RIC         1  2                                        C Record Identification Code

VERSION     3  1                                        C Version Number

BASEID      4  8  $BSIDFMT                              C Unique SP Identification Number

                               5,537             LOW-HIGH BASEID Count

M0010_ME   12  6                                        C Agency Medicare provider number

M0012_ME   18 15                                        C Agency Medicaid provider number

M0014_BR   33  2                                        C Agency branch state

M0016_BR   35 10                                        C Agency branch ID

M0030_ST   45  8                                        N Start of care date

M0032_R0   53  1                                        N Resumption of care date, NA flag

M0032_RO   54  8                                        N Resumption of care date

M0050_PA   62  2                                        C Patient-State

M0060_PA   64 11                                        C Patient-ZIP

M0066_PA   75  8                                        N Patient birth date

M0069_PA   83  1  GEND                                  N Patient sex

                               1,690                    1 Male
                               3,847                    2 Female

M0072_P7   84  1                                        N Primary referring physician, UK flag

M0072_PH   85 10                                        C Primary referring physician UPIN

M0080_AS   95  2  $DISCIOA                              C Discipline of person completing assess

                               4,747                   01 RN
                                 752                   02 PT
                                  10                   03 SLP/ST
                                  28                   04 OT

M0090_AS   97  8                                        N Assessment completion date

M0100_AS  105  2  $ACOMPOA                              C Assessment reason

                               1,499                   01 S/R; Start; further visits planned
                                   0                   02 S/R; Start; no further visits planned
                                 363                   03 S/R; Resumption of care
                               1,586                   04 Follow-up; Recertification
                                  44                   05 Follow-up; Other
                                 548                   06 Transfer to inpat fac; Patient not disch
                                  94                   07 Transfer to inpat fac; Patient disch
                                   8                   08 Disch from agency; Death at home
                               1,395                   09 Disch from agency; Disch from agency
                                   0                   10 Disch from agency; No visits completed

M0140_E0  107  1  INDICOA                               N Ethnicity; Asian

                               3,675                    . Missing
                               1,833                    0 Not indicated
                                  29                    1 Indicated

M0140_E1  108  1  INDICOA                               N Ethnicity; Afr Amer

                               3,675                    . Missing
                               1,658                    0 Not indicated
                                 204                    1 Indicated

M0140_E2  109  1  INDICOA                               N Ethnicity; Hispancic

                               3,675                    . Missing
                               1,733                    0 Not indicated
                                 129                    1 Indicated

M0140_E3  110  1  INDICOA                               N Ethnicity; Hawaii

                               3,675                    . Missing
                               1,858                    0 Not indicated
                                   4                    1 Indicated

M0140_E4  111  1  INDICOA                               N Ethnicity; White

                               3,675                    . Missing
                                 414                    0 Not indicated
                               1,448                    1 Indicated

M0140_E5  112  1  INDICOA                               N Ethnicity; Unknown

                               3,675                    . Missing
                               1,816                    0 Not indicated
                                  46                    1 Indicated

M0140_ET  113  1  INDICOA                               N Ethnicity; Am Indian

                               3,675                    . Missing
                               1,852                    0 Not indicated
                                  10                    1 Indicated

M0150_10  114  1  INDICOA                               N Payment; Workers comp

                               5,537                    0 Not indicated
                                   0                    1 Indicated

M0150_11  115  1  INDICOA                               N Payment; Title programs

                               5,536                    0 Not indicated
                                   1                    1 Indicated

M0150_12  116  1  INDICOA                               N Payment; Other govt

                               5,524                    0 Not indicated
                                  13                    1 Indicated

M0150_13  117  1  INDICOA                               N Payment; Private ins

                               5,344                    0 Not indicated
                                 193                    1 Indicated

M0150_14  118  1  INDICOA                               N Payment; Private HMO

                               5,515                    0 Not indicated
                                  22                    1 Indicated

M0150_15  119  1  INDICOA                               N Payment; Self-pay

                               5,387                    0 Not indicated
                                 150                    1 Indicated

M0150_16  120  1  INDICOA                               N Payment; Other

                               5,514                    0 Not indicated
                                  23                    1 Indicated

M0150_17  121  1  INDICOA                               N Payment; Unknown

                               3,675                    . Missing
                               1,862                    0 Not indicated
                                   0                    1 Indicated

M0150_C6  122  1  INDICOA                               N Payment; Medicare FFS

                                 775                    0 Not indicated
                               4,762                    1 Indicated

M0150_C7  123  1  INDICOA                               N Payment; Medicare HMO

                               4,962                    0 Not indicated
                                 575                    1 Indicated

M0150_C8  124  1  INDICOA                               N Payment; Medicaid FFS

                               5,031                    0 Not indicated
                                 506                    1 Indicated

M0150_C9  125  1  INDICOA                               N Payment; Medicaid HMO

                               5,521                    0 Not indicated
                                  16                    1 Indicated

M0150_CP  126  1  INDICOA                               N Payment; None

                               5,537                    0 Not indicated
                                   0                    1 Indicated

M0160_18  127  1  INDICOA                               N Finance limit; Medicine

                               5,537                    . Missing
                                   0                    0 Not indicated
                                   0                    1 Indicated

M0160_19  128  1  INDICOA                               N Finance limit; Ins copay

                               5,537                    . Missing
                                   0                    0 Not indicated
                                   0                    1 Indicated

M0160_20  129  1  INDICOA                               N Finance limit; Rent

                               5,537                    . Missing
                                   0                    0 Not indicated
                                   0                    1 Indicated

M0160_21  130  1  INDICOA                               N Finance limit; Food

                               5,537                    . Missing
                                   0                    0 Not indicated
                                   0                    1 Indicated

M0160_22  131  1  INDICOA                               N Finance limit; Other

                               5,537                    . Missing
                                   0                    0 Not indicated
                                   0                    1 Indicated

M0160_LT  132  1  INDICOA                               N Finance limit; None

                               5,537                    . Missing
                                   0                    0 Not indicated
                                   0                    1 Indicated

M0175_HS  133  1  INDICOA                               N Disch in past 14 days; Hospital

                               2,458                    . Missing
                               2,025                    0 Not indicated
                               1,054                    1 Indicated

M0175_NO  134  1  INDICOA                               N Disch in past 14 days; Not disch

                               2,458                    . Missing
                               1,328                    0 Not indicated
                               1,751                    1 Indicated

M0175_ON  135  1  INDICOA                               N Disch in past 14 days; Other nursing hom

                               2,458                    . Missing
                               3,077                    0 Not indicated
                                   2                    1 Indicated

M0175_OT  136  1  INDICOA                               N Disch in past 14 days; Other

                               2,458                    . Missing
                               3,075                    0 Not indicated
                                   4                    1 Indicated

M0175_RH  137  1  INDICOA                               N Disch in past 14 days; Rehab

                               2,458                    . Missing
                               2,900                    0 Not indicated
                                 179                    1 Indicated

M0175_SN  138  1  INDICOA                               N Disch in past 14 days; SNF

                               2,458                    . Missing
                               2,886                    0 Not indicated
                                 193                    1 Indicated

M0180_DS  139  1                                        C Disch in past 14 days; UK flag

M0180_IN  140  8                                        N Inpatient discharge date

M0190_14  148  7                                        C Inpatient diag 1 ICD9

M0190_26  155  7                                        C Inpatient diag 2 ICD9

M0200_RE  162  1  YESNOOA                               N Treatment regimen change

