RIC         1  2                                        C Record Identification Code

VERSION     3  1                                        C Version Number

BASEID      4  8  $BSIDFMT                              C Unique SP Identification Number

                              23,659             LOW-HIGH BASEID Count

AA2        12  2  GEND                                  N ID; sex

                                   1                    . Missing
                               5,051                    1 Male
                              18,607                    2 Female

AA3        14  8                                        N ID; birthdate

AA4        24  2  RACEETH                               N ID; race/ethnicity

                                 112                    . Missing
                                  21                    1 Amer Indian/Alaskan Native
                                 202                    2 Asian/Pacific Islander
                               2,701                    3 Black, not of Hispanic origin
                                 714                    4 Hispanic
                              19,909                    5 White, not of Hispanic origin

AA6A       26 15                                        C ID; facility provider number, state

AA6B       41 12                                        C ID, facility provider number, federal

AA8A       53  2  $PASSESS                              C ID; primary reason for assessment

                               4,490                   00 None of above
                               2,026                   01 Admission assessment
                               2,109                   02 Annual assessment
                                 904                   03 Signif change is status assessment
                                   5                   04 Signif correction of prior full
                               8,574                   05 Quarterly review assessment
                               1,778                   06 Discharged; return not anticipated
                               1,764                   07 Discharged; return anticipated
                                 384                   08 Discharged; prior to initial assessment
                               1,622                   09 Re-entry
                                   3                   10 Signif correction of prior quarterly

AA8B       55  1  $CASSESS                              C ID; codes for assessments required

                              17,021                      Missing
                               2,435                    1 Medicare 5 day assessment
                               1,080                    2 Medicare 30 day assessment
                                 414                    3 Medicare 60 day assessment
                                 180                    4 Medicare 90 day assessment
                                 338                    5 Medicare readmission/return assessment
                                 114                    6 Other state required assessment
                               1,900                    7 Medicare 14 day assessment
                                 177                    8 Other Medicare required assessment

AB1        56  8                                        N Residential; date of entry

AB2        66  2  ADMITFRM                              N Residential; admitted from

                              16,439                    . Missing
                                 941                    1 Private home w/ no home health services
                                 257                    2 Private home w/ home health services
                                 413                    3 Board and care/assist living/group home
                                 436                    4 Nursing home
                               4,899                    5 Acute care hospital
                                  46                    6 Psychiatric hospital, MR/DD facility
                                 158                    7 Rehabilitation hospital
                                  70                    8 Other

AB3        68  2  YESNOALO                              N Residential; lived alone

                              16,812                    . Missing
                               3,566                    0 No
                               2,551                    1 Yes
                                 730                    2 In other facility

AB4        70  5                                        C Residential; zip code, prior primary res

AB5A       75  2  INDIC                                 N Residential; prior stay in nursing home

                              13,793                    . Missing
                               7,286                    0 Not indicated
                               2,580                    1 Indicated

AB5B       77  2  INDIC                                 N Residential; stay in other nursing home

                              13,794                    . Missing
                               8,318                    0 Not indicated
                               1,547                    1 Indicated

AB5C       79  2  INDIC                                 N Residential; other residential facility

                              13,794                    . Missing
                               8,509                    0 Not indicated
                               1,356                    1 Indicated

AB5D       81  2  INDIC                                 N Residential; MH/psychiatric setting

                              13,794                    . Missing
                               9,723                    0 Not indicated
                                 142                    1 Indicated

AB5E       83  2  INDIC                                 N Residential; MR/DD setting

                              13,794                    . Missing
                               9,851                    0 Not indicated
                                  14                    1 Indicated

AB5F       85  2  INDIC                                 N Residential; none of above

                              13,793                    . Missing
                               4,840                    0 Not indicated
                               5,026                    1 Indicated

AB6        87 21                                        C Demo; lifetime occupation(s)

AB7       108  2  HIEDUCAT                              N Demo; highest of education complete

                              16,930                    . Missing
                                  75                    1 No schooling
                               1,326                    2 8th grade/less
                                 970                    3 9-11 grades
                               3,020                    4 High school
                                 293                    5 Technical or trade school
                                 615                    6 Some college
                                 223                    7 Bachelors degree
                                 207                    8 Graduate degree

AB8A      110  2  PRIMLANG                              N Demo; primary language

                              16,811                    . Missing
                               6,610                    0 English
                                 115                    1 Spanish
                                   0                    2 French
                                 123                    3 Other

AB8B      112  9                                        C Demo; other primary language

AB9       121  2  YESNO                                 N Mental; indication of MR/MI/DD history

                              16,815                    . Missing
                               6,389                    0 No
                                 455                    1 Yes

AB10A     123  2  INDIC                                 N Mental; status, no MR/DD

                              16,807                    . Missing
                                 198                    0 Not indicated
                               6,654                    1 Indicated

AB10B     125  2  INDIC                                 N Mental; status, downs syndrome

                              23,459                    . Missing
                                 189                    0 Not indicated
                                  11                    1 Indicated

AB10C     127  2  INDIC                                 N Mental; status, autism

                              23,459                    . Missing
                                 199                    0 Not indicated
                                   1                    1 Indicated

AB10D     129  2  INDIC                                 N Mental; status, epilepsy

                              23,459                    . Missing
                                 199                    0 Not indicated
                                   1                    1 Indicated

AB10E     131  2  INDIC                                 N Mental; status, other organic condition

                              23,459                    . Missing
                                 196                    0 Not indicated
                                   4                    1 Indicated

AB10F     133  2  INDIC                                 N Mental; status, MR/DD w/ no organic cond

                              23,459                    . Missing
                                  76                    0 Not indicated
                                 124                    1 Indicated

AB11      135  8                                        N Date background information completed

AC1A      145  2  INDIC                                 N Routine; event, stays up late at night

                              17,008                    . Missing
                               4,019                    0 Not indicated
                               2,632                    1 Indicated

AC1B      147  2  INDIC                                 N Routine; event, naps regularly

                              17,010                    . Missing
                               2,638                    0 Not indicated
                               4,011                    1 Indicated

AC1C      149  2  INDIC                                 N Routine; event, goes out 1+ days

                              17,008                    . Missing
                               3,373                    0 Not indicated
                               3,278                    1 Indicated

AC1D      151  2  INDIC                                 N Routine; event, stays busy

                              17,007                    . Missing
                               3,160                    0 Not indicated
                               3,492                    1 Indicated

AC1E      153  2  INDIC                                 N Routine; event, most of time spent alone

                              17,005                    . Missing
                               3,740                    0 Not indicated
                               2,914                    1 Indicated

AC1F      155  2  INDIC                                 N Routine; event, moves independent indoor

                              17,004                    . Missing
                               1,672                    0 Not indicated
                               4,983                    1 Indicated

AC1G      157  2  INDIC                                 N Routine; event, use of tobacco products

                              17,007                    . Missing
                               6,072                    0 Not indicated
                                 580                    1 Indicated

AC1H      159  2  INDIC                                 N Routine; event, none of above

                              17,004                    . Missing
                               6,381                    0 Not indicated
                                 274                    1 Indicated

AC1I      161  2  INDIC                                 N Routine; eating, distinct food pref

                              17,005                    . Missing
                               5,512                    0 Not indicated
                               1,142                    1 Indicated

AC1J      163  2  INDIC                                 N Routine; eating, eats between meals

                              17,007                    . Missing
                               4,432                    0 Not indicated
                               2,220                    1 Indicated

AC1K      165  2  INDIC                                 N Routine; eating, use of alcoholic bev

                              17,007                    . Missing
                               6,315                    0 Not indicated
                                 337                    1 Indicated

AC1L      167  2  INDIC                                 N Routine; eating, none of above

                              17,005                    . Missing
                               3,015                    0 Not indicated
                               3,639                    1 Indicated

AC1M      169  2  INDIC                                 N Routine; ADL, bedclothes most of day

                              17,006                    . Missing
                               6,366                    0 Not indicated
                                 287                    1 Indicated

AC1N      171  2  INDIC                                 N Routine; ADL, wakens to toilet

                              17,004                    . Missing
                               3,093                    0 Not indicated
                               3,562                    1 Indicated

AC1O      173  2  INDIC                                 N Routine; ADL, irregular bowel movement

                              17,006                    . Missing
                               5,783                    0 Not indicated
                                 870                    1 Indicated

AC1P      175  2  INDIC                                 N Routine; ADL, showers for bathing

                              17,004                    . Missing
                               2,699                    0 Not indicated
                               3,956                    1 Indicated

AC1Q      177  2  INDIC                                 N Routine; ADL, bathing in PM

                              17,006                    . Missing
                               5,979                    0 Not indicated
                                 674                    1 Indicated

AC1R      179  2  INDIC                                 N Routine; ADL, none of above

                              17,004                    . Missing
                               5,344                    0 Not indicated
                               1,311                    1 Indicated

AC1S      181  2  INDIC                                 N Routine; involve, daily contact family

                              17,005                    . Missing
                               1,293                    0 Not indicated
                               5,361                    1 Indicated

AC1T      183  2  INDIC                                 N Routine; involve, attends church

                              17,006                    . Missing
                               4,140                    0 Not indicated
                               2,513                    1 Indicated

AC1U      185  2  INDIC                                 N Routine; involve, strength in faith

                              17,008                    . Missing
                               2,766                    0 Not indicated
                               3,885                    1 Indicated

AC1V      187  2  INDIC                                 N Routine; involve, animal companion

                              17,007                    . Missing
                               5,805                    0 Not indicated
                                 847                    1 Indicated

AC1W      189  2  INDIC                                 N Routine; involve, group activities

                              17,012                    . Missing
                               4,855                    0 Not indicated
                               1,792                    1 Indicated

AC1X      191  2  INDIC                                 N Routine; involve, none of above

                              17,004                    . Missing
                               5,962                    0 Not indicated
                                 693                    1 Indicated

AC1Y      193  2  INDIC                                 N Routine; unknown routines

                              16,796                    . Missing
                               6,656                    0 Not indicated
                                 207                    1 Indicated

A2        195  5                                        C Background; room number

A3A       200  8                                        N Background; assessment reference date

A4B       210  2                                        N Background; original or copy number

A4A       212  8                                        N Background; date of reentry

A5        222  2  MARITAL                               N Background; marital status

                              12,330                    . Missing
                               1,302                    1 Never married
                               2,602                    2 Married
                               6,356                    3 Widowed
                                 126                    4 Separated
                                 943                    5 Divorced

A6        224 12                                        C Background; medical record number

A7A       236  2  INDIC                                 N Payment; Medicaid per diem

                              17,496                    . Missing
                               3,221                    0 Not indicated
                               2,942                    1 Indicated

A7B       238  2  INDIC                                 N Payment; Medicare per diem

                              17,495                    . Missing
                               4,172                    0 Not indicated
                               1,992                    1 Indicated

A7C       240  2  INDIC                                 N Payment; Medicare ancillary part A

                              17,496                    . Missing
                               4,969                    0 Not indicated
                               1,194                    1 Indicated

A7D       242  2  INDIC                                 N Payment; Medicare ancillary part B

                              17,495                    . Missing
                               5,408                    0 Not indicated
                                 756                    1 Indicated

A7E       244  2  INDIC                                 N Payment; CHAMPUS per diem

                              17,498                    . Missing
                               6,160                    0 Not indicated
                                   1                    1 Indicated

A7F       246  2  INDIC                                 N Payment; VA per diem

                              17,498                    . Missing
                               6,122                    0 Not indicated
                                  39                    1 Indicated

A7G       248  2  INDIC                                 N Payment; self/family pays full per diem

                              17,496                    . Missing
                               5,395                    0 Not indicated
                                 768                    1 Indicated

A7H       250  2  INDIC                                 N Payment; Mcaid res liab/Mcare co-payment

                              17,495                    . Missing
                               5,335                    0 Not indicated
                                 829                    1 Indicated

A7I       252  2  INDIC                                 N Payment; private insurance per diem

                              17,498                    . Missing
                               5,461                    0 Not indicated
                                 700                    1 Indicated

A7J       254  2  INDIC                                 N Payment; other per diem

                              17,498                    . Missing
                               6,043                    0 Not indicated
                                 118                    1 Indicated

A9A       256  2  INDIC                                 N Decisions; legal guardian

                              17,495                    . Missing
                               5,954                    0 Not indicated
                                 210                    1 Indicated

A9B       258  2  INDIC                                 N Decisions; other legal oversight

                              17,495                    . Missing
                               6,049                    0 Not indicated
                                 115                    1 Indicated

A9C       260  2  INDIC                                 N Decisions; dur power attorney/health

