services, High, ADL Index 16-18/Special payment situation 90-day assessment"					
RUX4A	10/01/11		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RUX4B	10/01/11		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RUX4C	10/01/11		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RUX4D	10/01/11		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RUX50	10/01/10		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/90-day. "					
RUX51	10/01/10		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
RUX52	10/01/10		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay)."					
RUX53	10/01/10		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND CCA. "					
RUX54	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
RUX55	10/01/10		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RUX56	10/01/10		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RUX5A	10/01/11		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RUX5B	10/01/11		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RUX5C	10/01/11		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RUX5D	10/01/11		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RUX60	10/01/10		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following:  SNF notified untimely of MSP denial, or 
 SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
RUX78	01/01/06	* 09/30/10	SNF	"Rehabilitation, Ultra High, plus Extensive Services, High, ADL Index 16-18/OMRA replacing 14-day Medicare-required assessment"					
RUX79	01/01/06	* 09/30/10	SNF	"Rehabilitation, Ultra High, plus Extensive Services, High, ADL Index 16-18/Special payment situation 14-day assessment"					
RUX8A	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/TRICARE 120-day assessment "					
RUX8B	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/TRICARE 150-day assessment "					
RUX8C	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/TRICARE 180-day assessment "					
RUX8D	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/TRICARE 210-day assessment "					
RUX8E	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/TRICARE 240-day assessment "					
RUX8F	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/TRICARE 270-day assessment "					
RUX8G	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/TRICARE 300-day assessment "					
RUX8H	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/TRICARE 330-day assessment "					
RUX8I	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/TRICARE 360-day assessment "					
RUX8X	07/01/98		SNF	"Ultra High Rehab plus Extensive , ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval "					
RVA01	07/01/98		SNF	"Very High Rehab , ADL Index 0-5/Stand-alone OBRA SCSA OR SCPA OR CCA."					
RVA02	07/01/98		SNF	"Very High Rehab , ADL Index 0-5/Stand-alone SOT OMRA (not Medicare short stay)."					
RVA03	07/01/98		SNF	"Very High Rehab , ADL Index 0-5/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA."					
RVA04	07/01/98	* 09/30/10	SNF	"Rehabilitation, Very High, ADL Index 4-8/Medicare 90 day assessment (Full)"					
RVA05	07/01/98		SNF	"Very High Rehab , ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RVA06	10/01/10		SNF	"Very High Rehab , ADL Index 0-5/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RVA07	07/01/98		SNF	"Very High Rehab , ADL Index 0-5/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA. "					
RVA08	07/01/98	* 09/30/10	SNF	"Rehabilitation, Very High, ADL Index 4-8/Other Medicare Required Assessment (OMRA) "					
RVA0A	10/01/11		SNF	"Very High Rehab , ADL Index 0-5/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
RVA0B	10/01/11		SNF	"Very High Rehab , ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
RVA0C	10/01/11		SNF	"Very High Rehab , ADL Index 0-5/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
RVA0D	10/01/11		SNF	"Very High Rehab , ADL Index 0-5/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
RVA10	10/01/10		SNF	"Very High Rehab , ADL Index 0-5/5-day or readmission return. "					
RVA11	07/01/98		SNF	"Very High Rehab , ADL Index 0-5/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
RVA12	10/01/10		SNF	"Very High Rehab , ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
RVA13	10/01/10		SNF	"Very High Rehab , ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
RVA14	10/01/10		SNF	"Very High Rehab , ADL Index 0-5/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
RVA15	10/01/10		SNF	"Very High Rehab , ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RVA16	10/01/10		SNF	"Very High Rehab , ADL Index 0-5/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
RVA17	07/01/98		SNF	"Very High Rehab , ADL Index 0-5/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
RVA18 	10/01/00	* 09/30/10	SNF	"Rehabilitation, Very High, ADL Index 4-8/OMRA replacing 5-day Medicare assessment"					
RVA19	07/01/02	* 09/30/10	SNF	"Rehabilitation, Very High, ADL Index 4-8/Special payment situation 5-day assessment"					
RVA1A	10/01/11		SNF	"Very High Rehab , ADL Index 0-5/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RVA1B	10/01/11		SNF	"Very High Rehab , ADL Index 0-5/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RVA1C	10/01/11		SNF	"Very High Rehab , ADL Index 0-5/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RVA20	10/01/10		SNF	"Very High Rehab , ADL Index 0-5/14-day. "					
RVA21	10/01/10		SNF	"Very High Rehab , ADL Index 0-5/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
RVA22	10/01/10		SNF	"Very High Rehab , ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay)."					
RVA23	10/01/10		SNF	"Very High Rehab , ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND CCA. "					
RVA24	10/01/10		SNF	"Very High Rehab , ADL Index 0-5/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
RVA25	10/01/10		SNF	"Very High Rehab , ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
RVA26	10/01/10		SNF	"Very High Rehab , ADL Index 0-5/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RVA28	10/01/00	* 09/30/10	SNF	"Rehabilitation, Very High, ADL Index 4-8/OMRA replacing 30-day Medicare assessment"					
RVA29	07/01/02	* 09/30/10	SNF	"Rehabilitation, Very High, ADL Index 4-8/Special payment situation 30-day assessment"					
RVA2A	10/01/11		SNF	"Very High Rehab , ADL Index 0-5/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RVA2B	10/01/11		SNF	"Very High Rehab , ADL Index 0-5/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RVA2C	10/01/11		SNF	"Very High Rehab , ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RVA2D	10/01/11		SNF	"Very High Rehab , ADL Index 0-5/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RVA30	07/01/98		SNF	"Very High Rehab , ADL Index 0-5/30-day. "					
RVA31	07/01/98		SNF	"Very High Rehab , ADL Index 0-5/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
RVA32	07/01/98		SNF	"Very High Rehab , ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay)."					
RVA33	07/01/98		SNF	"Very High Rehab , ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND CCA."					
RVA34	07/01/98		SNF	"Very High Rehab , ADL Index 0-5/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
RVA35	07/01/98		SNF	"Very High Rehab , ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RVA36	10/01/10		SNF	"Very High Rehab , ADL Index 0-5/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
RVA37	07/01/98	* 09/30/10	SNF	"Rehabilitation, Very High, ADL Index 4-8/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
RVA38	07/01/98	* 09/30/10	SNF	"Rehabilitation, Very High, ADL Index 4-8/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
RVA39	07/01/02	* 09/30/10	SNF	"Rehabilitation, Very High, ADL Index 4-8/Special payment situation 60-day assessment"					
RVA3A	10/01/11		SNF	"Very High Rehab , ADL Index 0-5/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RVA3B	10/01/11		SNF	"Very High Rehab , ADL Index 0-5/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RVA3C	10/01/11		SNF	"Very High Rehab , ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RVA3D	10/01/11		SNF	"Very High Rehab , ADL Index 0-5/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RVA40	07/01/98		SNF	"Very High Rehab , ADL Index 0-5/60-day. "					
RVA41	07/01/98		SNF	"Very High Rehab , ADL Index 0-5/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
RVA42	07/01/98		SNF	"Very High Rehab , ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay)."					
RVA43	07/01/98		SNF	"Very High Rehab , ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) AND CCA."					
RVA44	07/01/98		SNF	"Very High Rehab , ADL Index 0-5/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
RVA45	07/01/98		SNF	"Very High Rehab , ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RVA46	10/01/10		SNF	"Very High Rehab , ADL Index 0-5/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
RVA47	07/01/98	* 09/30/10	SNF	"Rehabilitation, Very High, ADL Index 4-8/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
RVA48	10/01/00	* 09/30/10	SNF	"Rehabilitation, Very High, ADL Index 4-8/OMRA replacing 90-day Medicare-required assessment"					
RVA49	07/01/02	* 09/30/10	SNF	"Rehabilitation, Very High, ADL Index 4-8/Special payment situation 90-day assessment"					
RVA4A	10/01/11		SNF	"Very High Rehab , ADL Index 0-5/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RVA4B	10/01/11		SNF	"Very High Rehab , ADL Index 0-5/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RVA4C	10/01/11		SNF	"Very High Rehab , ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RVA4D	10/01/11		SNF	"Very High Rehab , ADL Index 0-5/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RVA50	10/01/10		SNF	"Very High Rehab , ADL Index 0-5/90-day. "					
RVA51	10/01/10		SNF	"Very High Rehab , ADL Index 0-5/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
RVA52	10/01/10		SNF	"Very High Rehab , ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay)."					