                               2,280                    . Missing
                               1,552                    0 No
                               1,705                    1 Yes

M0210_27  163  7                                        C Changed regimen; ICD9 2

M0210_28  170  7                                        C Changed regimen; ICD9 3

M0210_29  177  7                                        C Changed regimen; ICD9 4

M0210_CH  184  7                                        C Changed regimen; ICD9 1

M0220_30  191  1  $INDICOA                              C Prior condition; Catheter

                               3,580                      Missing
                               1,876                    0 Not indicated
                                  81                    1 Indicated

M0220_31  192  1  $INDICOA                              C Prior condition; Intr pain

                               3,580                      Missing
                               1,728                    0 Not indicated
                                 229                    1 Indicated

M0220_32  193  1  $INDICOA                              C Prior condition; Impaired decision

                               3,580                      Missing
                               1,592                    0 Not indicated
                                 365                    1 Indicated

M0220_33  194  1  $INDICOA                              C Prior condition; Disruptive beh

                               3,580                      Missing
                               1,917                    0 Not indicated
                                  40                    1 Indicated

M0220_34  195  1  $INDICOA                              C Prior condition; Memory loss

                               3,580                      Missing
                               1,694                    0 Not indicated
                                 263                    1 Indicated

M0220_35  196  1  $INDICOA                              C Prior condition; None of listed

                               3,580                      Missing
                               1,144                    0 Not indicated
                                 813                    1 Indicated

M0220_36  197  1  $INDICOA                              C Prior condition; No change

                               3,675                      Missing
                               1,728                    0 Not indicated
                                 134                    1 Indicated

M0220_37  198  1  $INDICOA                              C Prior condition; Unknown

                               3,675                      Missing
                               1,848                    0 Not indicated
                                  14                    1 Indicated

M0220_PR  199  1  $INDICOA                              C Prior condition; Urinary incont

                               3,580                      Missing
                               1,300                    0 Not indicated
                                 657                    1 Indicated

M0230_38  200  2  $SEVEROA                              C Primary diag; Severity rating

                               2,045                      Missing
                                   2                   00 Asymptomatic, not treatement needed
                                  98                   01 Symptoms contr with current therapy
                               1,667                   02 Symptoms contr with difficulty
                               1,531                   03 Symptoms poorly contr, freq dose adjust
                                 194                   04 Symptoms poorly contr, hist rehospitali

M0230_PR  202  7                                        C Primary diag; ICD9

M0240_39  209  2  $SEVEROA                              C Oth diag 1; Severity rating

                               2,105                      Missing
                                   7                   00 Asymptomatic, not treatement needed
                                 267                   01 Symptoms contr with current therapy
                               1,815                   02 Symptoms contr with difficulty
                               1,226                   03 Symptoms poorly contr, freq dose adjust
                                 117                   04 Symptoms poorly contr, hist rehospitali

M0240_40  211  7                                        C Oth diag 2; ICD9

M0240_41  218  2  $SEVEROA                              C Oth diag 2; Severity rating

                               2,317                      Missing
                                  13                   00 Asymptomatic, not treatement needed
                                 393                   01 Symptoms contr with current therapy
                               1,815                   02 Symptoms contr with difficulty
                                 928                   03 Symptoms poorly contr, freq dose adjust
                                  71                   04 Symptoms poorly contr, hist rehospitali

M0240_42  220  7                                        C Oth diag 3; ICD9

M0240_43  227  2  $SEVEROA                              C Oth diag 3; Severity rating

                               2,724                      Missing
                                  17                   00 Asymptomatic, not treatement needed
                                 458                   01 Symptoms contr with current therapy
                               1,616                   02 Symptoms contr with difficulty
                                 675                   03 Symptoms poorly contr, freq dose adjust
                                  47                   04 Symptoms poorly contr, hist rehospitali

M0240_44  229  7                                        C Oth diag 4; ICD9

M0240_45  236  2  $SEVEROA                              C Oth diag 4; Severity rating

                               3,234                      Missing
                                  20                   00 Asymptomatic, not treatement needed
                                 460                   01 Symptoms contr with current therapy
                               1,326                   02 Symptoms contr with difficulty
                                 455                   03 Symptoms poorly contr, freq dose adjust
                                  42                   04 Symptoms poorly contr, hist rehospitali

M0240_46  238  7                                        C Oth diag 5; ICD9

M0240_47  245  2  $SEVEROA                              C Oth diag 5; Severity rating

                               3,856                      Missing
                                  14                   00 Asymptomatic, not treatement needed
                                 386                   01 Symptoms contr with current therapy
                                 908                   02 Symptoms contr with difficulty
                                 345                   03 Symptoms poorly contr, freq dose adjust
                                  28                   04 Symptoms poorly contr, hist rehospitali

M0240_OT  247  7                                        C Oth diag 1; ICD9

M0250_48  254  1  INDICOA                               N Home therapies; Par nutr

                                 650                    . Missing
                               4,885                    0 Not indicated
                                   2                    1 Indicated

M0250_49  255  1  INDICOA                               N Home therapies; Ent nutr

                                 650                    . Missing
                               4,825                    0 Not indicated
                                  62                    1 Indicated

M0250_50  256  1  INDICOA                               N Home therapies; None of above

                                 650                    . Missing
                                 140                    0 Not indicated
                               4,747                    1 Indicated

M0250_TH  257  1  INDICOA                               N Home therapies; IV infusion

                                 650                    . Missing
                               4,803                    0 Not indicated
                                  84                    1 Indicated

M0260_OA  258  2  $OVPRGOA                              C Overall prognosis

                               3,675                      Missing
                                  11                   UK Unknown
                                 318                   00 Poor
                               1,533                   01 Good/Fair

M0270_RH  260  2  $REPRGOA                              C Rehab prognosis

                               3,675                      Missing
                                  14                   UK Unknown
                                 661                   00 Guarded
                               1,187                   01 Good

M0280_LI  262  2  $LIFEEOA                              C Life expectancy

                               2,280                      Missing
                               2,623                   00 Life expectancy is greater than 6 months
                                 634                   01 life expectancy is 6 month or fewer

M0290_51  264  1  INDICOA                               N High risk factors; Obesity

                               2,280                    . Missing
                               2,801                    0 Not indicated
                                 456                    1 Indicated

M0290_52  265  1  INDICOA                               N High risk factors; Alcohol

                               2,280                    . Missing
                               3,226                    0 Not indicated
                                  31                    1 Indicated

M0290_53  266  1  INDICOA                               N High risk factors; Drugs

                               2,280                    . Missing
                               3,231                    0 Not indicated
                                  26                    1 Indicated

M0290_54  267  1  INDICOA                               N High risk factors; None

                               2,280                    . Missing
                                 661                    0 Not indicated
                               2,596                    1 Indicated

M0290_55  268  1  INDICOA                               N High risk factors; Unknown

                               3,675                    . Missing
                               1,829                    0 Not indicated
                                  33                    1 Indicated

M0290_RS  269  1  INDICOA                               N High risk factors; Smoking

                               2,280                    . Missing
                               3,092                    0 Not indicated
                                 165                    1 Indicated

M0300_CU  270  2  $CURREOA                              C Current residence

                               2,280                      Missing
                               2,360                   01 Patient owned or rented residence
                                 438                   02 Family member residence
                                  32                   03 Boarding home or rented room
                                 410                   04 Board and care or assisted living facili
                                  17                   05 Other