                              17,495                    . Missing
                               3,851                    0 Not indicated
                               2,313                    1 Indicated

A9D       262  2  INDIC                                 N Decisions; dur power attorney/financial

                              17,495                    . Missing
                               4,688                    0 Not indicated
                               1,476                    1 Indicated

A9E       264  2  INDIC                                 N Decisions; family member responsible

                              17,495                    . Missing
                               2,280                    0 Not indicated
                               3,884                    1 Indicated

A9F       266  2  INDIC                                 N Decisions; patient responsible for self

                              17,495                    . Missing
                               3,920                    0 Not indicated
                               2,244                    1 Indicated

A9G       268  2  INDIC                                 N Decisions; none of the above

                              17,497                    . Missing
                               5,964                    0 Not indicated
                                 198                    1 Indicated

A10A      270  2  INDIC                                 N Adv directives; living will

                              17,498                    . Missing
                               5,013                    0 Not indicated
                               1,148                    1 Indicated

A10B      272  2  INDIC                                 N Adv directives; do not resuscitate

                              12,517                    . Missing
                               6,016                    0 Not indicated
                               5,126                    1 Indicated

A10C      274  2  INDIC                                 N Adv directives; do not hospitalize

                              12,520                    . Missing
                              10,962                    0 Not indicated
                                 177                    1 Indicated

A10D      276  2  INDIC                                 N Adv directives; organ donation

                              17,500                    . Missing
                               6,148                    0 Not indicated
                                  11                    1 Indicated

A10E      278  2  INDIC                                 N Adv directives; autopsy request

                              17,499                    . Missing
                               6,160                    0 Not indicated
                                   0                    1 Indicated

A10F      280  2  INDIC                                 N Adv directives; feeding restrict

                              17,499                    . Missing
                               5,504                    0 Not indicated
                                 656                    1 Indicated

A10G      282  2  INDIC                                 N Adv directives; medication restrict

                              17,499                    . Missing
                               5,978                    0 Not indicated
                                 182                    1 Indicated

A10H      284  2  INDIC                                 N Adv directives; other treatment restrict

                              17,499                    . Missing
                               5,739                    0 Not indicated
                                 421                    1 Indicated

A10I      286  2  INDIC                                 N Adv directives; none of above

                              17,500                    . Missing
                               3,423                    0 Not indicated
                               2,736                    1 Indicated

B1        288  2  YESNO                                 N Cognitive; comatose

                               5,554                    . Missing
                              18,100                    0 No
                                   5                    1 Yes

B2A       290  2  MEMORY                                N Cognitive; short-term memory OK

                               5,623                    . Missing
                               5,671                    0 Memory OK
                              12,365                    1 Memory problem

B2B       292  2  MEMORY                                N Cognitive; long-term memory OK

                               5,625                    . Missing
                               9,806                    0 Memory OK
                               8,228                    1 Memory problem

B3A       294  2  INDIC                                 N Cognitive; recall; current season

                               7,961                    . Missing
                               7,599                    0 Not indicated
                               8,099                    1 Indicated

B3B       296  2  INDIC                                 N Cognitive; recall; location of own room

                               7,959                    . Missing
                               5,612                    0 Not indicated
                              10,088                    1 Indicated

B3C       298  2  INDIC                                 N Cognitive; recall; staff names/faces

                               7,947                    . Missing
                               4,473                    0 Not indicated
                              11,239                    1 Indicated

B3D       300  2  INDIC                                 N Cognitive; recall; lives in nursing home

                               7,963                    . Missing
                               4,832                    0 Not indicated
                              10,864                    1 Indicated

B3E       302  2  INDIC                                 N Cognitive; recall; none of the above

                               7,949                    . Missing
                              12,954                    0 Not indicated
                               2,756                    1 Indicated

B4        304  2  COGNITIV                              N Cognitive; daily decision making skills

                               5,562                    . Missing
                               4,400                    0 Independent
                               4,270                    1 Modified independence
                               7,131                    2 Moderately impaired
                               2,296                    3 Severely impaired

B5A       306  2  COGNITIV                              N Cognitive; delirium, easily distracted

                               5,558                    . Missing
                              15,678                    0 Independent
                               2,322                    1 Modified independence
                                 101                    2 Moderately impaired
                                   0                    3 Severely impaired

B5B       308  2  COGNITIV                              N Cognitive; delirium, altered perception

                               5,558                    . Missing
                              16,400                    0 Independent
                               1,589                    1 Modified independence
                                 112                    2 Moderately impaired
                                   0                    3 Severely impaired

B5C       310  2  COGNITIV                              N Cognitive; delirium, disorganized speech

                               5,558                    . Missing
                              16,171                    0 Independent
                               1,852                    1 Modified independence
                                  78                    2 Moderately impaired
                                   0                    3 Severely impaired

B5D       312  2  COGNITIV                              N Cognitive; delirium, restlessness

                               5,559                    . Missing
                              15,882                    0 Independent
                               2,097                    1 Modified independence
                                 121                    2 Moderately impaired
                                   0                    3 Severely impaired

B5E       314  2  COGNITIV                              N Cognitive; delirium, lethargy

                               5,559                    . Missing
                              16,833                    0 Independent
                               1,135                    1 Modified independence
                                 132                    2 Moderately impaired
                                   0                    3 Severely impaired

B5F       316  2  COGNITIV                              N Cognitive; delirium, varied function

                               5,558                    . Missing
                              14,366                    0 Independent
                               3,571                    1 Modified independence
                                 164                    2 Moderately impaired
                                   0                    3 Severely impaired

B6        318  2  CHANGE                                N Cognitive; change in last 90 days

                              17,505                    . Missing
                               5,519                    0 No change
                                 121                    1 Improved
                                 514                    2 Deteriorated

C1        320  2  HEAR                                  N Comm; hearing ability

                              17,508                    . Missing
                               4,603                    0 Hears adequately
                               1,008                    1 Minimal difficulty
                                 481                    2 Hears in special situations only
                                  59                    3 Highly impaired

C2A       322  2  INDIC                                 N Comm; hearing aid, present and used

                              17,500                    . Missing
                               5,733                    0 Not indicated
                                 426                    1 Indicated

C2B       324  2  INDIC                                 N Comm; hearing aid, present and not used

                              17,500                    . Missing
                               6,030                    0 Not indicated
                                 129                    1 Indicated

C2C       326  2  INDIC                                 N Comm; other receptive used

                              17,500                    . Missing
                               6,088                    0 Not indicated
                                  71                    1 Indicated

C2D       328  2  INDIC                                 N Comm; none of above comm methods used

                              17,502                    . Missing
                                 621                    0 Not indicated
                               5,536                    1 Indicated

C3A       330  2  INDIC                                 N Comm; modes, speech

                              17,501                    . Missing
                                 278                    0 Not indicated
                               5,880                    1 Indicated

C3B       332  2  INDIC                                 N Comm; modes, writing messages to clarify

                              17,501                    . Missing
                               6,058                    0 Not indicated
                                 100                    1 Indicated

C3C       334  2  INDIC                                 N Comm; modes, ASL or braille

                              17,502                    . Missing
                               6,141                    0 Not indicated
                                  16                    1 Indicated

C3D       336  2  INDIC                                 N Comm; modes, signs, gestures, or sounds

                              17,502                    . Missing
                               5,456                    0 Not indicated
                                 701                    1 Indicated

C3E       338  2  INDIC                                 N Comm; modes, communication board

                              17,503                    . Missing
                               6,098                    0 Not indicated
                                  58                    1 Indicated

C3F       340  2  INDIC                                 N Comm; modes, other

                              17,501                    . Missing
                               6,123                    0 Not indicated
                                  35                    1 Indicated

C3G       342  2  INDIC                                 N Comm; modes, none of above

                              17,503                    . Missing
                               6,039                    0 Not indicated
                                 117                    1 Indicated

C4        344  2  UNDERSTO                              N Comm; ability to make self understood

                               5,564                    . Missing
                              11,026                    0 Understood
                               3,521                    1 Usually understood
                               2,255                    2 Sometimes understood
                               1,293                    3 Rarely/Never understood

C5        346  2  CLEAR                                 N Comm, speech clarity

                              17,500                    . Missing
                               5,190                    0 clear speech
                                 763                    1 unclear speech
                                 206                    2 no speech

C6        348  2  UNDERSTA                              N Comm; ability to understand others

                               5,563                    . Missing
                               9,746                    0 Understands
                               4,477                    1 Usually understands
                               2,874                    2 Sometimes understands
                                 999                    3 Rarely/Never understands

C7        350  2  CHANGE                                N Comm; change in last 90 days

                              17,502                    . Missing
                               5,786                    0 No change
                                  49                    1 Improved
                                 322                    2 Deteriorated

D1        352  2  ADEQUATE                              N Vision

                              13,252                    . Missing
                               7,084                    0 Adequate
                               2,082                    1 Impaired
                                 620                    2 Moderately impaired
                                 482                    3 Highly impaired
                                 139                    4 Severely impaired

D2A       354  2  INDIC                                 N Vision; limitation, side vision problems

                              17,557                    . Missing
                               5,966                    0 Not indicated
                                 136                    1 Indicated

D2B       356  2  INDIC                                 N Vision; limitation, halos/rings/flashes

                              17,557                    . Missing
                               6,084                    0 Not indicated
                                  18                    1 Indicated

D2C       358  2  INDIC                                 N Vision; limitation, none of above

                              17,559                    . Missing
                                 146                    0 Not indicated
                               5,954                    1 Indicated

D3        360  2  YESNO                                 N Vision; corrective eyewear, etc.

                              17,555                    . Missing
                               1,830                    0 No
                               4,274                    1 Yes

E1A       362  2  INDICTH                               N Mood; negative statements

                               5,561                    . Missing
                              17,402                    0 Not exhibited in last 30 days
                                 632                    1 Exhibited up to 5 days week
                                  64                    2 Exhibited 6 to 7 days week

E1B       364  2  INDICTH                               N Mood; repetitive questions

                               5,561                    . Missing
                              17,297                    0 Not exhibited in last 30 days
                                 675                    1 Exhibited up to 5 days week
                                 126                    2 Exhibited 6 to 7 days week

E1C       366  2  INDICTH                               N Mood; repetitive verbalizations

                               5,564                    . Missing
                              17,084                    0 Not exhibited in last 30 days
                                 749                    1 Exhibited up to 5 days week
                                 262                    2 Exhibited 6 to 7 days week

E1D       368  2  INDICTH                               N Mood; persistent anger w/ self or others

                               5,561                    . Missing
                              15,940                    0 Not exhibited in last 30 days
                               1,771                    1 Exhibited up to 5 days week
                                 387                    2 Exhibited 6 to 7 days week

E1E       370  2  INDICTH                               N Mood; self deprecation

                               5,561                    . Missing
                              17,737                    0 Not exhibited in last 30 days
                                 347                    1 Exhibited up to 5 days week
                                  14                    2 Exhibited 6 to 7 days week

E1F       372  2  INDICTH                               N Mood; unrealistic fears

                               5,561                    . Missing
                              17,462                    0 Not exhibited in last 30 days
                                 542                    1 Exhibited up to 5 days week
                                  94                    2 Exhibited 6 to 7 days week

E1G       374  2  INDICTH                               N Mood; belief terrible going to happen

                               5,561                    . Missing
                              17,930                    0 Not exhibited in last 30 days
                                 149                    1 Exhibited up to 5 days week
                                  19                    2 Exhibited 6 to 7 days week

E1H       376  2  INDICTH                               N Mood; repetitive health complaints

                               5,561                    . Missing
                              16,111                    0 Not exhibited in last 30 days
                               1,549                    1 Exhibited up to 5 days week
                                 438                    2 Exhibited 6 to 7 days week

E1I       378  2  INDICTH                               N Mood; repetitive anxious complaints

                               5,561                    . Missing
                              15,937                    0 Not exhibited in last 30 days
                               1,697                    1 Exhibited up to 5 days week
                                 464                    2 Exhibited 6 to 7 days week

E1J       380  2  INDICTH                               N Mood; unpleasant mood in AM

                               5,561                    . Missing
                              17,358                    0 Not exhibited in last 30 days
                                 629                    1 Exhibited up to 5 days week
                                 111                    2 Exhibited 6 to 7 days week

E1K       382  2  INDICTH                               N Mood; insomnia/change in sleep pattern

                               5,561                    . Missing
                              16,688                    0 Not exhibited in last 30 days
                               1,314                    1 Exhibited up to 5 days week
                                  96                    2 Exhibited 6 to 7 days week

E1L       384  2  INDICTH                               N Mood; sad/worried facial expressions