RVA53	10/01/10		SNF	"Very High Rehab , ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND CCA. "					
RVA54	07/01/98		SNF	"Very High Rehab , ADL Index 0-5/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
RVA55	10/01/10		SNF	"Very High Rehab , ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RVA56	10/01/10		SNF	"Very High Rehab , ADL Index 0-5/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RVA5A	10/01/11		SNF	"Very High Rehab , ADL Index 0-5/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RVA5B	10/01/11		SNF	"Very High Rehab , ADL Index 0-5/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RVA5C	10/01/11		SNF	"Very High Rehab , ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RVA5D	10/01/11		SNF	"Very High Rehab , ADL Index 0-5/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RVA60	10/01/10		SNF	"Very High Rehab , ADL Index 0-5/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following:  SNF notified untimely of MSP denial, or 
 SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
RVA78	10/01/00	* 09/30/10	SNF	"Rehabilitation, Very High, ADL Index 4-8/OMRA replacing 14-day Medicare-required assessment"					
RVA79	07/01/02	* 09/30/10	SNF	"Rehabilitation, Very High, ADL Index 4-8/Special payment situation 14-day assessment"					
RVA8A	07/01/98		SNF	"Very High Rehab , ADL Index 0-5/TRICARE 120-day assessment "					
RVA8B	07/01/98		SNF	"Very High Rehab , ADL Index 0-5/TRICARE 150-day assessment "					
RVA8C	07/01/98		SNF	"Very High Rehab , ADL Index 0-5/TRICARE 180-day assessment "					
RVA8D	07/01/98		SNF	"Very High Rehab , ADL Index 0-5/TRICARE 210-day assessment "					
RVA8E	07/01/98		SNF	"Very High Rehab , ADL Index 0-5/TRICARE 240-day assessment "					
RVA8F	07/01/98		SNF	"Very High Rehab , ADL Index 0-5/TRICARE 270-day assessment "					
RVA8G	07/01/98		SNF	"Very High Rehab , ADL Index 0-5/TRICARE 300-day assessment "					
RVA8H	07/01/98		SNF	"Very High Rehab , ADL Index 0-5/TRICARE 330-day assessment "					
RVA8I	07/01/98		SNF	"Very High Rehab , ADL Index 0-5/TRICARE 360-day assessment "					
RVA8X	07/01/98		SNF	"Very High Rehab , ADL Index 0-5/TRICARE Post 360-day assessments with 30-day interval "					
RVB01	07/01/98		SNF	"Very High Rehab , ADL Index 6-10/Stand-alone OBRA SCSA OR SCPA OR CCA."					
RVB02	07/01/98		SNF	"Very High Rehab , ADL Index 6-10/Stand-alone SOT OMRA (not Medicare short stay)."					
RVB03	07/01/98		SNF	"Very High Rehab , ADL Index 6-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA."					
RVB04	07/01/98	* 09/30/10	SNF	"Rehabilitation, Very High, ADL Index 9-15/Medicare 90 day assessment (Full)"					
RVB05	07/01/98		SNF	"Very High Rehab , ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RVB06	10/01/10		SNF	"Very High Rehab , ADL Index 6-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RVB07	07/01/98		SNF	"Very High Rehab , ADL Index 6-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA. "					
RVB08	07/01/98	* 09/30/10	SNF	"Rehabilitation, Very High, ADL Index 9-15/Other Medicare Required Assessment (OMRA) "					
RVB0A	10/01/11		SNF	"Very High Rehab , ADL Index 6-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
RVB0B	10/01/11		SNF	"Very High Rehab , ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
RVB0C	10/01/11		SNF	"Very High Rehab , ADL Index 6-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
RVB0D	10/01/11		SNF	"Very High Rehab , ADL Index 6-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
RVB10	10/01/10		SNF	"Very High Rehab , ADL Index 6-10/5-day or readmission return. "					
RVB11	07/01/98		SNF	"Very High Rehab , ADL Index 6-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
RVB12	10/01/10		SNF	"Very High Rehab , ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
RVB13	10/01/10		SNF	"Very High Rehab , ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
RVB14	10/01/10		SNF	"Very High Rehab , ADL Index 6-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
RVB15	10/01/10		SNF	"Very High Rehab , ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RVB16	10/01/10		SNF	"Very High Rehab , ADL Index 6-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
RVB17	07/01/98		SNF	"Very High Rehab , ADL Index 6-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
RVB18 	10/01/00	* 09/30/10	SNF	"Rehabilitation, Very High, ADL Index 9-15/OMRA replacing 5-day Medicare assessment"					
RVB19	07/01/02	* 09/30/10	SNF	"Rehabilitation, Very High, ADL Index 9-15/Special payment situation 5-day assessment"					
RVB1A	10/01/11		SNF	"Very High Rehab , ADL Index 6-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RVB1B	10/01/11		SNF	"Very High Rehab , ADL Index 6-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RVB1C	10/01/11		SNF	"Very High Rehab , ADL Index 6-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RVB20	10/01/10		SNF	"Very High Rehab , ADL Index 6-10/14-day. "					
RVB21	10/01/10		SNF	"Very High Rehab , ADL Index 6-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
RVB22	10/01/10		SNF	"Very High Rehab , ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay)."					
RVB23	10/01/10		SNF	"Very High Rehab , ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND CCA. "					
RVB24	10/01/10		SNF	"Very High Rehab , ADL Index 6-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
RVB25	10/01/10		SNF	"Very High Rehab , ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
RVB26	10/01/10		SNF	"Very High Rehab , ADL Index 6-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RVB28	10/01/00	* 09/30/10	SNF	"Rehabilitation, Very High, ADL Index 9-15/OMRA replacing 30-day Medicare assessment"					
RVB29	07/01/02	* 09/30/10	SNF	"Rehabilitation, Very High, ADL Index 9-15/Special payment situation 30-day assessment"					
RVB2A	10/01/11		SNF	"Very High Rehab , ADL Index 6-10/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RVB2B	10/01/11		SNF	"Very High Rehab , ADL Index 6-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RVB2C	10/01/11		SNF	"Very High Rehab , ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RVB2D	10/01/11		SNF	"Very High Rehab , ADL Index 6-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RVB30	07/01/98		SNF	"Very High Rehab , ADL Index 6-10/30-day. "					
RVB31	07/01/98		SNF	"Very High Rehab , ADL Index 6-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
RVB32	07/01/98		SNF	"Very High Rehab , ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay)."					
RVB33	07/01/98		SNF	"Very High Rehab , ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND CCA."					
RVB34	07/01/98		SNF	"Very High Rehab , ADL Index 6-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
RVB35	07/01/98		SNF	"Very High Rehab , ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RVB36	10/01/10		SNF	"Very High Rehab , ADL Index 6-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
RVB37	07/01/98	* 09/30/10	SNF	"Rehabilitation, Very High, ADL Index 9-15/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
RVB38	07/01/98	* 09/30/10	SNF	"Rehabilitation, Very High, ADL Index 9-15/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
RVB39	07/01/02	* 09/30/10	SNF	"Rehabilitation, Very High, ADL Index 9-15/Special payment situation 60-day assessment"					
RVB3A	10/01/11		SNF	"Very High Rehab , ADL Index 6-10/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RVB3B	10/01/11		SNF	"Very High Rehab , ADL Index 6-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RVB3C	10/01/11		SNF	"Very High Rehab , ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RVB3D	10/01/11		SNF	"Very High Rehab , ADL Index 6-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RVB40	07/01/98		SNF	"Very High Rehab , ADL Index 6-10/60-day. "					
RVB41	07/01/98		SNF	"Very High Rehab , ADL Index 6-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
RVB42	07/01/98		SNF	"Very High Rehab , ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay)."					
RVB43	07/01/98		SNF	"Very High Rehab , ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) AND CCA."					
RVB44	07/01/98		SNF	"Very High Rehab , ADL Index 6-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
RVB45	07/01/98		SNF	"Very High Rehab , ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RVB46	10/01/10		SNF	"Very High Rehab , ADL Index 6-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
RVB47	07/01/98	* 09/30/10	SNF	"Rehabilitation, Very High, ADL Index 9-15/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
RVB48	10/01/00	* 09/30/10	SNF	"Rehabilitation, Very High, ADL Index 9-15/OMRA replacing 90-day Medicare-required assessment"					
RVB49	07/01/02	* 09/30/10	SNF	"Rehabilitation, Very High, ADL Index 9-15/Special payment situation 90-day assessment"					
RVB4A	10/01/11		SNF	"Very High Rehab , ADL Index 6-10/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RVB4B	10/01/11		SNF	"Very High Rehab , ADL Index 6-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RVB4C	10/01/11		SNF	"Very High Rehab , ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RVB4D	10/01/11		SNF	"Very High Rehab , ADL Index 6-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RVB50	10/01/10		SNF	"Very High Rehab , ADL Index 6-10/90-day. "					
RVB51	10/01/10		SNF	"Very High Rehab , ADL Index 6-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
RVB52	10/01/10		SNF	"Very High Rehab , ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay)."					