M0310_S0  272  1  INDICOA                               N Struct barriers; Stairs must

                               5,537                    . Missing
                                   0                    0 Not indicated
                                   0                    1 Indicated

M0310_S1  273  1  INDICOA                               N Struct barriers; Stairs opt

                               5,537                    . Missing
                                   0                    0 Not indicated
                                   0                    1 Indicated

M0310_S2  274  1  INDICOA                               N Struct barriers; Stairs outside

                               5,537                    . Missing
                                   0                    0 Not indicated
                                   0                    1 Indicated

M0310_S3  275  1  INDICOA                               N Struct barriers; Doorways

                               5,537                    . Missing
                                   0                    0 Not indicated
                                   0                    1 Indicated

M0310_ST  276  1  INDICOA                               N Struct barriers; None

                               5,537                    . Missing
                                   0                    0 Not indicated
                                   0                    1 Indicated

M0320_10  277  1  INDICOA                               N Safety haz; Floor covering

                               5,537                    . Missing
                                   0                    0 Not indicated
                                   0                    1 Indicated

M0320_11  278  1  INDICOA                               N Safety haz; Railings

                               5,537                    . Missing
                                   0                    0 Not indicated
                                   0                    1 Indicated

M0320_12  279  1  INDICOA                               N Safety haz; Haz Materials

                               5,537                    . Missing
                                   0                    0 Not indicated
                                   0                    1 Indicated

M0320_13  280  1  INDICOA                               N Safety haz; Lead paint

                               5,537                    . Missing
                                   0                    0 Not indicated
                                   0                    1 Indicated

M0320_14  281  1  INDICOA                               N Safety haz; Other

                               5,537                    . Missing
                                   0                    0 Not indicated
                                   0                    1 Indicated

M0320_S4  282  1  INDICOA                               N Safety haz; Floor,roof,windows

                               5,537                    . Missing
                                   0                    0 Not indicated
                                   0                    1 Indicated

M0320_S5  283  1  INDICOA                               N Safety haz; Lighting

                               5,537                    . Missing
                                   0                    0 Not indicated
                                   0                    1 Indicated

M0320_S6  284  1  INDICOA                               N Safety haz; Appliances

                               5,537                    . Missing
                                   0                    0 Not indicated
                                   0                    1 Indicated

M0320_S7  285  1  INDICOA                               N Safety haz; Heating

                               5,537                    . Missing
                                   0                    0 Not indicated
                                   0                    1 Indicated

M0320_S8  286  1  INDICOA                               N Safety haz; Cooling

                               5,537                    . Missing
                                   0                    0 Not indicated
                                   0                    1 Indicated

M0320_S9  287  1  INDICOA                               N Safety haz; Lack of fire devices

                               5,537                    . Missing
                                   0                    0 Not indicated
                                   0                    1 Indicated

M0320_SA  288  1  INDICOA                               N Safety haz; None

                               5,537                    . Missing
                                   0                    0 Not indicated
                                   0                    1 Indicated

M0330_15  289  1  INDICOA                               N Sanitation haz; No running water

                               5,537                    . Missing
                                   0                    0 Not indicated
                                   0                    1 Indicated

M0330_16  290  1  INDICOA                               N Sanitation haz; Contaminated water

                               5,537                    . Missing
                                   0                    0 Not indicated
                                   0                    1 Indicated

M0330_17  291  1  INDICOA                               N Sanitation haz; No toilet fac

                               5,537                    . Missing
                                   0                    0 Not indicated
                                   0                    1 Indicated

M0330_18  292  1  INDICOA                               N Sanitation haz; Outdoor toilet fac

                               5,537                    . Missing
                                   0                    0 Not indicated
                                   0                    1 Indicated

M0330_19  293  1  INDICOA                               N Sanitation haz; Inadequate sewer disp

                               5,537                    . Missing
                                   0                    0 Not indicated
                                   0                    1 Indicated

M0330_20  294  1  INDICOA                               N Sanitation haz; Inadequate food stor

                               5,537                    . Missing
                                   0                    0 Not indicated
                                   0                    1 Indicated

M0330_21  295  1  INDICOA                               N Sanitation haz; No food refridge

                               5,537                    . Missing
                                   0                    0 Not indicated
                                   0                    1 Indicated

M0330_22  296  1  INDICOA                               N Sanitation haz; No cooking fac

                               5,537                    . Missing
                                   0                    0 Not indicated
                                   0                    1 Indicated

M0330_23  297  1  INDICOA                               N Sanitation haz; Insects/rodents present

                               5,537                    . Missing
                                   0                    0 Not indicated
                                   0                    1 Indicated

M0330_24  298  1  INDICOA                               N Sanitation haz; No trash pickup

                               5,537                    . Missing
                                   0                    0 Not indicated
                                   0                    1 Indicated

M0330_25  299  1  INDICOA                               N Sanitation haz; Cluttered/Soiled living

                               5,537                    . Missing
                                   0                    0 Not indicated
                                   0                    1 Indicated

M0330_26  300  1  INDICOA                               N Sanitation haz; Other

                               5,537                    . Missing
                                   0                    0 Not indicated
                                   0                    1 Indicated

M0330_SA  301  1  INDICOA                               N Sanitation haz; None

                               5,537                    . Missing
                                   0                    0 Not indicated
                                   0                    1 Indicated

M0340_27  302  1  INDICOA                               N Patient lives w/ spouse

                               2,280                    . Missing
                               2,296                    0 Not indicated
                                 961                    1 Indicated

M0340_28  303  1  INDICOA                               N Patient lives w/ oth fam

                               2,280                    . Missing
                               2,289                    0 Not indicated
                                 968                    1 Indicated

M0340_29  304  1  INDICOA                               N Patient lives w/ friend

                               2,280                    . Missing
                               3,208                    0 Not indicated
                                  49                    1 Indicated

M0340_30  305  1  INDICOA                               N Patient lives w/ paid help

                               2,280                    . Missing
                               2,900                    0 Not indicated
                                 357                    1 Indicated

M0340_31  306  1  INDICOA                               N Patient lives w/ other

                               2,280                    . Missing
                               3,219                    0 Not indicated
                                  38                    1 Indicated

M0340_LI  307  1  INDICOA                               N Patient lives w/ alone

                               2,280                    . Missing
                               2,235                    0 Not indicated
                               1,022                    1 Indicated

M0350_A0  308  1  INDICOA                               N Assist person; Home resident

                               2,280                    . Missing
                               1,635                    0 Not indicated
                               1,622                    1 Indicated

M0350_A1  309  1  INDICOA                               N Assist person; Paid help

                               2,280                    . Missing
                               2,408                    0 Not indicated
                                 849                    1 Indicated

M0350_A2  310  1  INDICOA                               N Assist person; None

                               2,280                    . Missing
                               3,138                    0 Not indicated
                                 119                    1 Indicated

M0350_A3  311  1  INDICOA                               N Assist person; Unknown

                               3,675                    . Missing
                               1,862                    0 Not indicated
                                   0                    1 Indicated

M0350_AP  312  1  INDICOA                               N Assist person; Relative/Friend

                               2,280                    . Missing
                               1,531                    0 Not indicated
                               1,726                    1 Indicated