                               5,561                    . Missing
                              13,871                    0 Not exhibited in last 30 days
                               3,346                    1 Exhibited up to 5 days week
                                 881                    2 Exhibited 6 to 7 days week

E1M       386  2  INDICTH                               N Mood; crying/tearfulness

                               5,562                    . Missing
                              16,645                    0 Not exhibited in last 30 days
                               1,328                    1 Exhibited up to 5 days week
                                 124                    2 Exhibited 6 to 7 days week

E1N       388  2  INDICTH                               N Mood; repetitive physical movements

                               5,562                    . Missing
                              15,936                    0 Not exhibited in last 30 days
                               1,554                    1 Exhibited up to 5 days week
                                 607                    2 Exhibited 6 to 7 days week

E1O       390  2  INDICTH                               N Mood; withdrawal from activ of interest

                               5,562                    . Missing
                              17,245                    0 Not exhibited in last 30 days
                                 640                    1 Exhibited up to 5 days week
                                 212                    2 Exhibited 6 to 7 days week

E1P       392  2  INDICTH                               N Mood; reduced social interaction

                               5,561                    . Missing
                              17,028                    0 Not exhibited in last 30 days
                                 814                    1 Exhibited up to 5 days week
                                 256                    2 Exhibited 6 to 7 days week

E2        394  2  MODINDIC                              N Mood; persistence

                               5,562                    . Missing
                              10,726                    0 No mood indicators
                               4,666                    1 Indicators present, easily altered
                               2,705                    2 Indicators present, not easily altered

E3        396  2  CHANGE                                N Mood; change in last 90 days

                              17,506                    . Missing
                               5,360                    0 No change
                                 279                    1 Improved
                                 514                    2 Deteriorated

E4AA      398  2  BEHAVA                                N Behavior; wandering frequency

                               5,559                    . Missing
                              17,099                    0 Behavior not exhibited
                                 451                    1 1 to 3 days
                                 154                    2 4 to 6 days
                                 396                    3 Behavior exhibited daily

E4AB      400  2  BEHAVB                                N Behavior; wandering alterability

                               5,559                    . Missing
                              17,571                    0 Behavior not present or easily altered
                                 529                    1 Behavior not easily altered

E4BA      402  2  BEHAVA                                N Behavior; verbally abusive frequency

                               5,559                    . Missing
                              16,911                    0 Behavior not exhibited
                                 951                    1 1 to 3 days
                                 133                    2 4 to 6 days
                                 105                    3 Behavior exhibited daily

E4BB      404  2  BEHAVB                                N Behavior; verbally abusive alterability

                               5,559                    . Missing
                              17,464                    0 Behavior not present or easily altered
                                 636                    1 Behavior not easily altered

E4CA      406  2  BEHAVA                                N Behavior; physical abusive frequency

                               5,559                    . Missing
                              17,407                    0 Behavior not exhibited
                                 539                    1 1 to 3 days
                                 101                    2 4 to 6 days
                                  53                    3 Behavior exhibited daily

E4CB      408  2  BEHAVB                                N Behavior; physical abusive alterability

                               5,559                    . Missing
                              17,758                    0 Behavior not present or easily altered
                                 342                    1 Behavior not easily altered

E4DA      410  2  BEHAVA                                N Behavior; soc inappropriate frequency

                               5,559                    . Missing
                              16,728                    0 Behavior not exhibited
                                 863                    1 1 to 3 days
                                 255                    2 4 to 6 days
                                 254                    3 Behavior exhibited daily

E4DB      412  2  BEHAVB                                N Behavior; soc inappropriate alterability

                               5,559                    . Missing
                              17,297                    0 Behavior not present or easily altered
                                 803                    1 Behavior not easily altered

E4EA      414  2  BEHAVA                                N Behavior; resists care frequency

                               5,559                    . Missing
                              15,276                    0 Behavior not exhibited
                               1,875                    1 1 to 3 days
                                 536                    2 4 to 6 days
                                 413                    3 Behavior exhibited daily

E4EB      416  2  BEHAVB                                N Behavior; resists care alterability

                               5,559                    . Missing
                              16,196                    0 Behavior not present or easily altered
                               1,904                    1 Behavior not easily altered

E5        418  2  CHANGE                                N Behavior; change in last 90 days

                              17,505                    . Missing
                               5,701                    0 No change
                                 150                    1 Improved
                                 303                    2 Deteriorated

F1A       420  2  INDIC                                 N Social; at ease interacting with others

                              17,554                    . Missing
                               1,205                    0 Not indicated
                               4,900                    1 Indicated

F1B       422  2  INDIC                                 N Social; at ease in structured activities

                              17,554                    . Missing
                               2,910                    0 Not indicated
                               3,195                    1 Indicated

F1C       424  2  INDIC                                 N Social; at ease in self-init activities

                              17,565                    . Missing
                               2,865                    0 Not indicated
                               3,229                    1 Indicated

F1D       426  2  INDIC                                 N Social; establishes own goals

                              17,565                    . Missing
                               4,555                    0 Not indicated
                               1,539                    1 Indicated

F1E       428  2  INDIC                                 N Social; involvement in life of facility

                              17,565                    . Missing
                               5,141                    0 Not indicated
                                 953                    1 Indicated

F1F       430  2  INDIC                                 N Social; accepts invitations group activ

                              17,554                    . Missing
                               4,750                    0 Not indicated
                               1,355                    1 Indicated

F1G       432  2  INDIC                                 N Social; none of above

                              17,556                    . Missing
                               5,355                    0 Not indicated
                                 748                    1 Indicated

F2A       434  2  INDIC                                 N Social; open conflict with staff

                              17,554                    . Missing
                               5,935                    0 Not indicated
                                 170                    1 Indicated

F2B       436  2  INDIC                                 N Social; unhappy with roommate

                              17,554                    . Missing
                               5,999                    0 Not indicated
                                 106                    1 Indicated

F2C       438  2  INDIC                                 N Social; unhappy with other residents

                              17,554                    . Missing
                               6,029                    0 Not indicated
                                  76                    1 Indicated

F2D       440  2  INDIC                                 N Social; open conflict w/ fam/friend

                              17,554                    . Missing
                               6,005                    0 Not indicated
                                 100                    1 Indicated

F2E       442  2  INDIC                                 N Social; absence of contact w/ fam/friend

                              17,554                    . Missing
                               6,008                    0 Not indicated
                                  97                    1 Indicated

F2F       444  2  INDIC                                 N Social; recent loss of close fam/friend

                              17,554                    . Missing
                               5,998                    0 Not indicated
                                 107                    1 Indicated

F2G       446  2  INDIC                                 N Social; does not adjust to routine chang

                              17,554                    . Missing
                               5,559                    0 Not indicated
                                 546                    1 Indicated

F2H       448  2  INDIC                                 N Social; none of above

                              17,556                    . Missing
                                 915                    0 Not indicated
                               5,188                    1 Indicated

F3A       450  2  INDIC                                 N Social; strong identity in past role

                              17,554                    . Missing
                               5,396                    0 Not indicated
                                 709                    1 Indicated

F3B       452  2  INDIC                                 N Social; sadness/anger at loss of role

                              17,554                    . Missing
                               5,840                    0 Not indicated
                                 265                    1 Indicated

F3C       454  2  INDIC                                 N Social; routine diff than prior pattern

                              17,554                    . Missing
                               5,654                    0 Not indicated
                                 451                    1 Indicated

F3D       456  2  INDIC                                 N Social; none of above

                              17,556                    . Missing
                               1,006                    0 Not indicated
                               5,097                    1 Indicated

G1AA      458  2  ADLA                                  N ADL; bed mobility, self-perform

                               5,548                    . Missing
                               4,722                    0 Independent
                               1,089                    1 Supervision
                               3,557                    2 Limited assistance
                               5,988                    3 Extensive assistance
                               2,752                    4 Total dependence
                                   3                    8 Activity did not occur

G1AB      460  2  ADLB                                  N ADL; bed mobility, supported

                               7,975                    . Missing
                               3,528                    0 No setup or physical help from staff
                               1,083                    1 Setup help only
                               7,653                    2 One person physical assist
                               3,417                    3 Two+ persons physical assist
                                   3                    8 Activity did not occur

G1BA      462  2  ADLA                                  N ADL; transfer, self-perform

                               5,548                    . Missing
                               3,253                    0 Independent
                               1,127                    1 Supervision
                               3,650                    2 Limited assistance
                               6,189                    3 Extensive assistance
                               3,740                    4 Total dependence
                                 152                    8 Activity did not occur

G1BB      464  2  ADLB                                  N ADL; transfer, supported

                               7,975                    . Missing
                               2,342                    0 No setup or physical help from staff
                               1,017                    1 Setup help only
                               7,287                    2 One person physical assist
                               4,895                    3 Two+ persons physical assist
                                 143                    8 Activity did not occur

G1CA      466  2  ADLA                                  N ADL; walk in room, self-perform

                               5,549                    . Missing
                               3,095                    0 Independent
                               1,401                    1 Supervision
                               3,153                    2 Limited assistance
                               2,408                    3 Extensive assistance
                                 175                    4 Total dependence
                               7,878                    8 Activity did not occur

G1CB      468  2  ADLB                                  N ADL; walk in room, supported

                               7,977                    . Missing
                               2,487                    0 No setup or physical help from staff
                               1,044                    1 Setup help only
                               4,707                    2 One person physical assist
                                 691                    3 Two+ persons physical assist
                               6,753                    8 Activity did not occur

G1DA      470  2  ADLA                                  N ADL; walk in corridor, self-perform

                               5,549                    . Missing
                               2,485                    0 Independent
                               1,668                    1 Supervision
                               3,069                    2 Limited assistance
                               2,195                    3 Extensive assistance
                                 170                    4 Total dependence
                               8,523                    8 Activity did not occur

G1DB      472  2  ADLB                                  N ADL; walk in corridor, supported

                               7,977                    . Missing
                               2,090                    0 No setup or physical help from staff
                               1,094                    1 Setup help only
                               4,597                    2 One person physical assist
                                 567                    3 Two+ persons physical assist
                               7,334                    8 Activity did not occur

G1EA      474  2  ADLA                                  N ADL; locomotion on unit, self-perform

                               5,549                    . Missing
                               4,616                    0 Independent
                               1,933                    1 Supervision
                               2,999                    2 Limited assistance
                               3,335                    3 Extensive assistance
                               4,851                    4 Total dependence
                                 376                    8 Activity did not occur

G1EB      476  2  ADLB                                  N ADL; locomotion on unit, supported

                               7,976                    . Missing
                               3,342                    0 No setup or physical help from staff
                               1,782                    1 Setup help only
                               9,971                    2 One person physical assist
                                 253                    3 Two+ persons physical assist
                                 335                    8 Activity did not occur

G1FA      478  2  ADLA                                  N ADL; locomotion off unit, self-perform

                               5,549                    . Missing
                               3,467                    0 Independent
                               1,725                    1 Supervision
                               2,506                    2 Limited assistance
                               2,998                    3 Extensive assistance
                               6,290                    4 Total dependence
                               1,124                    8 Activity did not occur

G1FB      480  2  ADLB                                  N ADL; locomotion off unit, supported

                               7,978                    . Missing
                               2,597                    0 No setup or physical help from staff
                               1,336                    1 Setup help only
                              10,603                    2 One person physical assist
                                 155                    3 Two+ persons physical assist
                                 990                    8 Activity did not occur

G1GA      482  2  ADLA                                  N ADL; dressing, self-perform

                               5,548                    . Missing
                               1,505                    0 Independent
                               1,252                    1 Supervision
                               3,780                    2 Limited assistance
                               7,565                    3 Extensive assistance
                               3,969                    4 Total dependence
                                  40                    8 Activity did not occur

G1GB      484  2  ADLB                                  N ADL; dressing, supported

                               7,975                    . Missing
                               1,034                    0 No setup or physical help from staff
                               1,091                    1 Setup help only
                              12,785                    2 One person physical assist
                                 735                    3 Two+ persons physical assist
                                  39                    8 Activity did not occur

G1HA      486  2  ADLA                                  N ADL; eating, self-perform

                               5,548                    . Missing
                               8,370                    0 Independent
                               4,129                    1 Supervision
                               1,660                    2 Limited assistance
                               1,426                    3 Extensive assistance
                               2,522                    4 Total dependence
                                   4                    8 Activity did not occur

G1HB      488  2  ADLB                                  N ADL; eating, supported

                               7,975                    . Missing
                               2,044                    0 No setup or physical help from staff
                               8,413                    1 Setup help only
                               5,199                    2 One person physical assist
                                  24                    3 Two+ persons physical assist
                                   4                    8 Activity did not occur