RVB53	10/01/10		SNF	"Very High Rehab , ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND CCA. "					
RVB54	07/01/98		SNF	"Very High Rehab , ADL Index 6-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
RVB55	10/01/10		SNF	"Very High Rehab , ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RVB56	10/01/10		SNF	"Very High Rehab , ADL Index 6-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RVB5A	10/01/11		SNF	"Very High Rehab , ADL Index 6-10/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RVB5B	10/01/11		SNF	"Very High Rehab , ADL Index 6-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RVB5C	10/01/11		SNF	"Very High Rehab , ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RVB5D	10/01/11		SNF	"Very High Rehab , ADL Index 6-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RVB60	10/01/10		SNF	"Very High Rehab , ADL Index 6-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following:  SNF notified untimely of MSP denial, or 
 SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
RVB78	10/01/00	* 09/30/10	SNF	"Rehabilitation, Very High, ADL Index 9-15/OMRA replacing 14-day Medicare-required assessment"					
RVB79	07/01/02	* 09/30/10	SNF	"Rehabilitation, Very High, ADL Index 9-15/Special payment situation 14-day assessment"					
RVB8A	07/01/98		SNF	"Very High Rehab , ADL Index 6-10/TRICARE 120-day assessment "					
RVB8B	07/01/98		SNF	"Very High Rehab , ADL Index 6-10/TRICARE 150-day assessment "					
RVB8C	07/01/98		SNF	"Very High Rehab , ADL Index 6-10/TRICARE 180-day assessment "					
RVB8D	07/01/98		SNF	"Very High Rehab , ADL Index 6-10/TRICARE 210-day assessment "					
RVB8E	07/01/98		SNF	"Very High Rehab , ADL Index 6-10/TRICARE 240-day assessment "					
RVB8F	07/01/98		SNF	"Very High Rehab , ADL Index 6-10/TRICARE 270-day assessment "					
RVB8G	07/01/98		SNF	"Very High Rehab , ADL Index 6-10/TRICARE 300-day assessment "					
RVB8H	07/01/98		SNF	"Very High Rehab , ADL Index 6-10/TRICARE 330-day assessment "					
RVB8I	07/01/98		SNF	"Very High Rehab , ADL Index 6-10/TRICARE 360-day assessment "					
RVB8X	07/01/98		SNF	"Very High Rehab , ADL Index 6-10/TRICARE Post 360-day assessments with 30-day interval "					
RVC01	07/01/98		SNF	"Very High Rehab , ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA."					
RVC02	07/01/98		SNF	"Very High Rehab , ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay)."					
RVC03	07/01/98		SNF	"Very High Rehab , ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA."					
RVC04	07/01/98	* 09/30/10	SNF	"Rehabilitation, Very High, ADL Index 16-18/Medicare 90 day assessment (Full)"					
RVC05	07/01/98		SNF	"Very High Rehab , ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RVC06	10/01/10		SNF	"Very High Rehab , ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RVC07	07/01/98		SNF	"Very High Rehab , ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA. "					
RVC08	07/01/98	* 09/30/10	SNF	"Rehabilitation, Very High, ADL Index 16-18/Other Medicare Required Assessment (OMRA) "					
RVC0A	10/01/11		SNF	"Very High Rehab , ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
RVC0B	10/01/11		SNF	"Very High Rehab , ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
RVC0C	10/01/11		SNF	"Very High Rehab , ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
RVC0D	10/01/11		SNF	"Very High Rehab , ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
RVC10	10/01/10		SNF	"Very High Rehab , ADL Index 11-16/5-day or readmission return. "					
RVC11	07/01/98		SNF	"Very High Rehab , ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
RVC12	10/01/10		SNF	"Very High Rehab , ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
RVC13	10/01/10		SNF	"Very High Rehab , ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
RVC14	10/01/10		SNF	"Very High Rehab , ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
RVC15	10/01/10		SNF	"Very High Rehab , ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RVC16	10/01/10		SNF	"Very High Rehab , ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
RVC17	07/01/98		SNF	"Very High Rehab , ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
RVC18 	10/01/00	* 09/30/10	SNF	"Rehabilitation, Very High, ADL Index 16-18/OMRA replacing 5-day Medicare assessment"					
RVC19	07/01/02	* 09/30/10	SNF	"Rehabilitation, Very High, ADL Index 16-18/Special payment situation 5-day assessment"					
RVC1A	10/01/11		SNF	"Very High Rehab , ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RVC1B	10/01/11		SNF	"Very High Rehab , ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RVC1C	10/01/11		SNF	"Very High Rehab , ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RVC20	10/01/10		SNF	"Very High Rehab , ADL Index 11-16/14-day. "					
RVC21	10/01/10		SNF	"Very High Rehab , ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
RVC22	10/01/10		SNF	"Very High Rehab , ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay)."					
RVC23	10/01/10		SNF	"Very High Rehab , ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND CCA. "					
RVC24	10/01/10		SNF	"Very High Rehab , ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
RVC25	10/01/10		SNF	"Very High Rehab , ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
RVC26	10/01/10		SNF	"Very High Rehab , ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RVC28	10/01/00	* 09/30/10	SNF	"Rehabilitation, Very High, ADL Index 16-18/OMRA replacing 30-day Medicare assessment"					
RVC29	07/01/02	* 09/30/10	SNF	"Rehabilitation, Very High, ADL Index 16-18/Special payment situation 30-day assessment"					
RVC2A	10/01/11		SNF	"Very High Rehab , ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RVC2B	10/01/11		SNF	"Very High Rehab , ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RVC2C	10/01/11		SNF	"Very High Rehab , ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RVC2D	10/01/11		SNF	"Very High Rehab , ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RVC30	07/01/98		SNF	"Very High Rehab , ADL Index 11-16/30-day. "					
RVC31	07/01/98		SNF	"Very High Rehab , ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
RVC32	07/01/98		SNF	"Very High Rehab , ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay)."					
RVC33	07/01/98		SNF	"Very High Rehab , ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND CCA."					
RVC34	07/01/98		SNF	"Very High Rehab , ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
RVC35	07/01/98		SNF	"Very High Rehab , ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RVC36	10/01/10		SNF	"Very High Rehab , ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
RVC37	07/01/98	* 09/30/10	SNF	"Rehabilitation, Very High, ADL Index 16-18/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
RVC38	07/01/98	* 09/30/10	SNF	"Rehabilitation, Very High, ADL Index 16-18/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
RVC39	07/01/02	* 09/30/10	SNF	"Rehabilitation, Very High, ADL Index 16-18/Special payment situation 60-day assessment"					
RVC3A	10/01/11		SNF	"Very High Rehab , ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RVC3B	10/01/11		SNF	"Very High Rehab , ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RVC3C	10/01/11		SNF	"Very High Rehab , ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RVC3D	10/01/11		SNF	"Very High Rehab , ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RVC40	07/01/98		SNF	"Very High Rehab , ADL Index 11-16/60-day. "					
RVC41	07/01/98		SNF	"Very High Rehab , ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
RVC42	07/01/98		SNF	"Very High Rehab , ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay)."					
RVC43	07/01/98		SNF	"Very High Rehab , ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) AND CCA."					
RVC44	07/01/98		SNF	"Very High Rehab , ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
RVC45	07/01/98		SNF	"Very High Rehab , ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RVC46	10/01/10		SNF	"Very High Rehab , ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
RVC47	07/01/98	* 09/30/10	SNF	"Rehabilitation, Very High, ADL Index 16-18/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
RVC48	10/01/00	* 09/30/10	SNF	"Rehabilitation, Very High, ADL Index 16-18/OMRA replacing 90-day Medicare-required assessment"					
RVC49	07/01/02	* 09/30/10	SNF	"Rehabilitation, Very High, ADL Index 16-18/Special payment situation 90-day assessment"					
RVC4A	10/01/11		SNF	"Very High Rehab , ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RVC4B	10/01/11		SNF	"Very High Rehab , ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RVC4C	10/01/11		SNF	"Very High Rehab , ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RVC4D	10/01/11		SNF	"Very High Rehab , ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RVC50	10/01/10		SNF	"Very High Rehab , ADL Index 11-16/90-day. "					
RVC51	10/01/10		SNF	"Very High Rehab , ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
RVC52	10/01/10		SNF	"Very High Rehab , ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay)."					
RVC53	10/01/10		SNF	"Very High Rehab , ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND CCA. "					
RVC54	07/01/98		SNF	"Very High Rehab , ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
RVC55	10/01/10		SNF	"Very High Rehab , ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RVC56	10/01/10		SNF	"Very High Rehab , ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RVC5A	10/01/11		SNF	"Very High Rehab , ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RVC5B	10/01/11		SNF	"Very High Rehab , ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RVC5C	10/01/11		SNF	"Very High Rehab , ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RVC5D	10/01/11		SNF	"Very High Rehab , ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RVC60	10/01/10		SNF	"Very High Rehab , ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following:  SNF notified untimely of MSP denial, or 
 SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
RVC78	10/01/00	* 09/30/10	SNF	"Rehabilitation, Very High, ADL Index 16-18/OMRA replacing 14-day Medicare-required assessment"					
RVC79	07/01/02	* 09/30/10	SNF	"Rehabilitation, Very High, ADL Index 16-18/Special payment situation 14-day assessment"					
RVC8A	07/01/98		SNF	"Very High Rehab , ADL Index 11-16/TRICARE 120-day assessment "					
RVC8B	07/01/98		SNF	"Very High Rehab , ADL Index 11-16/TRICARE 150-day assessment "					
RVC8C	07/01/98		SNF	"Very High Rehab , ADL Index 11-16/TRICARE 180-day assessment "					
RVC8D	07/01/98		SNF	"Very High Rehab , ADL Index 11-16/TRICARE 210-day assessment "					
RVC8E	07/01/98		SNF	"Very High Rehab , ADL Index 11-16/TRICARE 240-day assessment "					
RVC8F	07/01/98		SNF	"Very High Rehab , ADL Index 11-16/TRICARE 270-day assessment "					
RVC8G	07/01/98		SNF	"Very High Rehab , ADL Index 11-16/TRICARE 300-day assessment "					
RVC8H	07/01/98		SNF	"Very High Rehab , ADL Index 11-16/TRICARE 330-day assessment "					
RVC8I	07/01/98		SNF	"Very High Rehab , ADL Index 11-16/TRICARE 360-day assessment "					
RVC8X	07/01/98		SNF	"Very High Rehab , ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval "					
RVL01	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/Stand-alone OBRA SCSA OR SCPA OR CCA."					