M0360_PR  313  2  $PRICAOA                              C Primary caregiver

                               2,399                      Missing
                                   0                   UK Unknown
                                 505                   00 No one person
                                 753                   01 Spouse of significant other
                               1,021                   02 Daughter or son
                                 264                   03 Other family member
                                 101                   04 Friend, neighbor, community, church memb
                                 494                   05 Paid help

M0370_FR  315  2  $OFTASOA                              C Primary caregiver; How often

                               2,904                      Missing
                                   2                   UK Unknown
                               1,083                   01 Several times during day or night
                                 887                   02 Several times during day
                                 229                   03 Once daily
                                 255                   04 Three or more times per week
                                 138                   05 One to two times per week
                                  39                   06 Less often than weekly

M0380_10  317  1  $INDICOA                              C Caregiver assist; Unknown

                               3,988                      Missing
                               1,549                    0 Not indicated
                                   0                    1 Indicated

M0380_C4  318  1  $INDICOA                              C Caregiver assist; IADL

                               2,904                      Missing
                                 255                    0 Not indicated
                               2,378                    1 Indicated

M0380_C5  319  1  $INDICOA                              C Caregiver assist; Environmental

                               2,904                      Missing
                                 257                    0 Not indicated
                               2,376                    1 Indicated

M0380_C6  320  1  $INDICOA                              C Caregiver assist; Psychosocial

                               2,904                      Missing
                                 206                    0 Not indicated
                               2,427                    1 Indicated

M0380_C7  321  1  $INDICOA                              C Caregiver assist; Medical care

                               2,904                      Missing
                                 619                    0 Not indicated
                               2,014                    1 Indicated

M0380_C8  322  1  $INDICOA                              C Caregiver assist; Financial/Legal

                               2,904                      Missing
                               1,957                    0 Not indicated
                                 676                    1 Indicated

M0380_C9  323  1  $INDICOA                              C Caregiver assist; Health care agent

                               2,904                      Missing
                               2,101                    0 Not indicated
                                 532                    1 Indicated

M0380_CA  324  1  $INDICOA                              C Caregiver assist; ADL

                               2,904                      Missing
                               1,081                    0 Not indicated
                               1,552                    1 Indicated

M0390_VI  325  2  $VISIOOA                              C Physical assesment; Vision

                               2,045                      Missing
                               2,307                   00 Normal vision
                               1,056                   01 Partially impaired
                                 129                   02 Severely impaired

M0400_HE  327  2  $HEARIOA                              C Physical assesment; Hearing

                               3,675                      Missing
                               1,061                   00 No observable impairement
                                 633                   01 Minimal difficulty
                                 142                   02 Moderate difficulty
                                  20                   03 Severe difficulty
                                   6                   04 Unable to hear or nonresponsive

M0410_SP  329  2  $SPEECOA                              C Physical assesment; Speech

                               2,280                      Missing
                               2,136                   00 No observable impairement
                                 803                   01 Minimal difficulty
                                 205                   02 Moderate difficulty
                                  78                   03 Severe difficulty
                                  20                   04 Unable to express basic needs
                                  15                   05 Nonresponsive or unable to speak

M0420_FR  331  2  $FREQPOA                              C Frequency of pain

                                 650                      Missing
                               1,834                   00 No pain or pain does not interfere
                                 720                   01 Less often than daily
                               1,954                   02 Daily, but not constantly
                                 379                   03 All of the time

M0430_IN  333  1  YESNOOA                               N Intractable pain

                               2,280                    . Missing
                               2,816                    0 No
                                 441                    1 Yes

M0440_LE  334  1  YESNOOA                               N Skin lesion/Open wound

                                 650                    . Missing
                               1,853                    0 No
                               3,034                    1 Yes

M0445_PR  335  1  $YESNOOA                              C Pressure ulcer

                               3,486                      Missing
                               1,865                    0 No
                                 186                    1 Yes

M0450_N0  336  2  $ULNUMOA                              C No. of press ulcers Stage 2

                               4,687                      Missing
                                 673                   00 None
                                 120                   01 One
                                  41                   02 Two
                                   9                   03 Three
                                   7                   04 Four or more

M0450_N1  338  2  $ULNUMOA                              C No. of press ulcers Stage 3

                               4,692                      Missing
                                 754                   00 None
                                  61                   01 One
                                  17                   02 Two
                                   9                   03 Three
                                   4                   04 Four or more

M0450_N2  340  2  $ULNUMOA                              C No. of press ulcers Stage 4

                               4,694                      Missing
                                 807                   00 None
                                  17                   01 One
                                   6                   02 Two
                                   0                   03 Three
                                  13                   04 Four or more

M0450_NB  342  2  $ULNUMOA                              C No. of Press ulcers Stage 1

                               4,689                      Missing
                                 734                   00 None
                                  83                   01 One
                                  24                   02 Two
                                   3                   03 Three
                                   4                   04 Four or more

M0450_UN  344  1  $YESNOOA                              C Press ulcer cannot be observed

                               4,696                      Missing
                                 811                    0 No
                                  30                    1 Yes

M0460_ST  345  2  $ULSTGOA                              C Stage of most prob press ulcer

                               5,165                      Missing
                                  22                   NA No observable pressure ulcer
                                  89                   01 Stage one
                                 149                   02 Stage two
                                  77                   03 Stage three
                                  35                   04 Stage four

M0464_ST  347  2  $ULSTAOA                              C Status of most prob press ulcer

                               5,351                      Missing
                                   7                   NA No observable pressure ulcer
                                  35                   01 Fully granulating
                                  77                   02 Early/Partial granulation
                                  67                   03 Not healing

M0468_ST  349  1  $YESNOOA                              C Stasis ulcer

                               3,486                      Missing
                               2,001                    0 No
                                  50                    1 Yes

M0470_NB  350  2  $ULNUMOA                              C No. of statis ulcers

                               5,271                      Missing
                                 197                   00 None
                                  38                   01 One
                                  16                   02 Two
                                   7                   03 Three
                                   8                   04 Four or more

M0474_UN  352  1  $YESNOOA                              C Stasis ulcer that cannot be observed

                               5,275                      Missing
                                 257                    0 No
                                   5                    1 Yes

M0476_ST  353  2  $ULSTAOA                              C Status of most problemat stasis ulcer

                               5,204                      Missing
                                 216                   NA No observable pressure ulcer
                                   7                   01 Fully granulating
                                  60                   02 Early/Partial granulation
                                  50                   03 Not healing

M0482_SU  355  1  $YESNOOA                              C Surgical wound

                               3,486                      Missing
                               1,406                    0 No
                                 645                    1 Yes

M0484_NB  356  2  $ULNUMOA                              C No. of surgical wounds

                               4,892                      Missing
                                  18                   00 None
                                 445                   01 One
                                  92                   02 Two
                                  34                   03 Three
                                  56                   04 Four or more

M0486_UN  358  1  $YESNOOA                              C Surgical wound that cannot be observed

                               4,892                      Missing
                                 600                    0 No
                                  45                    1 Yes

M0488_ST  359  2  $ULSTAOA                              C Status of most problemat surgical wound

                               4,597                      Missing
                                 225                   NA No observable pressure ulcer
                                 313                   01 Fully granulating
                                 344                   02 Early/Partial granulation
                                  58                   03 Not healing

M0490_WH  361  2  $SBREAOA                              C When is patient dyspneic