G1IA      490  2  ADLA                                  N ADL; toilet use, self-perform

                               5,548                    . Missing
                               2,414                    0 Independent
                               1,102                    1 Supervision
                               3,135                    2 Limited assistance
                               6,282                    3 Extensive assistance
                               5,137                    4 Total dependence
                                  41                    8 Activity did not occur

G1IB      492  2  ADLB                                  N ADL; toilet use, supported

                               7,975                    . Missing
                               1,847                    0 No setup or physical help from staff
                                 851                    1 Setup help only
                               9,872                    2 One person physical assist
                               3,074                    3 Two+ persons physical assist
                                  40                    8 Activity did not occur

G1JA      494  2  ADLA                                  N ADL; personal hygiene, self-perform

                               5,548                    . Missing
                               1,677                    0 Independent
                               1,515                    1 Supervision
                               4,000                    2 Limited assistance
                               6,538                    3 Extensive assistance
                               4,378                    4 Total dependence
                                   3                    8 Activity did not occur

G1JB      496  2  ADLB                                  N ADL; personal hygiene, supported

                               7,975                    . Missing
                                 986                    0 No setup or physical help from staff
                               1,598                    1 Setup help only
                              12,465                    2 One person physical assist
                                 632                    3 Two+ persons physical assist
                                   3                    8 Activity did not occur

G2A       498  2  BATHING                               N ADL; bathing, self perform

                               5,549                    . Missing
                                 262                    0 Independent
                                 823                    1 Supervision
                               1,410                    2 Phys help limited to transfer only
                               9,444                    3 Phys help in part of bathing activity
                               6,063                    4 Total dependence
                                 108                    8 Activity did not occur

G2B       500  2  ADLB                                  N ADL; bathing, supported

                              17,496                    . Missing
                                  86                    0 No setup or physical help from staff
                                 290                    1 Setup help only
                               5,004                    2 One person physical assist
                                 735                    3 Two+ persons physical assist
                                  48                    8 Activity did not occur

G3A       502  2  BALANCE                               N ADL; balance while standing

                               8,016                    . Missing
                               1,091                    0 Maintained position
                               2,300                    1 Unsteady
                               3,450                    2 Partial physical support
                               8,802                    3 Not able to attempt test

G3B       504  2  BALANCE                               N ADL; balance while sitting

                               7,957                    . Missing
                               8,775                    0 Maintained position
                               1,707                    1 Unsteady
                               2,649                    2 Partial physical support
                               2,571                    3 Not able to attempt test

G4AA      506  2  RANGE                                 N ADL; neck, range of motion

                               5,557                    . Missing
                              16,825                    0 No limitation
                                 309                    1 Limitation on one side
                                 968                    2 Limitation on both sides

G4AB      508  2  VOL                                   N ADL; neck, voluntary motion

                               5,559                    . Missing
                              16,988                    0 No loss
                               1,007                    1 Partial loss
                                 105                    2 Full loss

G4BA      510  2  RANGE                                 N ADL; arm, range of motion

                               5,558                    . Missing
                              13,168                    0 No limitation
                               2,576                    1 Limitation on one side
                               2,357                    2 Limitation on both sides

G4BB      512  2  VOL                                   N ADL; arm, voluntary motion

                               5,560                    . Missing
                              13,496                    0 No loss
                               3,835                    1 Partial loss
                                 768                    2 Full loss

G4CA      514  2  RANGE                                 N ADL; hand, range of motion

                               5,558                    . Missing
                              14,652                    0 No limitation
                               2,042                    1 Limitation on one side
                               1,407                    2 Limitation on both sides

G4CB      516  2  VOL                                   N ADL; hand, voluntary motion

                               5,559                    . Missing
                              14,679                    0 No loss
                               2,675                    1 Partial loss
                                 746                    2 Full loss

G4DA      518  2  RANGE                                 N ADL; leg, range of motion

                               5,556                    . Missing
                              11,504                    0 No limitation
                               3,278                    1 Limitation on one side
                               3,321                    2 Limitation on both sides

G4DB      520  2  VOL                                   N ADL; leg, voluntary motion

                               5,558                    . Missing
                              11,849                    0 No loss
                               5,106                    1 Partial loss
                               1,146                    2 Full loss

G4EA      522  2  RANGE                                 N ADL; foot, range of motion

                               5,557                    . Missing
                              13,610                    0 No limitation
                               2,075                    1 Limitation on one side
                               2,417                    2 Limitation on both sides

G4EB      524  2  VOL                                   N ADL; foot, voluntary motion

                               5,560                    . Missing
                              13,546                    0 No loss
                               3,323                    1 Partial loss
                               1,230                    2 Full loss

G4FA      526  2  RANGE                                 N ADL; other, range of motion

                               5,660                    . Missing
                              17,085                    0 No limitation
                                 252                    1 Limitation on one side
                                 662                    2 Limitation on both sides

G4FB      528  2  VOL                                   N ADL; other, voluntary motion

                               5,674                    . Missing
                              17,264                    0 No loss
                                 620                    1 Partial loss
                                 101                    2 Full loss

G5A       530  2  INDIC                                 N ADL; used cane

                              17,495                    . Missing
                               3,472                    0 Not indicated
                               2,692                    1 Indicated

G5B       532  2  INDIC                                 N ADL; wheeled self

                              12,499                    . Missing
                               6,595                    0 Not indicated
                               4,565                    1 Indicated

G5C       534  2  INDIC                                 N ADL; other person wheeled

                              17,495                    . Missing
                               2,149                    0 Not indicated
                               4,015                    1 Indicated

G5D       536  2  INDIC                                 N ADL; wheelchair primary mode

                              17,495                    . Missing
                               2,201                    0 Not indicated
                               3,963                    1 Indicated

G5E       538  2  INDIC                                 N ADL; none of above

                              17,497                    . Missing
                               5,439                    0 Not indicated
                                 723                    1 Indicated

G6A       540  2  INDIC                                 N ADL; transfer, bedfast

                               5,567                    . Missing
                              17,393                    0 Not indicated
                                 699                    1 Indicated

G6B       542  2  INDIC                                 N ADL; transfer, bed rails used

                               5,568                    . Missing
                               8,868                    0 Not indicated
                               9,223                    1 Indicated

G6C       544  2  INDIC                                 N ADL; transfer, lifted manually

                              17,495                    . Missing
                               4,994                    0 Not indicated
                               1,170                    1 Indicated

G6D       546  2  INDIC                                 N ADL; transfer, lifted mechanically

                              17,495                    . Missing
                               5,537                    0 Not indicated
                                 627                    1 Indicated

G6E       548  2  INDIC                                 N ADL; transfer, transfer aid

                              17,495                    . Missing
                               3,821                    0 Not indicated
                               2,343                    1 Indicated

G6F       550  2  INDIC                                 N ADL; transfer, none of above

                              14,409                    . Missing
                               6,354                    0 Not indicated
                               2,896                    1 Indicated

G7        552  2  YESNO                                 N ADL; task segmentation

                               7,925                    . Missing
                               9,197                    0 No
                               6,537                    1 Yes

G8A       554  2  INDIC                                 N ADL; rehab potential, resident believes

                              17,495                    . Missing
                               4,448                    0 Not indicated
                               1,716                    1 Indicated

G8B       556  2  INDIC                                 N ADL; rehab potential, staff believes

                              17,495                    . Missing
                               4,159                    0 Not indicated
                               2,005                    1 Indicated

G8C       558  2  INDIC                                 N ADL; rehab potential, slow

                              17,495                    . Missing
                               5,519                    0 Not indicated
                                 645                    1 Indicated

G8D       560  2  INDIC                                 N ADL; rehab potential, diff in AM and PM

                              17,495                    . Missing
                               5,856                    0 Not indicated
                                 308                    1 Indicated

G8E       562  2  INDIC                                 N ADL; rehab potential, none of above

                              17,497                    . Missing
                               2,631                    0 Not indicated
                               3,531                    1 Indicated

G9        564  2  CHANGE                                N ADL; change in last 90 days

                              17,496                    . Missing
                               3,647                    0 No change
                                 596                    1 Improved
                               1,920                    2 Deteriorated

H1A       566  2  CONTINEN                              N Continence; bowel

                               5,553                    . Missing
                               8,750                    0 Continent
                               1,241                    1 Usually continent
                               1,228                    2 Occasionally incontinent
                               1,610                    3 Frequently incontinent
                               5,277                    4 Incontinent

H1B       568  2  CONTINEN                              N Continence; bladder

                               5,553                    . Missing
                               6,637                    0 Continent
                               1,412                    1 Usually continent
                               1,441                    2 Occasionally incontinent
                               3,208                    3 Frequently incontinent
                               5,408                    4 Incontinent

H2A       570  2  INDIC                                 N Continence; bowel regular

                              17,496                    . Missing
                               1,305                    0 Not indicated
                               4,858                    1 Indicated

H2B       572  2  INDIC                                 N Continence; bowel constipation

                              17,496                    . Missing
                               5,526                    0 Not indicated
                                 637                    1 Indicated

H2C       574  2  INDIC                                 N Continence; bowel diarrhea

                               7,995                    . Missing
                              15,195                    0 Not indicated
                                 469                    1 Indicated

H2D       576  2  INDIC                                 N Continence; bowel fecal impaction

                               5,617                    . Missing
                              18,034                    0 Not indicated
                                   8                    1 Indicated

H2E       578  2  INDIC                                 N Continence; scheduled plan

                              14,415                    . Missing
                               5,341                    0 Not indicated
                               3,903                    1 Indicated

H3A       580  2  INDIC                                 N Continence; none of above

                               5,580                    . Missing
                              12,797                    0 Not indicated
                               5,282                    1 Indicated

H3B       582  2  INDIC                                 N Continence; bladder retaining plan

                               5,581                    . Missing
                              17,942                    0 Not indicated
                                 136                    1 Indicated

H3C       584  2  INDIC                                 N Continence; external condom catheter

                               5,582                    . Missing
                              17,970                    0 Not indicated
                                 107                    1 Indicated

H3D       586  2  INDIC                                 N Continence; indwelling catheter

                               5,580                    . Missing
                              16,393                    0 Not indicated
                               1,686                    1 Indicated

H3E       588  2  INDIC                                 N Continence; intermittent catheter

                              17,496                    . Missing
                               6,119                    0 Not indicated
                                  44                    1 Indicated

H3F       590  2  INDIC                                 N Continence; did not use commode/urinal

                              17,496                    . Missing
                               5,567                    0 Not indicated
                                 596                    1 Indicated

H3G       592  2  INDIC                                 N Continence; pads/briefs used

                              17,496                    . Missing
                               2,431                    0 Not indicated
                               3,732                    1 Indicated

H3H       594  2  INDIC                                 N Continence; enemas/irrigation

                              17,496                    . Missing
                               6,122                    0 Not indicated
                                  41                    1 Indicated

H3I       596  2  INDIC                                 N Continence; ostomy present

                               5,582                    . Missing
                              17,672                    0 Not indicated
                                 405                    1 Indicated

H3J       598  2  INDIC                                 N Continence; none of above

                              14,357                    . Missing
                               5,659                    0 Not indicated
                               3,643                    1 Indicated

H4        600  2  CHANGE                                N Continence; change in last 90 days

                              17,498                    . Missing
                               5,303                    0 No change
                                 212                    1 Improved
                                 646                    2 Deteriorated

I1A       602  2  INDIC                                 N Diag; diabetes mellitus

                               8,041                    . Missing
                              10,744                    0 Not indicated
                               4,874                    1 Indicated

I1B       604  2  INDIC                                 N Diag; hyperthyroidism

                              17,496                    . Missing
                               6,112                    0 Not indicated
                                  51                    1 Indicated

I1C       606  2  INDIC                                 N Diag; hypothyroidism

                              17,496                    . Missing
                               4,935                    0 Not indicated
                               1,228                    1 Indicated

I1D       608  2  INDIC                                 N Diag; arteriosclerotic heart disease

                              12,293                    . Missing
                               9,922                    0 Not indicated
                               1,444                    1 Indicated

I1E       610  2  INDIC                                 N Diag; cardiac dysrhythmias

                              17,495                    . Missing
                               5,338                    0 Not indicated
                                 826                    1 Indicated

I1F       612  2  INDIC                                 N Diag; congestive heart failure

                              12,293                    . Missing
                               8,754                    0 Not indicated
                               2,612                    1 Indicated

I1G       614  2  INDIC                                 N Diag; deep vein thrombosis

                              17,495                    . Missing
                               5,979                    0 Not indicated
                                 185                    1 Indicated

I1H       616  2  INDIC                                 N Diag; hypertension

                              17,495                    . Missing
                               2,172                    0 Not indicated
                               3,992                    1 Indicated