RVL02	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/Stand-alone SOT OMRA (not Medicare short stay)."					
RVL03	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA."					
RVL04	01/01/06	* 09/30/10	SNF	"Rehabilitation, Very High, plus Extensive Services, Low, ADL Index 7-15/Medicare 90 day assessment (Full)"					
RVL05	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RVL06	10/01/10		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RVL07	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA. "					
RVL08	01/01/06	* 09/30/10	SNF	"Rehabilitation, Very High, plus Extensive Services, Low, ADL Index 7-15/Other Medicare Required Assessment (OMRA) "					
RVL0A	10/01/11		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
RVL0B	10/01/11		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
RVL0C	10/01/11		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
RVL0D	10/01/11		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
RVL10	10/01/10		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/5-day or readmission return. "					
RVL11	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
RVL12	10/01/10		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
RVL13	10/01/10		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
RVL14	10/01/10		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
RVL15	10/01/10		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RVL16	10/01/10		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
RVL17	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
RVL18 	01/01/06	* 09/30/10	SNF	"Rehabilitation, Very High, plus Extensive Services, Low, ADL Index 7-15/OMRA replacing 5-day Medicare assessment"					
RVL19	01/01/06	* 09/30/10	SNF	"Rehabilitation, Very High, plus Extensive Services, Low, ADL Index 7-15/Special payment situation 5-day assessment"					
RVL1A	10/01/11		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RVL1B	10/01/11		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RVL1C	10/01/11		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RVL20	10/01/10		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/14-day. "					
RVL21	10/01/10		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
RVL22	10/01/10		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay)."					
RVL23	10/01/10		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND CCA. "					
RVL24	10/01/10		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
RVL25	10/01/10		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
RVL26	10/01/10		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RVL28	01/01/06	* 09/30/10	SNF	"Rehabilitation, Very High, plus Extensive Services, Low, ADL Index 7-15/OMRA replacing 30-day Medicare assessment"					
RVL29	01/01/06	* 09/30/10	SNF	"Rehabilitation, Very High, plus Extensive Services, Low, ADL Index 7-15/Special payment situation 30-day assessment"					
RVL2A	10/01/11		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RVL2B	10/01/11		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RVL2C	10/01/11		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RVL2D	10/01/11		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RVL30	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/30-day. "					
RVL31	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
RVL32	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay)."					
RVL33	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND CCA."					
RVL34	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
RVL35	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RVL36	10/01/10		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
RVL37	01/01/06	* 09/30/10	SNF	"Rehabilitation, Very High, plus Extensive Services, Low, ADL Index 7-15/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
RVL38	01/01/06	* 09/30/10	SNF	"Rehabilitation, Very High, plus Extensive Services, Low, ADL Index 7-15/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
RVL39	01/01/06	* 09/30/10	SNF	"Rehabilitation, Very High, plus Extensive Services, Low, ADL Index 7-15/Special payment situation 60-day assessment"					
RVL3A	10/01/11		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RVL3B	10/01/11		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RVL3C	10/01/11		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RVL3D	10/01/11		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RVL40	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/60-day. "					
RVL41	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
RVL42	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay)."					
RVL43	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) AND CCA."					
RVL44	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
RVL45	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RVL46	10/01/10		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
RVL47	01/01/06	* 09/30/10	SNF	"Rehabilitation, Very High, plus Extensive Services, Low, ADL Index 7-15/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
RVL48	01/01/06	* 09/30/10	SNF	"Rehabilitation, Very High, plus Extensive Services, Low, ADL Index 7-15/OMRA replacing 90-day Medicare-required assessment"					
RVL49	01/01/06	* 09/30/10	SNF	"Rehabilitation, Very High, plus Extensive Services, Low, ADL Index 7-15/Special payment situation 90-day assessment"					
RVL4A	10/01/11		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RVL4B	10/01/11		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RVL4C	10/01/11		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RVL4D	10/01/11		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RVL50	10/01/10		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/90-day. "					
RVL51	10/01/10		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
RVL52	10/01/10		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay)."					
RVL53	10/01/10		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND CCA. "					
RVL54	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
RVL55	10/01/10		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RVL56	10/01/10		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RVL5A	10/01/11		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RVL5B	10/01/11		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RVL5C	10/01/11		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RVL5D	10/01/11		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RVL60	10/01/10		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following:  SNF notified untimely of MSP denial, or 
 SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
RVL78	01/01/06	* 09/30/10	SNF	"Rehabilitation, Very High, plus Extensive Services, Low, ADL Index 7-15/OMRA replacing 14-day Medicare-required assessment"					
RVL79	01/01/06	* 09/30/10	SNF	"Rehabilitation, Very High, plus Extensive Services, Low, ADL Index 7-15/Special payment situation 14-day assessment"					
RVL8A	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/TRICARE 120-day assessment "					
RVL8B	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/TRICARE 150-day assessment "					
RVL8C	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/TRICARE 180-day assessment "					
RVL8D	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/TRICARE 210-day assessment "					
RVL8E	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/TRICARE 240-day assessment "					
RVL8F	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/TRICARE 270-day assessment "					
RVL8G	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/TRICARE 300-day assessment "					
RVL8H	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/TRICARE 330-day assessment "					
RVL8I	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/TRICARE 360-day assessment "					
RVL8X	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 2-10/TRICARE Post 360-day assessments with 30-day interval "					
RVX01	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/Stand-alone OBRA SCSA OR SCPA OR CCA."					
RVX02	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/Stand-alone SOT OMRA (not Medicare short stay)."					
RVX03	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/SOT OMRA (not Medicare short stay) AND SCSA OR SOT OMRA (not Medicare short stay) AND SCPA OR SOT OMRA (not Medicare short stay) and CCA."					
RVX04	01/01/06	* 09/30/10	SNF	"Rehabilitation, Very High, plus Extensive Services, High, ADL Index 16-18/Medicare 90 day assessment (Full)"					
RVX05	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RVX06	10/01/10		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RVX07	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/Medicare short stay assessment AND SCSA OR Medicare short stay assessment AND SCPA OR Medicare short stay assessment AND CCA. "					
RVX08	01/01/06	* 09/30/10	SNF	"Rehabilitation, Very High, plus Extensive Services, High, ADL Index 16-18/Other Medicare Required Assessment (OMRA) "					
RVX0A	10/01/11		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/Stand-alone EOT OMRA reporting ROT or EOT OMRA reporting ROT w/ unscheduled OBRA SCSA or SCPA or CCA"					
RVX0B	10/01/11		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT"					
RVX0C	10/01/11		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/SOT OMRA (not short stay) w/ EOT OMRA reporting ROT and unscheduled OBRA SCSA or SCPA or CCA"					
RVX0D	10/01/11		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/Stand-alone COT OMRA whether or not combined w/ unscheduled OBRA SCSA or SCPA or CCA"					
RVX10	10/01/10		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/5-day or readmission return. "					
RVX11	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/5-day or readmission return AND SCSA OR 5-day or readmission return AND SCPA OR 5-day or readmission return AND CCA."					
RVX12	10/01/10		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay)."					
RVX13	10/01/10		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND CCA."					
RVX14	10/01/10		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/5-day or readmission return AND EOT OMRA OR 5-day or readmission return AND EOT OMRA AND SCSA OR 5-day or readmission return AND EOT OMRA AND SCPA OR 5-day or readmission return AND EOT OMRA AND CCA."					
RVX15	10/01/10		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RVX16	10/01/10		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 5-day or readmission return AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
RVX17	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/5-day or readmission return AND Medicare short stay assessment AND SCSA OR 5-day or readmission return AND Medicare short stay assessment AND SCPA OR 5-day or readmission return AND Medicare short stay assessment AND CCA. "					
RVX18 	01/01/06	* 09/30/10	SNF	"Rehabilitation, Very High, plus Extensive Services, High, ADL Index 16-18/OMRA replacing 5-day Medicare assessment"					
RVX19	01/01/06	* 09/30/10	SNF	"Rehabilitation, Very High, plus Extensive Services, High, ADL Index 16-18/Special payment situation 5-day assessment"					
RVX1A	10/01/11		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/PPS 5 day or readmission return combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RVX1B	10/01/11		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/PPS 5 day or readmission return combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RVX1C	10/01/11		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/PPS 5 day or readmission return combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RVX20	10/01/10		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/14-day. "					
RVX21	10/01/10		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/14-day AND SCSA OR 14-day AND SCPA OR 14-day AND CCA."					