                                 650                      Missing
                               1,606                   00 Never
                               1,256                   01 When walking more than 20 feet
                               1,309                   02 With moderate exertion
                                 598                   03 With minimal exertion
                                 118                   04 At rest (day or night)

M0500_R0  363  1  INDICOA                               N Respir treatment; Ventilator

                               2,280                    . Missing
                               3,257                    0 Not indicated
                                   0                    1 Indicated

M0500_R1  364  1  INDICOA                               N Respir treatment; Airway pressure

                               2,280                    . Missing
                               3,221                    0 Not indicated
                                  36                    1 Indicated

M0500_R2  365  1  INDICOA                               N Respir treatment; None

                               2,280                    . Missing
                                 468                    0 Not indicated
                               2,789                    1 Indicated

M0500_RE  366  1  INDICOA                               N Respir treatment; Oxygen

                               2,280                    . Missing
                               2,818                    0 Not indicated
                                 439                    1 Indicated

M0510_UT  367  2  $UTINFOA                              C Urinary tract infection

                               2,280                      Missing
                                  17                   NA Patient on prophylactic treatment
                                   9                   UK Unknown
                               3,007                   00 No
                                 224                   01 Yes

M0520_UR  369  2  $UIUCPOA                              C Urinary incontinence

                               1,867                      Missing
                               1,946                   00 No incontinence or catheter
                               1,542                   01 Patient is incintinent
                                 182                   02 Patient requires a urinary catheter

M0530_UR  371  2  $URINCOA                              C Urinary incontinence occurs

                               3,221                      Missing
                                 410                   00 Timed-voiding deters incontinence
                                 141                   01 During the night only
                               1,765                   02 During the day and night

M0540_BW  373  2  $BWINCOA                              C Bowel incontinence frequency

                                 650                      Missing
                                  85                   NA Patient has ostomy for bowel elimination
                                   3                   UK Unknown
                               3,873                   00 Very rarely or never has bowel incont
                                 192                   01 Less than once weekly
                                 346                   02 One to three times weekly
                                 146                   03 Four to six times weekly
                                 192                   04 On a daily basis
                                  50                   05 More often than once daily

M0550_OS  375  2  $BWOSTOA                              C Ostomy

                                 650                      Missing
                               4,802                   00 Does not have an ostomy
                                  69                   01 Ostomy was not related to inpatient stay
                                  16                   02 Ostomy was related to inpatient stay

M0560_CO  377  2  $COGFUOA                              C Cognitive functioning

                               2,280                      Missing
                               1,968                   00 Alert/Oriented
                                 835                   01 Req prompting
                                 319                   02 Req assist and some direction
                                  99                   03 Req conciderable assist in routine situa
                                  36                   04 Totally dependent due to disturbances

M0570_WH  379  2  $WCONFOA                              C When confused (reported or observed)

                               2,280                      Missing
                                  11                   NA Patient nonresponsive
                               1,696                   00 Never
                               1,067                   01 In new or complex situations
                                  55                   02 On awakening or at night only
                                 328                   03 During the day or evening
                                 100                   04 Constantly

M0580_WH  381  2  $WANXIOA                              C When anxious (reported or observed)

                               2,280                      Missing
                                  17                   NA Patient nonresponsive
                               1,997                   00 None of the time
                                 735                   01 Less often than daily
                                 485                   02 Daily, but not constantly
                                  23                   03 All of the time

M0590_D0  383  1  INDICOA                               N Sense of failure or self reproach

                               2,280                    . Missing
                               3,230                    0 Not indicated
                                  27                    1 Indicated

M0590_D1  384  1  INDICOA                               N Hopelessness

                               2,280                    . Missing
                               3,193                    0 Not indicated
                                  64                    1 Indicated

M0590_D2  385  1  INDICOA                               N Recurrent thoughts of death

                               2,280                    . Missing
                               3,246                    0 Not indicated
                                  11                    1 Indicated

M0590_D3  386  1  INDICOA                               N Thoughts of suicide

                               2,280                    . Missing
                               3,251                    0 Not indicated
                                   6                    1 Indicated

M0590_D4  387  1  INDICOA                               N None of the above feelings

                               2,280                    . Missing
                                 590                    0 Not indicated
                               2,667                    1 Indicated

M0590_DP  388  1  INDICOA                               N Depressed mood

                               2,280                    . Missing
                               2,696                    0 Not indicated
                                 561                    1 Indicated

M0600_10  389  1  INDICOA                               N None of the above behaviors

                               5,537                    . Missing
                                   0                    0 Not indicated
                                   0                    1 Indicated

M0600_B5  390  1  INDICOA                               N Diminished interest in most activities

                               5,537                    . Missing
                                   0                    0 Not indicated
                                   0                    1 Indicated

M0600_B6  391  1  INDICOA                               N Sleep disturbances

                               5,537                    . Missing
                                   0                    0 Not indicated
                                   0                    1 Indicated

M0600_B7  392  1  INDICOA                               N Recent change in appetite or weight

                               5,537                    . Missing
                                   0                    0 Not indicated
                                   0                    1 Indicated

M0600_B8  393  1  INDICOA                               N Agitation

                               5,537                    . Missing
                                   0                    0 Not indicated
                                   0                    1 Indicated

M0600_B9  394  1  INDICOA                               N A suicide attempt

                               5,537                    . Missing
                                   0                    0 Not indicated
                                   0                    1 Indicated

M0600_BE  395  1  INDICOA                               N Indecisiveness, lack of concentration

                               5,537                    . Missing
                                   0                    0 Not indicated
                                   0                    1 Indicated

M0610_11  396  1  INDICOA                               N Impaired decision-making

                               1,063                    . Missing
                               3,336                    0 Not indicated
                               1,138                    1 Indicated

M0610_12  397  1  INDICOA                               N Verbal disruption

                               1,063                    . Missing
                               4,396                    0 Not indicated
                                  78                    1 Indicated

M0610_13  398  1  INDICOA                               N Physical aggression

                               1,063                    . Missing
                               4,419                    0 Not indicated
                                  55                    1 Indicated

M0610_14  399  1  INDICOA                               N Disruptive, infantile, or socially inapp

                               1,063                    . Missing
                               4,418                    0 Not indicated
                                  56                    1 Indicated

M0610_15  400  1  INDICOA                               N Delusional, hallucinatory, or paranoid

                               1,063                    . Missing
                               4,356                    0 Not indicated
                                 118                    1 Indicated

M0610_16  401  1  INDICOA                               N None of the above behaivors demonstrated

                               1,063                    . Missing
                               1,578                    0 Not indicated
                               2,896                    1 Indicated

M0610_BD  402  1  INDICOA                               N Memory deficit

                               1,063                    . Missing
                               3,431                    0 Not indicated
                               1,043                    1 Indicated

M0620_BE  403  2  $FREQBOA                              C Frequency of behavior problems

                               2,280                      Missing
                                   0                    0 As reported
                               2,699                   00 Never
                                  49                   01 Less than once a month
                                  12                   02 One a month
                                  55                   03 Several times each month
                                 129                   04 Several times a week
                                 313                   05 At least daily

M0630_RE  405  1  YESNOOA                               N Receiving psychiatric nursing services

                               2,280                    . Missing
                               3,214                    0 No
                                  43                    1 Yes

M0640_CU  406  2  $GROOMOA                              C Grooming, current

                               2,280                      Missing
                                   0                   UK Unknown
                               1,772                   00 Able to groom self unaided
                                 737                   01 Utensils must be placed within reach
                                 526                   02 Someone must assis patient to groom self
                                 222                   03 Depends entirely upon another person