I1I       618  2  INDIC                                 N Diag; hypotension

                              17,495                    . Missing
                               6,090                    0 Not indicated
                                  74                    1 Indicated

I1J       620  2  INDIC                                 N Diag; peripheral vascular disease

                              12,293                    . Missing
                              10,118                    0 Not indicated
                               1,248                    1 Indicated

I1K       622  2  INDIC                                 N Diag; other cardiovascular disease

                              17,495                    . Missing
                               4,788                    0 Not indicated
                               1,376                    1 Indicated

I1L       624  2  INDIC                                 N Diag; arthritis

                              17,495                    . Missing
                               3,918                    0 Not indicated
                               2,246                    1 Indicated

I1M       626  2  INDIC                                 N Diag; hip fracture

                               7,929                    . Missing
                              14,716                    0 Not indicated
                               1,014                    1 Indicated

I1N       628  2  INDIC                                 N Diag; missing limb (e.g., amputation)

                              17,495                    . Missing
                               6,046                    0 Not indicated
                                 118                    1 Indicated

I1O       630  2  INDIC                                 N Diag; osteoporosis

                              17,495                    . Missing
                               4,667                    0 Not indicated
                               1,497                    1 Indicated

I1P       632  2  INDIC                                 N Diag; pathological bone fracture

                              17,495                    . Missing
                               6,117                    0 Not indicated
                                  47                    1 Indicated

I1Q       634  2  INDIC                                 N Diag; alzheimers disease

                              17,495                    . Missing
                               5,096                    0 Not indicated
                               1,068                    1 Indicated

I1R       636  2  INDIC                                 N Diag; aphasia

                               7,929                    . Missing
                              15,150                    0 Not indicated
                                 580                    1 Indicated

I1S       638  2  INDIC                                 N Diag; cerebral palsy

                               7,929                    . Missing
                              15,568                    0 Not indicated
                                 162                    1 Indicated

I1T       640  2  INDIC                                 N Diag; cerebrovascular accident (stroke)

                               7,929                    . Missing
                              12,709                    0 Not indicated
                               3,021                    1 Indicated

I1U       642  2  INDIC                                 N Diag; dementia other than alzheimers

                              17,495                    . Missing
                               4,120                    0 Not indicated
                               2,044                    1 Indicated

I1V       644  2  INDIC                                 N Diag; hemiplegia/hemiparesis

                               7,929                    . Missing
                              14,163                    0 Not indicated
                               1,567                    1 Indicated

I1W       646  2  INDIC                                 N Diag; multiple sclerosis

                               7,929                    . Missing
                              15,518                    0 Not indicated
                                 212                    1 Indicated

I1X       648  2  INDIC                                 N Diag; paraplegia

                              12,293                    . Missing
                              11,284                    0 Not indicated
                                  82                    1 Indicated

I1Y       650  2  INDIC                                 N Diag; parkinsons disease

                              17,495                    . Missing
                               5,704                    0 Not indicated
                                 460                    1 Indicated

I1Z       652  2  INDIC                                 N Diag; quadriplegia

                               7,929                    . Missing
                              15,580                    0 Not indicated
                                 150                    1 Indicated

I1AA      654  2  INDIC                                 N Diag; seizure disorder

                              17,495                    . Missing
                               5,690                    0 Not indicated
                                 474                    1 Indicated

I1BB      656  2  INDIC                                 N Diag; transient ischemic attack (TIA)

                              17,495                    . Missing
                               5,966                    0 Not indicated
                                 198                    1 Indicated

I1CC      658  2  INDIC                                 N Diag; traumatic brain injury

                              17,495                    . Missing
                               6,143                    0 Not indicated
                                  21                    1 Indicated

I1DD      660  2  INDIC                                 N Diag; anxiety disorder

                              17,495                    . Missing
                               5,112                    0 Not indicated
                               1,052                    1 Indicated

I1EE      662  2  INDIC                                 N Diag; depression

                               7,929                    . Missing
                               8,342                    0 Not indicated
                               7,388                    1 Indicated

I1FF      664  2  INDIC                                 N Diag; manic depression (bipolar disease)

                               7,929                    . Missing
                              15,229                    0 Not indicated
                                 501                    1 Indicated

I1GG      666  2  INDIC                                 N Diag; schizophrenia

                              12,292                    . Missing
                              10,951                    0 Not indicated
                                 416                    1 Indicated

I1HH      668  2  INDIC                                 N Diag; asthma

                              12,296                    . Missing
                              11,049                    0 Not indicated
                                 314                    1 Indicated

I1II      670  2  INDIC                                 N Diag; emphysema/COPD

                              12,293                    . Missing
                               9,629                    0 Not indicated
                               1,737                    1 Indicated

I1JJ      672  2  INDIC                                 N Diag; cataracts

                              17,495                    . Missing
                               5,728                    0 Not indicated
                                 436                    1 Indicated

I1KK      674  2  INDIC                                 N Diag; diabetic retinopathy

                              17,495                    . Missing
                               6,102                    0 Not indicated
                                  62                    1 Indicated

I1LL      676  2  INDIC                                 N Diag; glaucoma

                              17,495                    . Missing
                               5,574                    0 Not indicated
                                 590                    1 Indicated

I1MM      678  2  INDIC                                 N Diag; macular degeneration

                              17,495                    . Missing
                               5,829                    0 Not indicated
                                 335                    1 Indicated

I1NN      680  2  INDIC                                 N Diag; allergies

                              17,495                    . Missing
                               4,247                    0 Not indicated
                               1,917                    1 Indicated

I1OO      682  2  INDIC                                 N Diag; anemia

                              17,496                    . Missing
                               4,614                    0 Not indicated
                               1,549                    1 Indicated

I1PP      684  2  INDIC                                 N Diag; cancer

                              17,495                    . Missing
                               5,707                    0 Not indicated
                                 457                    1 Indicated

I1QQ      686  2  INDIC                                 N Diag; renal failure

                              17,495                    . Missing
                               5,901                    0 Not indicated
                                 263                    1 Indicated

I1RR      688  2  INDIC                                 N Diag; none of above

                              13,178                    . Missing
                               9,333                    0 Not indicated
                               1,148                    1 Indicated

I2A       690  2  INDIC                                 N Diag; antibiotic resistant infection

                               7,927                    . Missing
                              15,403                    0 Not indicated
                                 329                    1 Indicated

I2B       692  2  INDIC                                 N Diag; clostridium difficile (c. diff.)

                               7,927                    . Missing
                              15,540                    0 Not indicated
                                 192                    1 Indicated

I2C       694  2  INDIC                                 N Diag; conjunctivitis

                               7,927                    . Missing
                              15,675                    0 Not indicated
                                  57                    1 Indicated

I2D       696  2  INDIC                                 N Diag; HIV infection

                              12,447                    . Missing
                              11,198                    0 Not indicated
                                  14                    1 Indicated

I2E       698  2  INDIC                                 N Diag; pneumonia

                               7,927                    . Missing
                              15,019                    0 Not indicated
                                 713                    1 Indicated

I2F       700  2  INDIC                                 N Diag; respiratory infection

                               7,927                    . Missing
                              15,330                    0 Not indicated
                                 402                    1 Indicated

I2G       702  2  INDIC                                 N Diag; septicemia

                               7,927                    . Missing
                              15,617                    0 Not indicated
                                 115                    1 Indicated

I2H       704  2  INDIC                                 N Diag; sexually transmitted diseases

                              12,368                    . Missing
                              11,283                    0 Not indicated
                                   8                    1 Indicated

I2I       706  2  INDIC                                 N Diag; tuberculosis

                               7,927                    . Missing
                              15,720                    0 Not indicated
                                  12                    1 Indicated

I2J       708  2  INDIC                                 N Diag; urinary tract infection, 30 days

                               5,549                    . Missing
                              15,831                    0 Not indicated
                               2,279                    1 Indicated

I2K       710  2  INDIC                                 N Diag; viral hepatitus

                               7,927                    . Missing
                              15,708                    0 Not indicated
                                  24                    1 Indicated

I2L       712  2  INDIC                                 N Diag; wound infection

                               7,927                    . Missing
                              15,357                    0 Not indicated
                                 375                    1 Indicated

I2M       714  2  INDIC                                 N Diag; none of above

                              10,122                    . Missing
                               3,559                    0 Not indicated
                               9,978                    1 Indicated

I3A       716  7                                        C Diag; other diagnosis A

I3B       723  7                                        C Diag; other diagnosis B

I3C       730  7                                        C Diag; other diagnosis C

I3D       737  7                                        C Diag; other diagnosis D

I3E       744  7                                        C Diag; other diagnosis E

J1A       751  2  INDIC                                 N Health; weight gain/loss

                               7,938                    . Missing
                              15,364                    0 Not indicated
                                 357                    1 Indicated

J1B       753  2  INDIC                                 N Health; not able lie flat, short breath

                               7,937                    . Missing
                              15,127                    0 Not indicated
                                 595                    1 Indicated

J1C       755  2  INDIC                                 N Health; dehydrated

                               5,557                    . Missing
                              18,073                    0 Not indicated
                                  29                    1 Indicated

J1D       757  2  INDIC                                 N Health; insufficient fluid

                               7,936                    . Missing
                              15,311                    0 Not indicated
                                 412                    1 Indicated

J1E       759  2  INDIC                                 N Health; delusions

                               7,937                    . Missing
                              15,273                    0 Not indicated
                                 449                    1 Indicated

J1F       761  2  INDIC                                 N Health; dizziness/vertigo

                              17,495                    . Missing
                               6,041                    0 Not indicated
                                 123                    1 Indicated

J1G       763  2  INDIC                                 N Health; edema

                               7,936                    . Missing
                              12,018                    0 Not indicated
                               3,705                    1 Indicated

J1H       765  2  INDIC                                 N Health; fever

                               7,937                    . Missing
                              15,341                    0 Not indicated
                                 381                    1 Indicated

J1I       767  2  INDIC                                 N Health; hallucinations

                               5,558                    . Missing
                              17,912                    0 Not indicated
                                 189                    1 Indicated

J1J       769  2  INDIC                                 N Health; internal bleeding

                               7,936                    . Missing
                              15,614                    0 Not indicated
                                 109                    1 Indicated

J1K       771  2  INDIC                                 N Health; recurrent lung aspirations

                               7,936                    . Missing
                              15,681                    0 Not indicated
                                  42                    1 Indicated

J1L       773  2  INDIC                                 N Health; shortness of breath

                               7,937                    . Missing
                              14,465                    0 Not indicated
                               1,257                    1 Indicated

J1M       775  2  INDIC                                 N Health; syncope (fainting)

                              17,495                    . Missing
                               6,149                    0 Not indicated
                                  15                    1 Indicated

J1N       777  2  INDIC                                 N Health; unsteady gate

                               7,941                    . Missing
                               9,389                    0 Not indicated
                               6,329                    1 Indicated

J1O       779  2  INDIC                                 N Health; vomiting

                               7,939                    . Missing
                              15,444                    0 Not indicated
                                 276                    1 Indicated

J1P       781  2  INDIC                                 N Health; none of above

                              14,414                    . Missing
                               4,708                    0 Not indicated
                               4,537                    1 Indicated

J2A       783  2  PAINA                                 N Health; pain symptoms, frequency

                               5,552                    . Missing
                              11,010                    0 No pain
                               4,333                    1 Pain less than daily
                               2,764                    2 Pain daily

J2B       785  2  PAINB                                 N Health; pain symptoms, intensity

                              16,570                    . Missing
                               2,714                    1 Mild pain
                               3,854                    2 Moderate pain
                                 521                    3 Horrible/Excruciating pain

J3A       787  2  INDIC                                 N Health; pain site, back

                              20,958                    . Missing
                               2,005                    0 Not indicated
                                 696                    1 Indicated

J3B       789  2  INDIC                                 N Health; pain site, bone

                              20,959                    . Missing
                               2,469                    0 Not indicated
                                 231                    1 Indicated

J3C       791  2  INDIC                                 N Health; pain site, chest

                              20,960                    . Missing
                               2,675                    0 Not indicated
                                  24                    1 Indicated

J3D       793  2  INDIC                                 N Health; pain site, headache

                              20,960                    . Missing
                               2,486                    0 Not indicated
                                 213                    1 Indicated

J3E       795  2  INDIC                                 N Health; pain site, hip

                              20,958                    . Missing
                               2,239                    0 Not indicated
                                 462                    1 Indicated

J3F       797  2  INDIC                                 N Health; pain site, incisional

                              20,959                    . Missing
                               2,436                    0 Not indicated
                                 264                    1 Indicated