RVX22	10/01/10		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay)."					
RVX23	10/01/10		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND CCA. "					
RVX24	10/01/10		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/14-day AND EOT OMRA OR 14-day AND EOT OMRA AND SCSA OR14-day AND EOT OMRA AND SCPA OR 14-day AND EOT OMRA AND CCA."					
RVX25	10/01/10		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) and EOT OMRA."					
RVX26	10/01/10		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 14-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RVX28	01/01/06	* 09/30/10	SNF	"Rehabilitation, Very High, plus Extensive Services, High, ADL Index 16-18/OMRA replacing 30-day Medicare assessment"					
RVX29	01/01/06	* 09/30/10	SNF	"Rehabilitation, Very High, plus Extensive Services, High, ADL Index 16-18/Special payment situation 30-day assessment"					
RVX2A	10/01/11		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/PPS 14 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RVX2B	10/01/11		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/PPS day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RVX2C	10/01/11		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RVX2D	10/01/11		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/PPS 14 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RVX30	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/30-day. "					
RVX31	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/30-day AND SCSA OR 30-day AND SCPA OR 30-day AND CCA."					
RVX32	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay)."					
RVX33	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND CCA."					
RVX34	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/30-day AND EOT OMRA OR 30-day AND EOT OMRA AND SCSA OR 30-day AND EOT OMRA AND SCPA OR 30-day AND EOT OMRA AND CCA. "					
RVX35	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RVX36	10/01/10		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 30-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA. "					
RVX37	01/01/06	* 09/30/10	SNF	"Rehabilitation, Very High, plus Extensive Services, High, ADL Index 16-18/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
RVX38	01/01/06	* 09/30/10	SNF	"Rehabilitation, Very High, plus Extensive Services, High, ADL Index 16-18/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
RVX39	01/01/06	* 09/30/10	SNF	"Rehabilitation, Very High, plus Extensive Services, High, ADL Index 16-18/Special payment situation 60-day assessment"					
RVX3A	10/01/11		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/PPS 30 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RVX3B	10/01/11		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/PPS 30 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RVX3C	10/01/11		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RVX3D	10/01/11		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/PPS 30 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RVX40	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/60-day. "					
RVX41	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/60-day AND SCSA OR 60-day AND SPCA OR 60-day AND CCA. "					
RVX42	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay)."					
RVX43	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) AND CCA."					
RVX44	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/60-day AND EOT OMRA OR 60-day AND EOT OMRA AND SCSA OR 60-day AND EOT OMRA AND SCPA OR 60-day AND EOT OMRA AND CCA. "					
RVX45	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RVX46	10/01/10		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 60-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 60-day AND SOT OMRA (not Medicare short stay) and EOT OMRA AND CCA."					
RVX47	01/01/06	* 09/30/10	SNF	"Rehabilitation, Very High, plus Extensive Services, High, ADL Index 16-18/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
RVX48	01/01/06	* 09/30/10	SNF	"Rehabilitation, Very High, plus Extensive Services, High, ADL Index 16-18/OMRA replacing 90-day Medicare-required assessment"					
RVX49	01/01/06	* 09/30/10	SNF	"Rehabilitation, Very High, plus Extensive Services, High, ADL Index 16-18/Special payment situation 90-day assessment"					
RVX4A	10/01/11		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/PPS 60 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RVX4B	10/01/11		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/PPS 60 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RVX4C	10/01/11		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RVX4D	10/01/11		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/PPS 60 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RVX50	10/01/10		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/90-day. "					
RVX51	10/01/10		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/90-day AND SCSA OR 90-day AND SCPA OR 90-day AND CCA."					
RVX52	10/01/10		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay)."					
RVX53	10/01/10		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND CCA. "					
RVX54	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/90-day AND EOT OMRA OR 90-day AND EOT OMRA AND SCSA OR 90-day AND EOT OMRA AND SCPA OR 90-day AND EOT OMRA AND CCA. "					
RVX55	10/01/10		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA."					
RVX56	10/01/10		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCSA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND SCPA OR 90-day AND SOT OMRA (not Medicare short stay) AND EOT OMRA AND CCA."					
RVX5A	10/01/11		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/PPS 90 day combined w/ EOT OMRA reporting ROT, may be combined or not w/ 1 of following, unscheduled OBRA SCSA or SCPA or CCA"					
RVX5B	10/01/11		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/PPS 90 day combined only w/ both an SOT OMRA (not short stay) AND an EOT OMRA reporting ROT"					
RVX5C	10/01/11		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and an EOT OMRA reporting ROT AND combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RVX5D	10/01/11		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/PPS 90 day combined w/ both an SOT OMRA (not short stay) and a COT OMRA reporting ROT AND may be combined w/ any of the following, unscheduled OBRA SCSA or SCPA or CCA"					
RVX60	10/01/10		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/OBRA assessment used for PPS (Not combined with any PPS assessment) when Part A eligibility unknown at time of assessment due to one of the following:  SNF notified untimely of MSP denial, or 
 SNF notified untimely of revocation of payment ban, or beneficiary requested demand bill, or SNF notified untimely of beneficiarys disenrollment from MA plan.
"					
RVX78	01/01/06	* 09/30/10	SNF	"Rehabilitation, Very High, plus Extensive Services, High, ADL Index 16-18/OMRA replacing 14-day Medicare-required assessment"					
RVX79	01/01/06	* 09/30/10	SNF	"Rehabilitation, Very High, plus Extensive Services, High, ADL Index 16-18/Special payment situation 14-day assessment"					
RVX8A	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/TRICARE 120-day assessment "					
RVX8B	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/TRICARE 150-day assessment "					
RVX8C	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/TRICARE 180-day assessment "					
RVX8D	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/TRICARE 210-day assessment "					
RVX8E	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/TRICARE 240-day assessment "					
RVX8F	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/TRICARE 270-day assessment "					
RVX8G	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/TRICARE 300-day assessment "					
RVX8H	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/TRICARE 330-day assessment "					
RVX8I	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/TRICARE 360-day assessment "					
RVX8X	07/01/98		SNF	"Very High Rehab plus Extensive , ADL Index 11-16/TRICARE Post 360-day assessments with 30-day interval "					
SE101	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 0 -1/Medicare 5 day assessment (Full)"					
SE102	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 0 -1/Medicare 30 day assessment (Full)"					
SE103	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 0 -1/Medicare 60 day assessment (Full)"					
SE104	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 0 -1/Medicare 90 day assessment (Full)"					
SE105	10/01/00	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 0 -1/Readmission/Return Medicare assessment"					
SE107	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 0 -1/Medicare 14 day assessment (Full or comprehensive)"					
SE108	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 0 -1/Other Medicare Required Assessment (OMRA) "					
SE111	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 0 -1/Medicare 5 day assessment (comprehensive) AND initial admission assessment"					
SE117	10/01/00	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 0 -1/14-day Medicare assessment AND initial admission assessment"					
SE118 	10/01/00	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 0 -1/OMRA replacing 5-day Medicare assessment"					
SE119	07/01/02	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 0 -1/Special payment situation 5-day assessment"					
SE128	10/01/00	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 0 -1/OMRA replacing 30-day Medicare assessment"					
SE129	07/01/02	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 0 -1/Special payment situation 30-day assessment"					
SE130	10/01/00	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 0 -1/Off-cycle significant change assessment (outside assessment window) "					
SE131	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 0 -1/[7/98 def.] SCSA or OMRA/ Medicare 5 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 5-day Medicare required assessment"					
SE132	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 0 -1/[7/98 def.] SCSA or OMRA/ Medicare 30 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 30-day Medicare required assessment"					
SE133	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 0 -1/[7/98 def.] SCSA or OMRA/ Medicare 60 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 60-day Medicare required assessment"					
SE134	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 0 -1/[7/98 def.] SCSA or OMRA/ Medicare 90 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 90-day Medicare required assessment"					
SE135	10/01/00	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 0 -1/Significant change assessment REPLACES a readmission/return Medicare-required assessment"					