M0640_PR  408  2  $GROOMOA                              C Grooming, prior

                               3,675                      Missing
                                  18                   UK Unknown
                               1,001                   00 Able to groom self unaided
                                 387                   01 Utensils must be placed within reach
                                 298                   02 Someone must assis patient to groom self
                                 158                   03 Depends entirely upon another person

M0650_CU  410  2  $DRESSOA                              C Ability to dress upper body, current

                                 650                      Missing
                                   0                   UK Unknown
                               2,030                   00 No assist needed
                               1,238                   01 No assist needed if clothing laid out
                               1,145                   02 Assist from another person
                                 474                   03 Depends entirely upon another person

M0650_PR  412  2  $DRESSOA                              C Ability to dress upper body, prior

                               3,675                      Missing
                                  18                   UK Unknown
                                 873                   00 No assist needed
                                 404                   01 No assist needed if clothing laid out
                                 398                   02 Assist from another person
                                 169                   03 Depends entirely upon another person

M0660_CU  414  2  $DRESSOA                              C Ability to dress lower body, current

                                 650                      Missing
                                   0                   UK Unknown
                               1,710                   00 No assist needed
                                 897                   01 No assist needed if clothing laid out
                               1,633                   02 Assist from another person
                                 647                   03 Depends entirely upon another person

M0660_PR  416  2  $DRESSOA                              C Ability to dress lower body, prior

                               3,675                      Missing
                                  19                   UK Unknown
                                 797                   00 No assist needed
                                 288                   01 No assist needed if clothing laid out
                                 524                   02 Assist from another person
                                 234                   03 Depends entirely upon another person

M0670_CU  418  2  $BATHIOA                              C Bathing, current

                                 650                      Missing
                                   0                   UK Unknown
                                 577                   00 Bathes self independently
                                 839                   01 Bathes self with use of devices
                               1,381                   02 Bathes with intermittent assist
                               1,207                   03 Bathes with complete assist/supervision
                                 557                   04 Unable, bed/bedside chair
                                 326                   05 Unable, totally bathed by another person

M0670_PR  420  2  $BATHIOA                              C Bathing, prior

                               3,675                      Missing
                                  20                   UK Unknown
                                 435                   00 Bathes self independently
                                 295                   01 Bathes self with use of devices
                                 409                   02 Bathes with intermittent assist
                                 390                   03 Bathes with complete assist/supervision
                                 192                   04 Unable, bed/bedside chair
                                 121                   05 Unable, totally bathed by another person

M0680_CU  422  2  $TOILEOA                              C Toileting, current

                                 650                      Missing
                                   0                   UK Unknown
                               2,971                   00 Toilet, to and from independently
                               1,169                   01 Toilet, when reminded/assist/supervised
                                 297                   02 Unable toil, able to bedside commode
                                  45                   03 Unable toil/bedside commode, able bedpan
                                 405                   04 Depends entirely upon another person

M0680_PR  424  2  $TOILEOA                              C Toileting, prior

                               3,675                      Missing
                                  18                   UK Unknown
                               1,179                   00 Toilet, to and from independently
                                 417                   01 Toilet, when reminded/assist/supervised
                                  96                   02 Unable toil, able to bedside commode
                                  22                   03 Unable toil/bedside commode, able bedpan
                                 130                   04 Depends entirely upon another person

M0690_CU  426  2  $TRANSOA                              C Transferring, current

                                 650                      Missing
                                   0                   UK Unknown
                               1,334                   00 Able to independently transfer
                               2,860                   01 Transfers with minimal assist or device
                                 391                   02 Unable transfer self, able to pivot
                                 148                   03 Unable transfer self, unable to pivot
                                  28                   04 Bedfast, unable trans, able to positio
                                 126                   05 Bedfast, unable trans, unable to positio

M0690_PR  428  2  $TRANSOA                              C Transferring, prior

                               3,675                      Missing
                                  19                   UK Unknown
                                 647                   00 Able to independently transfer
                                 947                   01 Transfers with minimal assist or device
                                 146                   02 Unable transfer self, able to pivot
                                  49                   03 Unable transfer self, unable to pivot
                                  19                   04 Bedfast, unable trans, able to positio
                                  35                   05 Bedfast, unable trans, unable to positio

M0700_CU  430  2  $AMBULOA                              C Ambulation/Locomotion, current

                                 650                      Missing
                                   0                   UK Unknown
                                 605                   00 Able to independently walk/stairs
                               2,951                   01 Able to walk w/ device, assist w/ stairs
                                 796                   02 Able to walk w/ constant assist/supervis
                                 233                   03 Chairfast, able to wheel self independ
                                 203                   04 Chairfast, unable to wheel self independ
                                  99                   05 Bedfast, unable to ambulate/or chair

M0700_PR  432  2  $AMBULOA                              C Ambulation/Locomotion, prior

                               3,675                      Missing
                                  20                   UK Unknown
                                 439                   00 Able to independently walk/stairs
                                 927                   01 Able to walk w/ device, assist w/ stairs
                                 308                   02 Able to walk w/ constant assist/supervis
                                  77                   03 Chairfast, able to wheel self independ
                                  64                   04 Chairfast, unable to wheel self independ
                                  27                   05 Bedfast, unable to ambulate/or chair

M0710_CU  434  2  $FEEDIOA                              C Feeding or eating, current

                               2,280                      Missing
                                   0                   UK Unknown
                               2,179                   00 Able independently feed self
                                 913                   01 Able feed self with intermittent assist
                                 129                   02 Unable feed self, complete assist/superv
                                  14                   03 Able take nutri oral, rec tube feedi
                                  18                   04 Unable take nutri oral, rec tube feedi
                                   4                   05 Unable take nutri oral or tube feedi

M0710_PR  436  2  $FEEDIOA                              C Feeding or eating, prior

                               3,675                      Missing
                                  15                   UK Unknown
                               1,236                   00 Able independently feed self
                                 513                   01 Able feed self with intermittent assist
                                  77                   02 Unable feed self, complete assist/superv
                                  10                   03 Able take nutri oral, rec tube feedi
                                   8                   04 Unable take nutri oral, rec tube feedi
                                   3                   05 Unable take nutri oral or tube feedi

M0720_CU  438  2  $MEALSOA                              C Planning/Preparing light meals, current

                               2,280                      Missing
                                   0                   UK Unknown
                               1,189                   00 Able to independently prepare all meals
                               1,039                   01 Unable to prepare meals on regular basis
                               1,029                   02 Unable to prepare any meals

M0720_PR  440  2  $MEALSOA                              C Planning/Preparing light meals, prior

                               3,675                      Missing
                                  19                   UK Unknown
                                 723                   00 Able to independently prepare all meals
                                 470                   01 Unable to prepare meals on regular basis
                                 650                   02 Unable to prepare any meals

M0730_CU  442  2  $TRANPOA                              C Transportation, current

                               2,280                      Missing
                                   0                   UK Unknown
                                 241                   00 Able to independently drive car
                               2,888                   01 Able to ride when car driven by another
                                 128                   02 Unable to ride in car, trans by ambulanc

M0730_PR  444  2  $TRANPOA                              C Transportation, prior

                               3,675                      Missing
                                  15                   UK Unknown
                                 323                   00 Able to independently drive car
                               1,425                   01 Able to ride when car driven by another
                                  99                   02 Unable to ride in car, trans by ambulanc