J3G       799  2  INDIC                                 N Health; pain site, joint, other than hip

                              20,960                    . Missing
                               1,832                    0 Not indicated
                                 867                    1 Indicated

J3H       801  2  INDIC                                 N Health; pain site, soft tissue

                              20,962                    . Missing
                               2,290                    0 Not indicated
                                 407                    1 Indicated

J3I       803  2  INDIC                                 N Health; pain site, stomach pain

                              20,960                    . Missing
                               2,605                    0 Not indicated
                                  94                    1 Indicated

J3J       805  2  INDIC                                 N Health; pain site, other

                              20,961                    . Missing
                               1,745                    0 Not indicated
                                 953                    1 Indicated

J4A       807  2  INDIC                                 N Health; fell in last 30 days

                               5,552                    . Missing
                              14,600                    0 Not indicated
                               3,507                    1 Indicated

J4B       809  2  INDIC                                 N Health; fell in last 31-180 days

                               5,551                    . Missing
                              13,172                    0 Not indicated
                               4,936                    1 Indicated

J4C       811  2  INDIC                                 N Health; hip fracture in last 180 days

                               5,551                    . Missing
                              17,295                    0 Not indicated
                                 813                    1 Indicated

J4D       813  2  INDIC                                 N Health; other fracture in last 180 days

                               5,552                    . Missing
                              17,194                    0 Not indicated
                                 913                    1 Indicated

J4E       815  2  INDIC                                 N Health; none of above

                               5,551                    . Missing
                               7,391                    0 Not indicated
                              10,717                    1 Indicated

J5A       817  2  INDIC                                 N Health; diseases make patterns unstable

                               5,551                    . Missing
                              11,102                    0 Not indicated
                               7,006                    1 Indicated

J5B       819  2  INDIC                                 N Health; episode of recurrent problem

                               5,551                    . Missing
                              14,785                    0 Not indicated
                               3,323                    1 Indicated

J5C       821  2  INDIC                                 N Health; end-stage disease, 6 mo. to live

                               5,551                    . Missing
                              17,874                    0 Not indicated
                                 234                    1 Indicated

J5D       823  2  INDIC                                 N Health; none of above

                               5,551                    . Missing
                               8,390                    0 Not indicated
                               9,718                    1 Indicated

K1A       825  2  INDIC                                 N Nutri; chewing problem

                               7,978                    . Missing
                              11,772                    0 Not indicated
                               3,909                    1 Indicated

K1B       827  2  INDIC                                 N Nutri; swallowing problem

                               7,971                    . Missing
                              12,995                    0 Not indicated
                               2,693                    1 Indicated

K1C       829  2  INDIC                                 N Nutri; mouth pain

                              17,497                    . Missing
                               6,138                    0 Not indicated
                                  24                    1 Indicated

K1D       831  2  INDIC                                 N Nutri; none of above

                              13,180                    . Missing
                               3,419                    0 Not indicated
                               7,060                    1 Indicated

K2A       833  2                                        N Nutri; height

K2B       835  3                                        N Nutri; weight

K3A       838  2  YESNO                                 N Nutri; weight loss, 5% in last 30

                               5,675                    . Missing
                              16,176                    0 No
                               1,808                    1 Yes

K3B       840  2  YESNO                                 N Nutri; weight gain, 5% in last 30

                               5,671                    . Missing
                              16,913                    0 No
                               1,075                    1 Yes

K4A       842  2  INDIC                                 N Nutri; complains about taste of food

                              17,495                    . Missing
                               6,114                    0 Not indicated
                                  50                    1 Indicated

K4B       844  2  INDIC                                 N Nutri; regular complaints of hunger

                              17,498                    . Missing
                               6,145                    0 Not indicated
                                  16                    1 Indicated

K4C       846  2  INDIC                                 N Nutri; leaves 25% food left uneaten

                              17,495                    . Missing
                               3,820                    0 Not indicated
                               2,344                    1 Indicated

K4D       848  2  INDIC                                 N Nutri; none of above

                              17,500                    . Missing
                               2,371                    0 Not indicated
                               3,788                    1 Indicated

K5A       850  2  INDIC                                 N Nutri; parenteral/IV

                               7,958                    . Missing
                              15,180                    0 Not indicated
                                 521                    1 Indicated

K5B       852  2  INDIC                                 N Nutri; feeding tube

                               5,572                    . Missing
                              17,174                    0 Not indicated
                                 913                    1 Indicated

K5C       854  2  INDIC                                 N Nutri; mechanically altered diet

                              17,498                    . Missing
                               4,339                    0 Not indicated
                               1,822                    1 Indicated

K5D       856  2  INDIC                                 N Nutri; syringe, oral feeding

                              17,495                    . Missing
                               6,159                    0 Not indicated
                                   5                    1 Indicated

K5E       858  2  INDIC                                 N Nutri; therapeutic diet

                              17,495                    . Missing
                               3,016                    0 Not indicated
                               3,148                    1 Indicated

K5F       860  2  INDIC                                 N Nutri; dietary supplement before meals

                              17,497                    . Missing
                               4,588                    0 Not indicated
                               1,574                    1 Indicated

K5G       862  2  INDIC                                 N Nutri; plate guard, built-up utensil,...

                              17,495                    . Missing
                               5,979                    0 Not indicated
                                 185                    1 Indicated

K5H       864  2  INDIC                                 N Nutri; planned weight change program

                               5,570                    . Missing
                              15,399                    0 Not indicated
                               2,690                    1 Indicated

K5I       866  2  INDIC                                 N Nutri; none of above

                              14,363                    . Missing
                               5,489                    0 Not indicated
                               3,807                    1 Indicated

K6A       868  2  CALORIES                              N Nutri; parenteral, total calories

                              22,322                    . Missing
                                 414                    0 None
                                 100                    1 1% - 25%
                                  30                    2 26% - 50%
                                  63                    3 51% - 75%
                                 730                    4 76% - 100%

K6B       870  2  FLUID                                 N Nutri; parenteral, fluid intake

                              22,320                    . Missing
                                  29                    0 None
                                 281                    1 1 to 500cc/day
                                 118                    2 501 to 1000cc/day
                                 198                    3 1001 to 1500cc/day
                                 396                    4 1501 to 2000cc/day
                                 317                    5 2001 or more cc/day

L1A       872  2  INDIC                                 N Dental; debris present prior to bed

                              17,549                    . Missing
                               6,107                    0 Not indicated
                                   3                    1 Indicated

L1B       874  2  INDIC                                 N Dental; dentures or removable bridge

                              17,549                    . Missing
                               3,247                    0 Not indicated
                               2,863                    1 Indicated

L1C       876  2  INDIC                                 N Dental; some/all natural teeth lost

                              17,549                    . Missing
                               4,537                    0 Not indicated
                               1,573                    1 Indicated

L1D       878  2  INDIC                                 N Dental; broken or loose teeth

                              17,549                    . Missing
                               5,878                    0 Not indicated
                                 232                    1 Indicated

L1E       880  2  INDIC                                 N Dental; inflamed gums

                              17,549                    . Missing
                               6,078                    0 Not indicated
                                  32                    1 Indicated

L1F       882  2  INDIC                                 N Dental; daily cleaning of teeth/dentures

                              17,549                    . Missing
                                  53                    0 Not indicated
                               6,057                    1 Indicated

L1G       884  2  INDIC                                 N Dental; none of above

                              17,551                    . Missing
                               6,094                    0 Not indicated
                                  14                    1 Indicated

M1A       886  2                                        N Skin; number of stage 1 ulcers

M1B       888  2                                        N Skin; number of stage 2 ulcers

M1C       890  2                                        N Skin; number of stage 3 ulcers

M1D       892  2                                        N Skin; number of stage 4 ulcers

M2A       894  2  ULCERSTA                              N Skin; highest stage, pressure ulcer

                               5,552                    . Missing
                              16,004                    0 None
                                 506                    1 Stage one
                               1,040                    2 Stage two
                                 195                    3 Stage three
                                 362                    4 Stage four

M2B       896  2  ULCERSTA                              N Skin; highest stage, stasis ulcer

                               5,551                    . Missing
                              17,781                    0 None
                                  20                    1 Stage one
                                 229                    2 Stage two
                                  34                    3 Stage three
                                  44                    4 Stage four

M3        898  2  YESNO                                 N Skin; ulcer resolved in last 90 days

                              12,309                    . Missing
                              10,242                    0 No
                               1,108                    1 Yes

M4A       900  2  INDIC                                 N Skin; abrasions, bruises

                               7,929                    . Missing
                              11,560                    0 Not indicated
                               4,170                    1 Indicated

M4B       902  2  INDIC                                 N Skin; burns, 2nd or 3rd degree

                               7,928                    . Missing
                              15,702                    0 Not indicated
                                  29                    1 Indicated

M4C       904  2  INDIC                                 N Skin; open lesions, not ulcer/rash/cut

                               7,928                    . Missing
                              15,427                    0 Not indicated
                                 304                    1 Indicated

M4D       906  2  INDIC                                 N Skin; rashes

                               7,928                    . Missing
                              14,126                    0 Not indicated
                               1,605                    1 Indicated

M4E       908  2  INDIC                                 N Skin; desensitized to pain or pressure

                               7,928                    . Missing
                              14,570                    0 Not indicated
                               1,161                    1 Indicated

M4F       910  2  INDIC                                 N Skin; tears or cuts, other than surgery

                               7,928                    . Missing
                              14,731                    0 Not indicated
                               1,000                    1 Indicated

M4G       912  2  INDIC                                 N Skin; surgical wounds

                               7,928                    . Missing
                              14,257                    0 Not indicated
                               1,474                    1 Indicated

M4H       914  2  INDIC                                 N Skin; none of above

                               7,933                    . Missing
                               7,057                    0 Not indicated
                               8,669                    1 Indicated

M5A       916  2  INDIC                                 N Skin; pressure rel device for chair

                               7,928                    . Missing
                               8,282                    0 Not indicated
                               7,449                    1 Indicated

M5B       918  2  INDIC                                 N Skin; pressure rel device for bed

                               7,928                    . Missing
                               4,529                    0 Not indicated
                              11,202                    1 Indicated

M5C       920  2  INDIC                                 N Skin; turning/repositioning program

                               7,929                    . Missing
                               9,442                    0 Not indicated
                               6,288                    1 Indicated

M5D       922  2  INDIC                                 N Skin; nutrition to manage skin prob

                               7,929                    . Missing
                              13,329                    0 Not indicated
                               2,401                    1 Indicated

M5E       924  2  INDIC                                 N Skin; ulcer care

                               7,929                    . Missing
                              13,840                    0 Not indicated
                               1,890                    1 Indicated

M5F       926  2  INDIC                                 N Skin; surgical wound care

                               7,928                    . Missing
                              14,458                    0 Not indicated
                               1,273                    1 Indicated

M5G       928  2  INDIC                                 N Skin; applic. of dressings, not feet

                               7,929                    . Missing
                              12,772                    0 Not indicated
                               2,958                    1 Indicated

M5H       930  2  INDIC                                 N Skin; applic. of ointment/med, not feet

                               7,929                    . Missing
                              10,972                    0 Not indicated
                               4,758                    1 Indicated

M5I       932  2  INDIC                                 N Skin; other preventative care, not feet

                               7,930                    . Missing
                               6,852                    0 Not indicated
                               8,877                    1 Indicated

M5J       934  2  INDIC                                 N Skin; none of above

                               7,933                    . Missing
                              14,406                    0 Not indicated
                               1,320                    1 Indicated

M6A       936  2  INDIC                                 N Skin; foot, one or more problems

                               7,928                    . Missing
                              12,713                    0 Not indicated
                               3,018                    1 Indicated

M6B       938  2  INDIC                                 N Skin; foot, infections

                               7,928                    . Missing
                              15,568                    0 Not indicated
                                 163                    1 Indicated

M6C       940  2  INDIC                                 N Skin; foot, open lesions

                               7,932                    . Missing
                              15,418                    0 Not indicated
                                 309                    1 Indicated

M6D       942  2  INDIC                                 N Skin; foot, nails/calluses trimmed

                               7,933                    . Missing
                               8,507                    0 Not indicated
                               7,219                    1 Indicated

M6E       944  2  INDIC                                 N Skin; foot, preventative care

                               7,928                    . Missing
                              12,198                    0 Not indicated
                               3,533                    1 Indicated

M6F       946  2  INDIC                                 N Skin; foot, application of dressings

                               7,927                    . Missing
                              15,073                    0 Not indicated
                                 659                    1 Indicated

M6G       948  2  INDIC                                 N Skin; none of above

                               7,932                    . Missing
                              10,309                    0 Not indicated
                               5,418                    1 Indicated