SE137	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 0 -1/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
SE138	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 0 -1/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
SE139	07/01/02	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 0 -1/Special payment situation 60-day assessment"					
SE140	10/01/00	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 0 -1/Off-cycle significant change correction assessment of a prior assessment (outside assessment window)"					
SE141	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 0 -1/Significant Correction of Prior Full Assessment/Medicare 5 Day Assessment "					
SE142	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 0 -1/Significant Correction of Prior Full Assessment/Medicare 30 Day Assessment "					
SE143	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 0 -1/Significant Correction of Prior Full Assessment/Medicare 60 Day Assessment "					
SE144	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 0 -1/Significant Correction of Prior Full Assessment/Medicare 90 Day Assessment "					
SE145	10/01/00	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 0 -1/Significant correction of a prior assessment REPLACES a readmission/return assessment"					
SE147	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 0 -1/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
SE148	10/01/00	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 0 -1/OMRA replacing 90-day Medicare-required assessment"					
SE149	07/01/02	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 0 -1/Special payment situation 90-day assessment"					
SE154	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 0 -1/Quarterly review assessment-Medicare 90 day assessment (Full) "					
SE178	10/01/00	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 0 -1/OMRA replacing 14-day Medicare-required assessment"					
SE179	07/01/02	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 0 -1/Special payment situation 14-day assessment"					
SE18A	08/01/03	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 0 -1/TRICARE 120-day assessment "					
SE18B	08/01/03	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 0 -1/TRICARE 150-day assessment "					
SE18C	08/01/03	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 0 -1/TRICARE 180-day assessment "					
SE18D	08/01/03	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 0 -1/TRICARE 210-day assessment "					
SE18E	08/01/03	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 0 -1/TRICARE 240-day assessment "					
SE18F	08/01/03	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 0 -1/TRICARE 270-day assessment "					
SE18G	08/01/03	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 0 -1/TRICARE 300-day assessment "					
SE18H	08/01/03	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 0 -1/TRICARE 330-day assessment"					
SE18I	08/01/03	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 0 -1/TRICARE 360-day assessment  "					
SE18X	08/01/03	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 0 -1/TRICARE Post 360-day assessments with 30-day interval "					
SE201	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 2 - 3/Medicare 5 day assessment (Full)"					
SE202	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 2 - 3/Medicare 30 day assessment (Full)"					
SE203	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 2 - 3/Medicare 60 day assessment (Full)"					
SE204	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 2 - 3/Medicare 90 day assessment (Full)"					
SE205	10/01/00	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 2 - 3/Readmission/Return Medicare assessment"					
SE207	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 2 - 3/Medicare 14 day assessment (Full or comprehensive)"					
SE208	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 2 - 3/Other Medicare Required Assessment (OMRA) "					
SE211	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 2 - 3/Medicare 5 day assessment (comprehensive) AND initial admission assessment"					
SE217	10/01/00	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 2 - 3/14-day Medicare assessment AND initial admission assessment"					
SE218 	10/01/00	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 2 - 3/OMRA replacing 5-day Medicare assessment"					
SE219	07/01/02	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 2 - 3/Special payment situation 5-day assessment"					
SE228	10/01/00	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 2 - 3/OMRA replacing 30-day Medicare assessment"					
SE229	07/01/02	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 2 - 3/Special payment situation 30-day assessment"					
SE230	10/01/00	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 2 - 3/Off-cycle significant change assessment (outside assessment window) "					
SE231	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 2 - 3/[7/98 def.] SCSA or OMRA/ Medicare 5 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 5-day Medicare required assessment"					
SE232	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 2 - 3/[7/98 def.] SCSA or OMRA/ Medicare 30 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 30-day Medicare required assessment"					
SE233	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 2 - 3/[7/98 def.] SCSA or OMRA/ Medicare 60 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 60-day Medicare required assessment"					
SE234	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 2 - 3/[7/98 def.] SCSA or OMRA/ Medicare 90 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 90-day Medicare required assessment"					
SE235	10/01/00	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 2 - 3/Significant change assessment REPLACES a readmission/return Medicare-required assessment"					
SE237	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 2 - 3/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
SE238	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 2 - 3/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
SE239	07/01/02	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 2 - 3/Special payment situation 60-day assessment"					
SE240	10/01/00	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 2 - 3/Off-cycle significant change correction assessment of a prior assessment (outside assessment window)"					
SE241	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 2 - 3/Significant Correction of Prior Full Assessment/Medicare 5 Day Assessment "					
SE242	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 2 - 3/Significant Correction of Prior Full Assessment/Medicare 30 Day Assessment "					
SE243	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 2 - 3/Significant Correction of Prior Full Assessment/Medicare 60 Day Assessment "					
SE244	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 2 - 3/Significant Correction of Prior Full Assessment/Medicare 90 Day Assessment "					
SE245	10/01/00	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 2 - 3/Significant correction of a prior assessment REPLACES a readmission/return assessment"					
SE247	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 2 - 3/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
SE248	10/01/00	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 2 - 3/OMRA replacing 90-day Medicare-required assessment"					
SE249	07/01/02	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 2 - 3/Special payment situation 90-day assessment"					
SE254	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 2 - 3/Quarterly review assessment-Medicare 90 day assessment (Full) "					
SE278	10/01/00	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 2 - 3/OMRA replacing 14-day Medicare-required assessment"					
SE279	07/01/02	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 2 - 3/Special payment situation 14-day assessment"					
SE28A	08/01/03	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 2 - 3/TRICARE 120-day assessment "					
SE28B	08/01/03	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 2 - 3/TRICARE 150-day assessment "					
SE28C	08/01/03	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 2 - 3/TRICARE 180-day assessment "					
SE28D	08/01/03	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 2 - 3/TRICARE 210-day assessment "					
SE28E	08/01/03	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 2 - 3/TRICARE 240-day assessment "					
SE28F	08/01/03	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 2 - 3/TRICARE 270-day assessment "					
SE28G	08/01/03	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 2 - 3/TRICARE 300-day assessment "					
SE28H	08/01/03	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 2 - 3/TRICARE 330-day assessment"					
SE28I	08/01/03	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 2 - 3/TRICARE 360-day assessment  "					
SE28X	08/01/03	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 2 - 3/TRICARE Post 360-day assessments with 30-day interval "					
SE301	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 4 - 5/Medicare 5 day assessment (Full)"					
SE302	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 4 - 5/Medicare 30 day assessment (Full)"					
SE303	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 4 - 5/Medicare 60 day assessment (Full)"					
SE304	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 4 - 5/Medicare 90 day assessment (Full)"					
SE305	10/01/00	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 4 - 5/Readmission/Return Medicare assessment"					
SE307	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 4 - 5/Medicare 14 day assessment (Full or comprehensive)"					
SE308	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 4 - 5/Other Medicare Required Assessment (OMRA) "					
SE311	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 4 - 5/Medicare 5 day assessment (comprehensive) AND initial admission assessment"					
SE317	10/01/00	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 4 - 5/14-day Medicare assessment AND initial admission assessment"					
SE318 	10/01/00	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 4 - 5/OMRA replacing 5-day Medicare assessment"					
SE319	07/01/02	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 4 - 5/Special payment situation 5-day assessment"					
SE328	10/01/00	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 4 - 5/OMRA replacing 30-day Medicare assessment"					
SE329	07/01/02	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 4 - 5/Special payment situation 30-day assessment"					