M0740_CU  446  2  $LAUNDOA                              C Laundry, current

                               2,280                      Missing
                                   0                   UK Unknown
                                 321                   00 Able to independently do laundry
                                 940                   01 Able to do only lt laundry, assist heavy
                               1,996                   02 Unable to do any laundry

M0740_PR  448  2  $LAUNDOA                              C Laundry, prior

                               3,675                      Missing
                                  15                   UK Unknown
                                 357                   00 Able to independently do laundry
                                 418                   01 Able to do only lt laundry, assist heavy
                               1,072                   02 Unable to do any laundry

M0750_CU  450  2  $HOUSEOA                              C Housekeeping, current

                               2,280                      Missing
                                   0                   UK Unknown
                                 201                   00 Able independently perform houskeep
                                 935                   01 Able perform only light houskeep
                                 225                   02 Able perform houskeep w/ intermit assist
                                 448                   03 Unable perform houskeep w/o compl assist
                               1,448                   04 Unable particip in any houskeep tasks

M0750_PR  452  2  $HOUSEOA                              C Housekeeping, prior

                               3,675                      Missing
                                  16                   UK Unknown
                                 316                   00 Able independently perform houskeep
                                 401                   01 Able perform only light houskeep
                                  81                   02 Able perform houskeep w/ intermit assist
                                 217                   03 Unable perform houskeep w/o compl assist
                                 831                   04 Unable particip in any houskeep tasks

M0760_CU  454  2  $SHOPPOA                              C Shopping, current

                               2,280                      Missing
                                   0                   UK Unknown
                                 170                   00 Able to independently shop
                                 922                   01 Able to shop, but needs some assistance
                               1,197                   02 Unable to shop, but can arrange delivery
                                 968                   03 Needs someone to do all shop and errands

M0760_PR  456  2  $SHOPPOA                              C Shopping, prior

                               3,675                      Missing
                                  16                   UK Unknown
                                 297                   00 Able to independently shop
                                 421                   01 Able to shop, but needs some assistance
                                 509                   02 Unable to shop, but can arrange delivery
                                 619                   03 Needs someone to do all shop and errands

M0770_CU  458  2  $TELEPOA                              C Ability to use telephone, current

                               2,280                      Missing
                                  78                   NA Patient does not have a telephone
                                   0                   UK Unknown
                               2,289                   00 Able independently dial/answer calls
                                 228                   01 Able use a specif adapted phone and call
                                 218                   02 Able answer calls, diff placing calls
                                 188                   03 Able answer calls only some of the time
                                 103                   04 Unable answer phone at all, can listen
                                 153                   05 Totaly unable to use the telephone

M0770_PR  460  2  $TELEPOA                              C Ability to use telephone, prior

                               3,675                      Missing
                                  52                   NA Patient does not have a telephone
                                  15                   UK Unknown
                               1,272                   00 Able independently dial/answer calls
                                 134                   01 Able use a specif adapted phone and call
                                 125                   02 Able answer calls, diff placing calls
                                 104                   03 Able answer calls only some of the time
                                  67                   04 Unable answer phone at all, can listen
                                  93                   05 Totaly unable to use the telephone

M0780_CU  462  2  $MANRXOA                              C Manage oral medica, current

                               2,280                      Missing
                                  36                   NA No med of this type prescribed
                                   0                   UK Unknown
                               1,277                   00 Able to independently take correct med
                               1,101                   01 Able to take med corect times w/ assist
                                 843                   02 Unable to take med unless administered

M0780_PR  464  2  $MANRXOA                              C Manage oral medica, prior

                               3,675                      Missing
                                  29                   NA No med of this type prescribed
                                  16                   UK Unknown
                                 708                   00 Able to independently take correct med
                                 551                   01 Able to take med corect times w/ assist
                                 558                   02 Unable to take med unless administered

M0790_CU  466  2  $MANRXOA                              C Manage inhalation/mist medica, current

                               2,280                      Missing
                               2,576                   NA No med of this type prescribed
                                   0                   UK Unknown
                                 330                   00 Able to independently take correct med
                                 211                   01 Able to take med corect times w/ assist
                                 140                   02 Unable to take med unless administered

M0790_PR  468  2  $MANRXOA                              C Manage inhalation/mist medica, prior

                               3,675                      Missing
                               1,434                   NA No med of this type prescribed
                                  32                   UK Unknown
                                 189                   00 Able to independently take correct med
                                 108                   01 Able to take med corect times w/ assist
                                  99                   02 Unable to take med unless administered

M0800_CU  470  2  $MANRXOA                              C Manage injectable medica, current

                               1,867                      Missing
                               2,900                   NA No med of this type prescribed
                                   0                   UK Unknown
                                 229                   00 Able to independently take correct med
                                 105                   01 Able to take med corect times w/ assist
                                 436                   02 Unable to take med unless administered

M0800_PR  472  2  $MANRXOA                              C Manage injectable medica, prior

                               3,675                      Missing
                               1,485                   NA No med of this type prescribed
                                  42                   UK Unknown
                                 110                   00 Able to independently take correct med
                                  42                   01 Able to take med corect times w/ assist
                                 183                   02 Unable to take med unless administered

M0810_PA  474  2  $PQUIPOA                              C Patient management of equipment

                               2,280                      Missing
                               2,730                   NA No equipment used in this type of care
                                 121                   00 Able to independently manage all equip
                                 126                   01 Able to manage equip if someone sets up
                                  72                   02 Req considerable assist managing equip
                                  49                   03 Only able to monitor equipment
                                 159                   04 Depends entirely upon another person

M0820_CG  476  2  $CQUIPOA                              C Caregiver management of equipment

                               5,010                      Missing
                                  44                   NA No caregiver
                                   5                   UK Unknown
                                 273                   00 Able to independently manage all equip
                                 131                   01 Able to manage equip if someone sets up
                                  23                   02 Req considerable assist managing equip
                                  17                   03 Only able to monitor equipment
                                  34                   04 Depends entirely upon another person

M0825_TH  478  2  $YESNAOA                              C Indication of therapy need

                               2,522                      Missing
                                 261                   NA Inapplicable
                               1,823                   00 No
                                 931                   01 Yes

M0830_E0  480  1  INDICOA                               N Emerg; Hospital emergency room

                               3,500                    . Missing
                               1,616                    0 Not indicated
                                 421                    1 Indicated

M0830_E1  481  1  INDICOA                               N Emerg; Doctors office emerg visit

                               3,500                    . Missing
                               1,993                    0 Not indicated
                                  44                    1 Indicated

M0830_E2  482  1  INDICOA                               N Emerg; Outpatient depart/clinic emerg

                               3,500                    . Missing
                               2,025                    0 Not indicated
                                  12                    1 Indicated

M0830_E3  483  1  INDICOA                               N Emerg; Unknown emergent care

                               3,500                    . Missing
                               2,001                    0 Not indicated
                                  36                    1 Indicated

M0830_EC  484  1  INDICOA                               N Emerg; No emergent care services

                               3,500                    . Missing
                                 507                    0 Not indicated
                               1,530                    1 Indicated

M0840_10  485  1  $INDICOA                              C Reas; GI bleeding, obstruction

                               5,066                      Missing
                                 459                    0 Not indicated
                                  12                    1 Indicated