N1A       950  2  INDIC                                 N Act; awake in morning

                               5,550                    . Missing
                               1,333                    0 Not indicated
                              16,776                    1 Indicated

N1B       952  2  INDIC                                 N Act; awake in afternoon

                               5,555                    . Missing
                               2,473                    0 Not indicated
                              15,631                    1 Indicated

N1C       954  2  INDIC                                 N Act; awake in evening

                               5,552                    . Missing
                               5,978                    0 Not indicated
                              12,129                    1 Indicated

N1D       956  2  INDIC                                 N Act; none of above

                               5,550                    . Missing
                              17,739                    0 Not indicated
                                 370                    1 Indicated

N2        958  2  AVRGTIME                              N Act; average time involved

                               5,558                    . Missing
                                 776                    0 Most - more than 2/3 time
                              16,243                    1 Some - from 1/3 to 2/3 time
                               1,025                    2 Little - less than 1/3 time
                                  57                    3 None

N3A       960  2  INDIC                                 N Act; settings, own room

                              17,501                    . Missing
                                 483                    0 Not indicated
                               5,675                    1 Indicated

N3B       962  2  INDIC                                 N Act; settings, day room

                              17,504                    . Missing
                               1,579                    0 Not indicated
                               4,576                    1 Indicated

N3C       964  2  INDIC                                 N Act; settings, inside NH, off unit

                              17,508                    . Missing
                               2,974                    0 Not indicated
                               3,177                    1 Indicated

N3D       966  2  INDIC                                 N Act; settings, outside facility

                              17,501                    . Missing
                               4,498                    0 Not indicated
                               1,660                    1 Indicated

N3E       968  2  INDIC                                 N Act; settings, none of above

                              17,503                    . Missing
                               6,134                    0 Not indicated
                                  22                    1 Indicated

N4A       970  2  INDIC                                 N Act; pref, cards, other games

                              17,501                    . Missing
                               3,219                    0 Not indicated
                               2,939                    1 Indicated

N4B       972  2  INDIC                                 N Act; pref, crafts/arts

                              17,501                    . Missing
                               4,437                    0 Not indicated
                               1,721                    1 Indicated

N4C       974  2  INDIC                                 N Act; pref, exercise/sports

                              17,501                    . Missing
                               3,289                    0 Not indicated
                               2,869                    1 Indicated

N4D       976  2  INDIC                                 N Act; pref, music

                              17,501                    . Missing
                                 691                    0 Not indicated
                               5,467                    1 Indicated

N4E       978  2  INDIC                                 N Act; pref, reading/writing

                              17,501                    . Missing
                               2,795                    0 Not indicated
                               3,363                    1 Indicated

N4F       980  2  INDIC                                 N Act; pref, spiritual/religious activitie

                              17,502                    . Missing
                               1,904                    0 Not indicated
                               4,253                    1 Indicated

N4G       982  2  INDIC                                 N Act; pref, trips/shopping

                              17,501                    . Missing
                               4,576                    0 Not indicated
                               1,582                    1 Indicated

N4H       984  2  INDIC                                 N Act; pref, walking/wheelchair outdoors

                              17,503                    . Missing
                               3,588                    0 Not indicated
                               2,568                    1 Indicated

N4I       986  2  INDIC                                 N Act; pref, watching TV

                              17,501                    . Missing
                                 866                    0 Not indicated
                               5,292                    1 Indicated

N4J       988  2  INDIC                                 N Act; pref, gardening or plants

                              17,501                    . Missing
                               5,004                    0 Not indicated
                               1,154                    1 Indicated

N4K       990  2  INDIC                                 N Act; pref, talking or conversing

                              17,501                    . Missing
                                 892                    0 Not indicated
                               5,266                    1 Indicated

N4L       992  2  INDIC                                 N Act; pref, helping others

                              17,503                    . Missing
                               5,190                    0 Not indicated
                                 966                    1 Indicated

N4M       994  2  INDIC                                 N Act; pref, none of above

                              17,503                    . Missing
                               6,139                    0 Not indicated
                                  17                    1 Indicated

N5A       996  2  ROUTINCH                              N Act; pref, change in type activities

                              17,503                    . Missing
                               5,917                    0 No change
                                 198                    1 Slight change
                                  41                    2 Major change

N5B       998  2  ROUTINCH                              N Act; pref, change in extent involvement

                              17,503                    . Missing
                               5,898                    0 No change
                                 211                    1 Slight change
                                  47                    2 Major change

O1       1000  2                                        N Rx; # of different med rec last 7

O2       1002  2  YESNO                                 N Rx; receiving med initiated, last 90

                              17,496                    . Missing
                               2,287                    0 No
                               3,876                    1 Yes

O3       1004  2  NUMDAY                                N Rx; # of days injections rec, last 7

                               8,026                    . Missing
                              15,633                  0-7 Number of days

O4A      1006  2  NUMDAY                                N Rx; # of days antipsychotic rec, last 7

                               5,551                    . Missing
                              18,108                  0-7 Number of days

O4B      1008  2  NUMDAY                                N Rx; # of days antianxiety rec, last 7

                               5,551                    . Missing
                              18,108                  0-7 Number of days

O4C      1010  2  NUMDAY                                N Rx; # of days antidepressant rec, last 7

                               5,552                    . Missing
                              18,107                  0-7 Number of days

O4D      1012  2  NUMDAY                                N Rx; # of days hypnotic rec, last 7

                               5,551                    . Missing
                              18,108                  0-7 Number of days

O4E      1014  2  NUMDAY                                N Rx; # of days diuretic rec, last 7

                               5,551                    . Missing
                              18,108                  0-7 Number of days

P1AA     1016  2  INDIC                                 N Special; chemotherapy

                               7,951                    . Missing
                              15,636                    0 Not indicated
                                  72                    1 Indicated

P1AB     1018  2  INDIC                                 N Special; dialysis

                               7,924                    . Missing
                              15,597                    0 Not indicated
                                 138                    1 Indicated

P1AC     1020  2  INDIC                                 N Special; IV medication

                               7,924                    . Missing
                              13,164                    0 Not indicated
                               2,571                    1 Indicated

P1AD     1022  2  INDIC                                 N Special; intake/output

                               7,925                    . Missing
                              11,526                    0 Not indicated
                               4,208                    1 Indicated

P1AE     1024  2  INDIC                                 N Special; monitoring acute med condition

                               7,924                    . Missing
                              10,158                    0 Not indicated
                               5,577                    1 Indicated

P1AF     1026  2  INDIC                                 N Special; ostomy care

                               7,924                    . Missing
                              14,965                    0 Not indicated
                                 770                    1 Indicated

P1AG     1028  2  INDIC                                 N Special; oxygen therapy

                               7,924                    . Missing
                              13,371                    0 Not indicated
                               2,364                    1 Indicated

P1AH     1030  2  INDIC                                 N Special; radiation

                               7,924                    . Missing
                              15,710                    0 Not indicated
                                  25                    1 Indicated

P1AI     1032  2  INDIC                                 N Special; suctioning

                               7,924                    . Missing
                              15,621                    0 Not indicated
                                 114                    1 Indicated

P1AJ     1034  2  INDIC                                 N Special; tracheostomy

                               7,924                    . Missing
                              15,655                    0 Not indicated
                                  80                    1 Indicated

P1AK     1036  2  INDIC                                 N Special; transfusions

                               7,924                    . Missing
                              15,418                    0 Not indicated
                                 317                    1 Indicated

P1AL     1038  2  INDIC                                 N Special; ventilator or respirator

                               7,924                    . Missing
                              15,684                    0 Not indicated
                                  51                    1 Indicated

P1AM     1040  2  INDIC                                 N Special; alcoholic/drug treatment

                               7,924                    . Missing
                              15,732                    0 Not indicated
                                   3                    1 Indicated

P1AN     1042  2  INDIC                                 N Special; alzheimers/dementia spec care

                               7,924                    . Missing
                              15,129                    0 Not indicated
                                 606                    1 Indicated

P1AO     1044  2  INDIC                                 N Special; hospice care

                               7,924                    . Missing
                              15,482                    0 Not indicated
                                 253                    1 Indicated

P1AP     1046  2  INDIC                                 N Special; pediatric unite

                               7,924                    . Missing
                              15,733                    0 Not indicated
                                   2                    1 Indicated

P1AQ     1048  2  INDIC                                 N Special; respite care

                               7,924                    . Missing
                              15,729                    0 Not indicated
                                   6                    1 Indicated

P1AR     1050  2  INDIC                                 N Special; community skill training

                               7,924                    . Missing
                              12,764                    0 Not indicated
                               2,971                    1 Indicated

P1AS     1052  2  INDIC                                 N Special; none of above

                               7,929                    . Missing
                               9,383                    0 Not indicated
                               6,347                    1 Indicated

P1BAA    1054  2  NUMDAY                                N Special; speech therapy days

                               7,974                    . Missing
                              15,685                  0-7 Number of days

P1BAB    1056  4  NUMMINS                               N Special; speech therapy minutes

                               7,957                    . Missing
                              15,702               0-9999 Number of minutes

P1BBA    1060  2  NUMDAY                                N Special; occupational therapy days

                               7,937                    . Missing
                              15,722                  0-7 Number of days

P1BBB    1062  4  NUMMINS                               N Special; occupational therapy minutes

                               7,954                    . Missing
                              15,705               0-9999 Number of minutes

P1BCA    1066  2  NUMDAY                                N Special; physical therapy days

                               7,936                    . Missing
                              15,723                  0-7 Number of days

P1BCB    1068  4  NUMMINS                               N Special; physical therapy minutes

                               7,953                    . Missing
                              15,706               0-9999 Number of minutes

P1BDA    1072  2  NUMDAY                                N Special; respiratory therapy days

                               7,936                    . Missing
                              15,723                  0-7 Number of days

P1BDB    1074  4  NUMMINS                               N Special; respiratory therapy minutes

                               7,956                    . Missing
                              15,703               0-9999 Number of minutes

P1BEA    1078  2  NUMDAY                                N Special; psychological therapy days

                               7,937                    . Missing
                              15,722                  0-7 Number of days

P1BEB    1080  4  NUMMINS                               N Special; psychological therapy minutes

                               7,957                    . Missing
                              15,702               0-9999 Number of minutes

P2A      1084  2  INDIC                                 N Special; behavior symptom eval program

                              17,495                    . Missing
                               5,763                    0 Not indicated
                                 401                    1 Indicated

P2B      1086  2  INDIC                                 N Special; mental health specialist eval

                              17,495                    . Missing
                               5,186                    0 Not indicated
                                 978                    1 Indicated

P2C      1088  2  INDIC                                 N Special; group therapy

                              17,495                    . Missing
                               6,083                    0 Not indicated
                                  81                    1 Indicated

P2D      1090  2  INDIC                                 N Special; deliberate environment changes

                              17,495                    . Missing
                               6,044                    0 Not indicated
                                 120                    1 Indicated

P2E      1092  2  INDIC                                 N Special; reorientation

                              17,495                    . Missing
                               3,540                    0 Not indicated
                               2,624                    1 Indicated

P2F      1094  2  INDIC                                 N Special; none of above

                              17,497                    . Missing
                               3,171                    0 Not indicated
                               2,991                    1 Indicated

P3A      1096  2  NUMDAY                                N Special; rehab, passive range of motion

                               7,927                    . Missing
                              15,732                  0-7 Number of days

P3B      1098  2  NUMDAY                                N Special; rehab, active range of motion

                               7,928                    . Missing
                              15,731                  0-7 Number of days

P3C      1100  2  NUMDAY                                N Special; rehab, splint or brace

                               7,927                    . Missing
                              15,732                  0-7 Number of days

P3D      1102  2  NUMDAY                                N Special; practice, bed mobility

                               7,928                    . Missing
                              15,731                  0-7 Number of days

P3E      1104  2  NUMDAY                                N Special; practice, transfer

                               7,928                    . Missing
                              15,731                  0-7 Number of days

P3F      1106  2  NUMDAY                                N Special; practice, walking

                               7,929                    . Missing
                              15,730                  0-7 Number of days

P3G      1108  2  NUMDAY                                N Special; practice, dressing or grooming

                               7,928                    . Missing
                              15,731                  0-7 Number of days

P3H      1110  2  NUMDAY                                N Special; practice, eating or swallowing

                               7,928                    . Missing
                              15,731                  0-7 Number of days

P3I      1112  2  NUMDAY                                N Special; practice, ampu/prosthesis care

                               7,929                    . Missing
                              15,730                  0-7 Number of days

P3J      1114  2  NUMDAY                                N Special; practice, communication