SE330	10/01/00	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 4 - 5/Off-cycle significant change assessment (outside assessment window) "					
SE331	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 4 - 5/[7/98 def.] SCSA or OMRA/ Medicare 5 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 5-day Medicare required assessment"					
SE332	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 4 - 5/[7/98 def.] SCSA or OMRA/ Medicare 30 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 30-day Medicare required assessment"					
SE333	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 4 - 5/[7/98 def.] SCSA or OMRA/ Medicare 60 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 60-day Medicare required assessment"					
SE334	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 4 - 5/[7/98 def.] SCSA or OMRA/ Medicare 90 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 90-day Medicare required assessment"					
SE335	10/01/00	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 4 - 5/Significant change assessment REPLACES a readmission/return Medicare-required assessment"					
SE337	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 4 - 5/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
SE338	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 4 - 5/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
SE339	07/01/02	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 4 - 5/Special payment situation 60-day assessment"					
SE340	10/01/00	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 4 - 5/Off-cycle significant change correction assessment of a prior assessment (outside assessment window)"					
SE341	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 4 - 5/Significant Correction of Prior Full Assessment/Medicare 5 Day Assessment "					
SE342	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 4 - 5/Significant Correction of Prior Full Assessment/Medicare 30 Day Assessment "					
SE343	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 4 - 5/Significant Correction of Prior Full Assessment/Medicare 60 Day Assessment "					
SE344	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 4 - 5/Significant Correction of Prior Full Assessment/Medicare 90 Day Assessment "					
SE345	10/01/00	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 4 - 5/Significant correction of a prior assessment REPLACES a readmission/return assessment"					
SE347	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 4 - 5/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
SE348	10/01/00	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 4 - 5/OMRA replacing 90-day Medicare-required assessment"					
SE349	07/01/02	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 4 - 5/Special payment situation 90-day assessment"					
SE354	07/01/98	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 4 - 5/Quarterly review assessment-Medicare 90 day assessment (Full) "					
SE378	10/01/00	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 4 - 5/OMRA replacing 14-day Medicare-required assessment"					
SE379	07/01/02	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 4 - 5/Special payment situation 14-day assessment"					
SE38A	08/01/03	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 4 - 5/TRICARE 120-day assessment "					
SE38B	08/01/03	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 4 - 5/TRICARE 150-day assessment "					
SE38C	08/01/03	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 4 - 5/TRICARE 180-day assessment "					
SE38D	08/01/03	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 4 - 5/TRICARE 210-day assessment "					
SE38E	08/01/03	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 4 - 5/TRICARE 240-day assessment "					
SE38F	08/01/03	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 4 - 5/TRICARE 270-day assessment "					
SE38G	08/01/03	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 4 - 5/TRICARE 300-day assessment "					
SE38H	08/01/03	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 4 - 5/TRICARE 330-day assessment"					
SE38I	08/01/03	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 4 - 5/TRICARE 360-day assessment  "					
SE38X	08/01/03	* 09/30/10	SNF	"Extensive Services, ADL Index 7 -18, Count 4 - 5/TRICARE Post 360-day assessments with 30-day interval "					
SSA01	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 7 - 14/Medicare 5 day assessment (Full)"					
SSA02	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 7 - 14/Medicare 30 day assessment (Full)"					
SSA03	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 7 - 14/Medicare 60 day assessment (Full)"					
SSA04	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 7 - 14/Medicare 90 day assessment (Full)"					
SSA05	10/01/00	* 09/30/10	SNF	"Special Care, ADL Index 7 - 14/Readmission/Return Medicare assessment"					
SSA07	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 7 - 14/Medicare 14 day assessment (Full or comprehensive)"					
SSA08	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 7 - 14/Other Medicare Required Assessment (OMRA) "					
SSA11	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 7 - 14/Medicare 5 day assessment (comprehensive) AND initial admission assessment"					
SSA17	10/01/00	* 09/30/10	SNF	"Special Care, ADL Index 7 - 14/14-day Medicare assessment AND initial admission assessment"					
SSA18 	10/01/00	* 09/30/10	SNF	"Special Care, ADL Index 7 - 14/OMRA replacing 5-day Medicare assessment"					
SSA19	07/01/02	* 09/30/10	SNF	"Special Care, ADL Index 7 - 14/Special payment situation 5-day assessment"					
SSA28	10/01/00	* 09/30/10	SNF	"Special Care, ADL Index 7 - 14/OMRA replacing 30-day Medicare assessment"					
SSA29	07/01/02	* 09/30/10	SNF	"Special Care, ADL Index 7 - 14/Special payment situation 30-day assessment"					
SSA30	10/01/00	* 09/30/10	SNF	"Special Care, ADL Index 7 - 14/Off-cycle significant change assessment (outside assessment window) "					
SSA31	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 7 - 14/[7/98 def.] SCSA or OMRA/ Medicare 5 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 5-day Medicare required assessment"					
SSA32	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 7 - 14/[7/98 def.] SCSA or OMRA/ Medicare 30 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 30-day Medicare required assessment"					
SSA33	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 7 - 14/[7/98 def.] SCSA or OMRA/ Medicare 60 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 60-day Medicare required assessment"					
SSA34	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 7 - 14/[7/98 def.] SCSA or OMRA/ Medicare 90 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 90-day Medicare required assessment"					
SSA35	10/01/00	* 09/30/10	SNF	"Special Care, ADL Index 7 - 14/Significant change assessment REPLACES a readmission/return Medicare-required assessment"					
SSA37	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 7 - 14/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
SSA38	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 7 - 14/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
SSA39	07/01/02	* 09/30/10	SNF	"Special Care, ADL Index 7 - 14/Special payment situation 60-day assessment"					
SSA40	10/01/00	* 09/30/10	SNF	"Special Care, ADL Index 7 - 14/Off-cycle significant change correction assessment of a prior assessment (outside assessment window)"					
SSA41	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 7 - 14/Significant Correction of Prior Full Assessment/Medicare 5 Day Assessment "					
SSA42	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 7 - 14/Significant Correction of Prior Full Assessment/Medicare 30 Day Assessment "					
SSA43	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 7 - 14/Significant Correction of Prior Full Assessment/Medicare 60 Day Assessment "					
SSA44	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 7 - 14/Significant Correction of Prior Full Assessment/Medicare 90 Day Assessment "					
SSA45	10/01/00	* 09/30/10	SNF	"Special Care, ADL Index 7 - 14/Significant correction of a prior assessment REPLACES a readmission/return assessment"					
SSA47	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 7 - 14/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
SSA48	10/01/00	* 09/30/10	SNF	"Special Care, ADL Index 7 - 14/OMRA replacing 90-day Medicare-required assessment"					
SSA49	07/01/02	* 09/30/10	SNF	"Special Care, ADL Index 7 - 14/Special payment situation 90-day assessment"					
SSA54	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 7 - 14/Quarterly review assessment-Medicare 90 day assessment (Full) "					
SSA78	10/01/00	* 09/30/10	SNF	"Special Care, ADL Index 7 - 14/OMRA replacing 14-day Medicare-required assessment"					
SSA79	07/01/02	* 09/30/10	SNF	"Special Care, ADL Index 7 - 14/Special payment situation 14-day assessment"					
SSA8A	08/01/03	* 09/30/10	SNF	"Special Care, ADL Index 7 - 14/TRICARE 120-day assessment "					
SSA8B	08/01/03	* 09/30/10	SNF	"Special Care, ADL Index 7 - 14/TRICARE 150-day assessment "					
SSA8C	08/01/03	* 09/30/10	SNF	"Special Care, ADL Index 7 - 14/TRICARE 180-day assessment "					
SSA8D	08/01/03	* 09/30/10	SNF	"Special Care, ADL Index 7 - 14/TRICARE 210-day assessment "					
SSA8E	08/01/03	* 09/30/10	SNF	"Special Care, ADL Index 7 - 14/TRICARE 240-day assessment "					
SSA8F	08/01/03	* 09/30/10	SNF	"Special Care, ADL Index 7 - 14/TRICARE 270-day assessment "					
SSA8G	08/01/03	* 09/30/10	SNF	"Special Care, ADL Index 7 - 14/TRICARE 300-day assessment "					
SSA8H	08/01/03	* 09/30/10	SNF	"Special Care, ADL Index 7 - 14/TRICARE 330-day assessment"					
SSA8I	08/01/03	* 09/30/10	SNF	"Special Care, ADL Index 7 - 14/TRICARE 360-day assessment  "					
SSA8X	08/01/03	* 09/30/10	SNF	"Special Care, ADL Index 7 - 14/TRICARE Post 360-day assessments with 30-day interval "					
SSB01	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 15 - 16/Medicare 5 day assessment (Full)"					
SSB02	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 15 - 16/Medicare 30 day assessment (Full)"					
SSB03	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 15 - 16/Medicare 60 day assessment (Full)"					
SSB04	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 15 - 16/Medicare 90 day assessment (Full)"					
SSB05	10/01/00	* 09/30/10	SNF	"Special Care, ADL Index 15 - 16/Readmission/Return Medicare assessment"					
SSB07	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 15 - 16/Medicare 14 day assessment (Full or comprehensive)"					
SSB08	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 15 - 16/Other Medicare Required Assessment (OMRA) "					