M0840_11  486  1  $INDICOA                              C Reas; Other emergent care reason

                               5,066                      Missing
                                 253                    0 Not indicated
                                 218                    1 Indicated

M0840_12  487  1  $INDICOA                              C Reas; Unknown emergent care reason

                               5,066                      Missing
                                 433                    0 Not indicated
                                  38                    1 Indicated

M0840_E4  488  1  $INDICOA                              C Reas; Nausia, dehydration, malnutrition

                               5,066                      Missing
                                 433                    0 Not indicated
                                  38                    1 Indicated

M0840_E5  489  1  $INDICOA                              C Reas; Injury from fall or home accident

                               5,066                      Missing
                                 434                    0 Not indicated
                                  37                    1 Indicated

M0840_E6  490  1  $INDICOA                              C Reas; Respiratory problems

                               5,066                      Missing
                                 384                    0 Not indicated
                                  87                    1 Indicated

M0840_E7  491  1  $INDICOA                              C Reas; Wound infection, new lesion/ulcer

                               5,066                      Missing
                                 451                    0 Not indicated
                                  20                    1 Indicated

M0840_E8  492  1  $INDICOA                              C Reas; Cardiac problems

                               5,066                      Missing
                                 425                    0 Not indicated
                                  46                    1 Indicated

M0840_E9  493  1  $INDICOA                              C Reas; Hypo/Hyperglycemia, diabetes

                               5,066                      Missing
                                 466                    0 Not indicated
                                   5                    1 Indicated

M0840_EC  494  1  $INDICOA                              C Reas; Improper medication administration

                               5,066                      Missing
                                 466                    0 Not indicated
                                   5                    1 Indicated

M0855_IN  495  2  $INFACOA                              C Inpatient facility admitted to

                               3,500                      Missing
                               1,395                   NA No inpatient facility admission
                                 613                   01 Hospital
                                   5                   02 Rehabilitation facility
                                  23                   03 Nursing home
                                   1                   04 Hospice

M0870_DS  497  2  $DISPOOA                              C Discharge disposition

                               4,144                      Missing
                                  10                   UK Unknown, other
                               1,323                   01 Patient remained in the community
                                  36                   02 Patient transferred to a noninsti hospic
                                  24                   03 Unknown, location not served by agency

M0880_A0  499  1  $INDICOA                              C Svcs after disch; Family/Friends

                               4,212                      Missing
                                 339                    0 Not indicated
                                 986                    1 Indicated

M0880_A1  500  1  $INDICOA                              C Svcs after disch; Other comm resources

                               4,212                      Missing
                                 940                    0 Not indicated
                                 385                    1 Indicated

M0880_AF  501  1  $INDICOA                              C Svcs after disch; No services

                               4,212                      Missing
                               1,181                    0 Not indicated
                                 144                    1 Indicated

M0890_HO  502  2  $RHOSPOA                              C Reason admitted to acute care hospital

                               4,924                      Missing
                                  10                   UK Unknown
                                 520                   01 Hospitalization; Emergent care
                                  55                   02 Hospitalization; Urgent care
                                  28                   03 Hospitalization; Elective care

M0895_10  504  1  $INDICOA                              C ReasHosp; Scheduled surgical procedure

                               4,924                      Missing
                                 582                    0 Not indicated
                                  31                    1 Indicated

M0895_11  505  1  $INDICOA                              C ReasHosp; Urinary tract infection

                               4,924                      Missing
                                 593                    0 Not indicated
                                  20                    1 Indicated

M0895_12  506  1  $INDICOA                              C ReasHosp; IV catheter-related infection

                               4,924                      Missing
                                 613                    0 Not indicated
                                   0                    1 Indicated

M0895_13  507  1  $INDICOA                              C ReasHosp; Pulminary embolus

                               4,924                      Missing
                                 607                    0 Not indicated
                                   6                    1 Indicated

M0895_14  508  1  $INDICOA                              C ReasHosp; Uncontrolled pain

                               4,924                      Missing
                                 590                    0 Not indicated
                                  23                    1 Indicated

M0895_15  509  1  $INDICOA                              C ReasHosp; Psychotic episode

                               4,924                      Missing
                                 606                    0 Not indicated
                                   7                    1 Indicated

M0895_16  510  1  $INDICOA                              C ReasHosp; Other reason

                               4,924                      Missing
                                 295                    0 Not indicated
                                 318                    1 Indicated

M0895_H2  511  1  $INDICOA                              C ReasHosp; Injury from fall or home accid

                               4,924                      Missing
                                 580                    0 Not indicated
                                  33                    1 Indicated

M0895_H3  512  1  $INDICOA                              C ReasHosp; Respiratory problems

                               4,924                      Missing
                                 512                    0 Not indicated
                                 101                    1 Indicated

M0895_H4  513  1  $INDICOA                              C ReasHosp; Wound infection, new lesion/ul

                               4,924                      Missing
                                 575                    0 Not indicated
                                  38                    1 Indicated

M0895_H5  514  1  $INDICOA                              C ReasHosp; Hypo/Hyperglycemia, diabetes

                               4,924                      Missing
                                 606                    0 Not indicated
                                   7                    1 Indicated

M0895_H6  515  1  $INDICOA                              C ReasHosp; GI bleeding, obstruction

                               4,924                      Missing
                                 596                    0 Not indicated
                                  17                    1 Indicated

M0895_H7  516  1  $INDICOA                              C ReasHosp; Exac of CHF, heart failure

                               4,924                      Missing
                                 577                    0 Not indicated
                                  36                    1 Indicated

M0895_H8  517  1  $INDICOA                              C ReasHosp; Myocardial infarction, stroke

                               4,924                      Missing
                                 589                    0 Not indicated
                                  24                    1 Indicated

M0895_H9  518  1  $INDICOA                              C ReasHosp; Chemotherapy

                               4,924                      Missing
                                 611                    0 Not indicated
                                   2                    1 Indicated

M0895_HO  519  1  $INDICOA                              C ReasHosp; Improper medical administratio

                               4,924                      Missing
                                 605                    0 Not indicated
                                   8                    1 Indicated

M0900_17  520  1  $INDICOA                              C Reason admitted to nursing home

                               5,514                      Missing
                                  21                    0 Not indicated
                                   2                    1 Indicated

M0900_18  521  1  $INDICOA                              C ReasHome; Hospice care

                               5,514                      Missing
                                  23                    0 Not indicated
                                   0                    1 Indicated

M0900_19  522  1  $INDICOA                              C ReasHome; Permanent Placement

                               5,514                      Missing
                                  10                    0 Not indicated
                                  13                    1 Indicated

M0900_20  523  1  $INDICOA                              C ReasHome; Unsafe for care at home

                               5,514                      Missing
                                  19                    0 Not indicated
                                   4                    1 Indicated

M0900_21  524  1  $INDICOA                              C ReasHome; Other reason

                               5,514                      Missing
                                  18                    0 Not indicated
                                   5                    1 Indicated

M0900_22  525  1  $INDICOA                              C ReasHome; Unknown reason

                               5,514                      Missing
                                  22                    0 Not indicated
                                   1                    1 Indicated

M0900_NH  526  1  $INDICOA                              C ReasHome; Therapy Services

                               5,514                      Missing
                                  22                    0 Not indicated
                                   1                    1 Indicated

M0903_LA  527  8                                        N Date of last home visit

M0906_DC  535  8                                        N Discharge/Transfer/Death date