SSB11	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 15 - 16/Medicare 5 day assessment (comprehensive) AND initial admission assessment"					
SSB17	10/01/00	* 09/30/10	SNF	"Special Care, ADL Index 15 - 16/14-day Medicare assessment AND initial admission assessment"					
SSB18 	10/01/00	* 09/30/10	SNF	"Special Care, ADL Index 15 - 16/OMRA replacing 5-day Medicare assessment"					
SSB19	07/01/02	* 09/30/10	SNF	"Special Care, ADL Index 15 - 16/Special payment situation 5-day assessment"					
SSB28	10/01/00	* 09/30/10	SNF	"Special Care, ADL Index 15 - 16/OMRA replacing 30-day Medicare assessment"					
SSB29	07/01/02	* 09/30/10	SNF	"Special Care, ADL Index 15 - 16/Special payment situation 30-day assessment"					
SSB30	10/01/00	* 09/30/10	SNF	"Special Care, ADL Index 15 - 16/Off-cycle significant change assessment (outside assessment window) "					
SSB31	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 15 - 16/[7/98 def.] SCSA or OMRA/ Medicare 5 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 5-day Medicare required assessment"					
SSB32	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 15 - 16/[7/98 def.] SCSA or OMRA/ Medicare 30 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 30-day Medicare required assessment"					
SSB33	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 15 - 16/[7/98 def.] SCSA or OMRA/ Medicare 60 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 60-day Medicare required assessment"					
SSB34	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 15 - 16/[7/98 def.] SCSA or OMRA/ Medicare 90 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 90-day Medicare required assessment"					
SSB35	10/01/00	* 09/30/10	SNF	"Special Care, ADL Index 15 - 16/Significant change assessment REPLACES a readmission/return Medicare-required assessment"					
SSB37	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 15 - 16/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
SSB38	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 15 - 16/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
SSB39	07/01/02	* 09/30/10	SNF	"Special Care, ADL Index 15 - 16/Special payment situation 60-day assessment"					
SSB40	10/01/00	* 09/30/10	SNF	"Special Care, ADL Index 15 - 16/Off-cycle significant change correction assessment of a prior assessment (outside assessment window)"					
SSB41	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 15 - 16/Significant Correction of Prior Full Assessment/Medicare 5 Day Assessment "					
SSB42	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 15 - 16/Significant Correction of Prior Full Assessment/Medicare 30 Day Assessment "					
SSB43	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 15 - 16/Significant Correction of Prior Full Assessment/Medicare 60 Day Assessment "					
SSB44	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 15 - 16/Significant Correction of Prior Full Assessment/Medicare 90 Day Assessment "					
SSB45	10/01/00	* 09/30/10	SNF	"Special Care, ADL Index 15 - 16/Significant correction of a prior assessment REPLACES a readmission/return assessment"					
SSB47	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 15 - 16/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
SSB48	10/01/00	* 09/30/10	SNF	"Special Care, ADL Index 15 - 16/OMRA replacing 90-day Medicare-required assessment"					
SSB49	07/01/02	* 09/30/10	SNF	"Special Care, ADL Index 15 - 16/Special payment situation 90-day assessment"					
SSB54	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 15 - 16/Quarterly review assessment-Medicare 90 day assessment (Full) "					
SSB78	10/01/00	* 09/30/10	SNF	"Special Care, ADL Index 15 - 16/OMRA replacing 14-day Medicare-required assessment"					
SSB79	07/01/02	* 09/30/10	SNF	"Special Care, ADL Index 15 - 16/Special payment situation 14-day assessment"					
SSB8A	08/01/03	* 09/30/10	SNF	"Special Care, ADL Index 15 - 16/TRICARE 120-day assessment "					
SSB8B	08/01/03	* 09/30/10	SNF	"Special Care, ADL Index 15 - 16/TRICARE 150-day assessment "					
SSB8C	08/01/03	* 09/30/10	SNF	"Special Care, ADL Index 15 - 16/TRICARE 180-day assessment "					
SSB8D	08/01/03	* 09/30/10	SNF	"Special Care, ADL Index 15 - 16/TRICARE 210-day assessment "					
SSB8E	08/01/03	* 09/30/10	SNF	"Special Care, ADL Index 15 - 16/TRICARE 240-day assessment "					
SSB8F	08/01/03	* 09/30/10	SNF	"Special Care, ADL Index 15 - 16/TRICARE 270-day assessment "					
SSB8G	08/01/03	* 09/30/10	SNF	"Special Care, ADL Index 15 - 16/TRICARE 300-day assessment "					
SSB8H	08/01/03	* 09/30/10	SNF	"Special Care, ADL Index 15 - 16/TRICARE 330-day assessment"					
SSB8I	08/01/03	* 09/30/10	SNF	"Special Care, ADL Index 15 - 16/TRICARE 360-day assessment  "					
SSB8X	08/01/03	* 09/30/10	SNF	"Special Care, ADL Index 15 - 16/TRICARE Post 360-day assessments with 30-day interval "					
SSC01	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 17 -18/Medicare 5 day assessment (Full)"					
SSC02	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 17 -18/Medicare 30 day assessment (Full)"					
SSC03	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 17 -18/Medicare 60 day assessment (Full)"					
SSC04	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 17 -18/Medicare 90 day assessment (Full)"					
SSC05	10/01/00	* 09/30/10	SNF	"Special Care, ADL Index 17 -18/Readmission/Return Medicare assessment"					
SSC07	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 17 -18/Medicare 14 day assessment (Full or comprehensive)"					
SSC08	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 17 -18/Other Medicare Required Assessment (OMRA) "					
SSC11	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 17 -18/Medicare 5 day assessment (comprehensive) AND initial admission assessment"					
SSC17	10/01/00	* 09/30/10	SNF	"Special Care, ADL Index 17 -18/14-day Medicare assessment AND initial admission assessment"					
SSC18 	10/01/00	* 09/30/10	SNF	"Special Care, ADL Index 17 -18/OMRA replacing 5-day Medicare assessment"					
SSC19	07/01/02	* 09/30/10	SNF	"Special Care, ADL Index 17 -18/Special payment situation 5-day assessment"					
SSC28	10/01/00	* 09/30/10	SNF	"Special Care, ADL Index 17 -18/OMRA replacing 30-day Medicare assessment"					
SSC29	07/01/02	* 09/30/10	SNF	"Special Care, ADL Index 17 -18/Special payment situation 30-day assessment"					
SSC30	10/01/00	* 09/30/10	SNF	"Special Care, ADL Index 17 -18/Off-cycle significant change assessment (outside assessment window) "					
SSC31	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 17 -18/[7/98 def.] SCSA or OMRA/ Medicare 5 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 5-day Medicare required assessment"					
SSC32	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 17 -18/[7/98 def.] SCSA or OMRA/ Medicare 30 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 30-day Medicare required assessment"					
SSC33	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 17 -18/[7/98 def.] SCSA or OMRA/ Medicare 60 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 60-day Medicare required assessment"					
SSC34	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 17 -18/[7/98 def.] SCSA or OMRA/ Medicare 90 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 90-day Medicare required assessment"					
SSC35	10/01/00	* 09/30/10	SNF	"Special Care, ADL Index 17 -18/Significant change assessment REPLACES a readmission/return Medicare-required assessment"					
SSC37	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 17 -18/[7/98 def.] SCSA or OMRA/ Medicare 14 Day Assessment (Replacement), [10/00 def.] Significant change assessment REPLACES 14-day Medicare required assessment"					
SSC38	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 17 -18/[7/98 def.] Significant Change in Status Assessment (SCSA), [10/98 def.] OMRA replacing 60-day Medicare required assessment "					
SSC39	07/01/02	* 09/30/10	SNF	"Special Care, ADL Index 17 -18/Special payment situation 60-day assessment"					
SSC40	10/01/00	* 09/30/10	SNF	"Special Care, ADL Index 17 -18/Off-cycle significant change correction assessment of a prior assessment (outside assessment window)"					
SSC41	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 17 -18/Significant Correction of Prior Full Assessment/Medicare 5 Day Assessment "					
SSC42	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 17 -18/Significant Correction of Prior Full Assessment/Medicare 30 Day Assessment "					
SSC43	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 17 -18/Significant Correction of Prior Full Assessment/Medicare 60 Day Assessment "					
SSC44	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 17 -18/Significant Correction of Prior Full Assessment/Medicare 90 Day Assessment "					
SSC45	10/01/00	* 09/30/10	SNF	"Special Care, ADL Index 17 -18/Significant correction of a prior assessment REPLACES a readmission/return assessment"					
SSC47	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 17 -18/Significant Correction of Prior Full Assessment/Medicare 14 Day Assessment "					
SSC48	10/01/00	* 09/30/10	SNF	"Special Care, ADL Index 17 -18/OMRA replacing 90-day Medicare-required assessment"					
SSC49	07/01/02	* 09/30/10	SNF	"Special Care, ADL Index 17 -18/Special payment situation 90-day assessment"					
SSC54	07/01/98	* 09/30/10	SNF	"Special Care, ADL Index 17 -18/Quarterly review assessment-Medicare 90 day assessment (Full) "					
SSC78	10/01/00	* 09/30/10	SNF	"Special Care, ADL Index 17 -18/OMRA replacing 14-day Medicare-required assessment"					
SSC79	07/01/02	* 09/30/10	SNF	"Special Care, ADL Index 17 -18/Special payment situation 14-day assessment"					
SSC8A	08/01/03	* 09/30/10	SNF	"Special Care, ADL Index 17 -18/TRICARE 120-day assessment "					
SSC8B	08/01/03	* 09/30/10	SNF	"Special Care, ADL Index 17 -18/TRICARE 150-day assessment "					
SSC8C	08/01/03	* 09/30/10	SNF	"Special Care, ADL Index 17 -18/TRICARE 180-day assessment "					
SSC8D	08/01/03	* 09/30/10	SNF	"Special Care, ADL Index 17 -18/TRICARE 210-day assessment "					
SSC8E	08/01/03	* 09/30/10	SNF	"Special Care, ADL Index 17 -18/TRICARE 240-day assessment "					
SSC8F	08/01/03	* 09/30/10	SNF	"Special Care, ADL Index 17 -18/TRICARE 270-day assessment "					
SSC8G	08/01/03	* 09/30/10	SNF	"Special Care, ADL Index 17 -18/TRICARE 300-day assessment "					
SSC8H	08/01/03	* 09/30/10	SNF	"Special Care, ADL Index 17 -18/TRICARE 330-day assessment"					
SSC8I	08/01/03	* 09/30/10	SNF	"Special Care, ADL Index 17 -18/TRICARE 360-day assessment  "					
SSC8X	08/01/03	* 09/30/10	SNF	"Special Care, ADL Index 17 -18/TRICARE Post 360-day assessments with 30-day interval "					
									
NOTE	Code Effective Through Dates w/ an asterisk (*) are terminated for Medicare payer purposes only								
									
									