                               7,929                    . Missing
                              15,730                  0-7 Number of days

P3K      1116  2  NUMDAY                                N Special; practice, other

                               7,939                    . Missing
                              15,720                  0-7 Number of days

P4A      1118  2  USED                                  N Special; devices, full bed rails

                               5,548                    . Missing
                              16,010                    0 Not used
                                  74                    1 Used less than daily
                               2,027                    2 Used daily

P4B      1120  2  USED                                  N Special; devices, other types of rails

                               5,548                    . Missing
                              13,488                    0 Not used
                                 209                    1 Used less than daily
                               4,414                    2 Used daily

P4C      1122  2  USED                                  N Special; devices, trunk restraint

                               5,548                    . Missing
                              17,489                    0 Not used
                                  37                    1 Used less than daily
                                 585                    2 Used daily

P4D      1124  2  USED                                  N Special; devices, limb restraint

                               5,548                    . Missing
                              18,097                    0 Not used
                                   4                    1 Used less than daily
                                  10                    2 Used daily

P4E      1126  2  USED                                  N Special; devices, chair prevents rising

                               5,548                    . Missing
                              17,748                    0 Not used
                                  29                    1 Used less than daily
                                 334                    2 Used daily

P5       1128  2  NUMDAY2X                              N Special; # overnight hospital stays

                              17,495                    . Missing
                               6,164                 0-15 Number of days

P6       1130  2  NUMDAY2X                              N Special; # emergency room visits

                              17,474                    . Missing
                               6,185                 0-15 Number of days

P7       1132  2  NUMDAY2X                              N Special; # days physician examined

                               7,926                    . Missing
                              15,733                 0-15 Number of days

P8       1134  2  NUMDAY2X                              N Special; # days physician changed orders

                               7,926                    . Missing
                              15,733                 0-15 Number of days

P9       1136  2  YESNO                                 N Special; abnormal lab value last 90 days

                              17,498                    . Missing
                               1,678                    0 No
                               4,483                    1 Yes

Q1A      1138  2  YESNO                                 N Status; expresses pref of discharge

                              12,318                    . Missing
                               6,990                    0 No
                               4,351                    1 Yes

Q1B      1140  2  YESNO                                 N Status; support person pos to discharge

                              17,503                    . Missing
                               4,404                    0 No
                               1,752                    1 Yes

Q1C      1142  2  DISCHARG                              N Status; discharge projected

                              12,309                    . Missing
                               6,857                    0 No
                               1,499                    1 Within 30 days
                                 951                    2 Within 31-90 days
                               2,043                    3 Discharge status uncertain

Q2       1144  2  CHANGE                                N Status; overall care change last 90 days

                               5,560                    . Missing
                              13,984                    0 No change
                               1,186                    1 Improved
                               2,929                    2 Deteriorated

R1A      1146  2  YESNO                                 N Discharge; assess resident particip

                              17,495                    . Missing
                                 604                    0 No
                               5,560                    1 Yes

R1B      1148  2  YESNOFAM                              N Discharge; assess, family particip

                              17,496                    . Missing
                               3,108                    0 No
                               2,990                    1 Yes
                                  65                    2 No family

R1C      1150  2  YESNONON                              N Discharge; assess, signif other particip

                              17,511                    . Missing
                               3,808                    0 No
                                 462                    1 Yes
                               1,878                    2 None

R2B      1152  8                                        N Discharge; date RN assess complete

R3A      1162  2                                        N Discharge; code for resident disposition

R3B      1164  2                                        N Discharge; optional state code

R4       1166  8                                        N Discharge; date of discharge

T1AA     1176  2  NUMDAY                                N Supp; recreation therapy days

                              20,460                    . Missing
                               3,199                  0-7 Number of days

T1AB     1178  4  NUMMINS                               N Supp; recreation therapy minutes

                              20,461                    . Missing
                               3,198               0-9999 Number of minutes

T1B      1182  2  YESNO                                 N Supp; PT, OT, ST ordered first 14 days

                              20,878                    . Missing
                                 465                    0 No
                               2,316                    1 Yes

T1C      1184  2  NUMDAY2X                              N Supp; therapy days through day 15

                              21,339                    . Missing
                               2,320                 0-15 Number of days

T1D      1186  4  NUMMINS                               N Supp; total min therapy through day 15

                              21,339                    . Missing
                               2,320               0-9999 Number of minutes

T2A      1190  2  WALKDIST                              N Supp; furthest distance walked

                              21,617                    . Missing
                                 751                    0 150+ feet
                                 588                    1 51-149 feet
                                 268                    2 26-50 feet
                                 239                    3 10-25 feet
                                 196                    4 Less than 25 feet

T2B      1192  2  WALKTIME                              N Supp; time walked without sitting

                              21,621                    . Missing
                                 682                    0 1-2 minutes
                                 653                    1 3-4 minutes
                                 530                    2 5-10 minutes
                                 154                    3 11-15 minutes
                                  17                    4 16-30 minutes
                                   2                    5 31+ minutes

T2C      1194  2  WALKASSI                              N Supp; self-performance in walking

                              21,621                    . Missing
                                 434                    0 Independent
                                 373                    1 Supervision
                                 867                    2 Limited assistance
                                 364                    3 Extensive assistance

T2D      1196  2  WALKSUPP                              N Supp; walking support provided

                              21,622                    . Missing
                                 486                    0 No setup or physical help from staff
                                 287                    1 Setup help only
                               1,119                    2 One person physical assist
                                 145                    3 Two+ persons physical assist

T2E      1198  2  YESNO                                 N Supp; parallel bars used

                              21,595                    . Missing
                               1,939                    0 No
                                 125                    1 Yes

T3MDCR   1200  5                                        C Case mix group Medicare

T3STATE  1205  5                                        C Case mix group State

U01RA    1210  2  ROUTE                                 N Drug 1; route of administration

                              23,659                    . Missing
                                   0                    1 By mouth (PO)
                                   0                    2 Sub lingual (SL)
                                   0                    3 Intramuscular (IM)
                                   0                    4 Intravenous (IV)
                                   0                    5 Subcutaneous (SQ)
                                   0                    6 Rectal (R)
                                   0                    7 Topical
                                   0                    8 Inhalation
                                   0                    9 Enteral tube
                                   0                   10 Other

U01FR    1212  2  $FREQU                                C Drug 1; frequency

                              23,659                      Missing
                                   0                   && Invalid entry, &&
                                   0                   -- Invalid entry, --
                                   0                    C Continuous
                                   0                    O Other
                                   0                   PR (PRN) As necessary
                                   0                   QO Every other day
                                   0                   Q0 Invalid entry, Q0
                                   0                   Q4 Invalid entry, Q4
                                   0                   0O Invalid entry, 0O
                                   0                   00 Invalid entry, 00
                                   0                    1 Invalid entry, One
                                   0                   1D (QD or HS) Once daily
                                   0                   1H (QH) Every hour
                                   0                   1M (Q mo) Once each month
                                   0                   1W (Q week) Once each week
                                   0                   1X Invalid entry, 1X
                                   0                   12 Invalid entry, 12
                                   0                   2D (BID) Two times daily
                                   0                   2H (Q2H) Every 2 hours
                                   0                   2M Twice each month
                                   0                   2W Two times each week
                                   0                   21 Invalid entry, 21
                                   0                   3D (TID) Three times daily
                                   0                   3H (Q3H) Every 3 hours
                                   0                   3P Invalid entry, 3P
                                   0                   3W Three times each week
                                   0                   4D (QID) Four times daily
                                   0                   4H (Q4H) Every 4 hours
                                   0                   4W Four times each week
                                   0                   5D Five times daily
                                   0                   5W Five times each week
                                   0                   6D Invalid entry, 6D
                                   0                   6H (Q6H) Every 6 hours
                                   0                   6W Six times each week
                                   0                   8H (Q8H) Every 8 hours

U01AA    1214  5  $AMOUNT                               C Drug 1; amount administered

                              23,659             LOW-HIGH Amount administered

U01PR    1219  2  PRNN                                  N Drug 1; PRN-number of doses

                              23,659                    . Missing
                                   0                 0-99 Number of doses

U01NDC   1221  9  $NDCDRUG                              C Drug 1; National Drug Code (NDC)

                              23,659             LOW-HIGH National Drug Code

U02RA    1230  2  ROUTE                                 N Drug 2; route of administration

                              23,659                    . Missing
                                   0                    1 By mouth (PO)
                                   0                    2 Sub lingual (SL)
                                   0                    3 Intramuscular (IM)
                                   0                    4 Intravenous (IV)
                                   0                    5 Subcutaneous (SQ)
                                   0                    6 Rectal (R)
                                   0                    7 Topical
                                   0                    8 Inhalation
                                   0                    9 Enteral tube
                                   0                   10 Other

U02FR    1232  2  $FREQU                                C Drug 2; frequency

                              23,659                      Missing
                                   0                   && Invalid entry, &&
                                   0                   -- Invalid entry, --
                                   0                    C Continuous
                                   0                    O Other
                                   0                   PR (PRN) As necessary
                                   0                   QO Every other day
                                   0                   Q0 Invalid entry, Q0
                                   0                   Q4 Invalid entry, Q4
                                   0                   0O Invalid entry, 0O
                                   0                   00 Invalid entry, 00
                                   0                    1 Invalid entry, One
                                   0                   1D (QD or HS) Once daily
                                   0                   1H (QH) Every hour
                                   0                   1M (Q mo) Once each month
                                   0                   1W (Q week) Once each week
                                   0                   1X Invalid entry, 1X
                                   0                   12 Invalid entry, 12
                                   0                   2D (BID) Two times daily
                                   0                   2H (Q2H) Every 2 hours
                                   0                   2M Twice each month
                                   0                   2W Two times each week
                                   0                   21 Invalid entry, 21
                                   0                   3D (TID) Three times daily
                                   0                   3H (Q3H) Every 3 hours
                                   0                   3P Invalid entry, 3P
                                   0                   3W Three times each week
                                   0                   4D (QID) Four times daily
                                   0                   4H (Q4H) Every 4 hours
                                   0                   4W Four times each week
                                   0                   5D Five times daily
                                   0                   5W Five times each week
                                   0                   6D Invalid entry, 6D
                                   0                   6H (Q6H) Every 6 hours
                                   0                   6W Six times each week
                                   0                   8H (Q8H) Every 8 hours

U02AA    1234  5  $AMOUNT                               C Drug 2; amount administered

                              23,659             LOW-HIGH Amount administered

U02PR    1239  2  PRNN                                  N Drug 2; PRN-number of doses

                              23,659                    . Missing
                                   0                 0-99 Number of doses

U02NDC   1241  9  $NDCDRUG                              C Drug 2; National Drug Code (NDC)

                              23,659             LOW-HIGH National Drug Code

U03RA    1250  2  ROUTE                                 N Drug 3; route of administration

                              23,659                    . Missing
                                   0                    1 By mouth (PO)
                                   0                    2 Sub lingual (SL)
                                   0                    3 Intramuscular (IM)
                                   0                    4 Intravenous (IV)
                                   0                    5 Subcutaneous (SQ)
                                   0                    6 Rectal (R)
                                   0                    7 Topical
                                   0                    8 Inhalation
                                   0                    9 Enteral tube
                                   0                   10 Other

U03FR    1252  2  $FREQU                                C Drug 3; frequency

                              23,659                      Missing
                                   0                   && Invalid entry, &&
                                   0                   -- Invalid entry, --
                                   0                    C Continuous
                                   0                    O Other
                                   0                   PR (PRN) As necessary
                                   0                   QO Every other day
                                   0                   Q0 Invalid entry, Q0
                                   0                   Q4 Invalid entry, Q4
                                   0                   0O Invalid entry, 0O
                                   0                   00 Invalid entry, 00
                                   0                    1 Invalid entry, One
                                   0                   1D (QD or HS) Once daily
                                   0                   1H (QH) Every hour
                                   0                   1M (Q mo) Once each month
                                   0                   1W (Q week) Once each week
                                   0                   1X Invalid entry, 1X
                                   0                   12 Invalid entry, 12
                                   0                   2D (BID) Two times daily
                                   0                   2H (Q2H) Every 2 hours
                                   0                   2M Twice each month
                                   0                   2W Two times each week
                                   0                   21 Invalid entry, 21
                                   0                   3D (TID) Three times daily
                                   0                   3H (Q3H) Every 3 hours
                                   0                   3P Invalid entry, 3P
                                   0                   3W Three times each week
                                   0                   4D (QID) Four times daily
                                   0                   4H (Q4H) Every 4 hours
                                   0                   4W Four times each week
                                   0                   5D Five times daily
                                   0                   5W Five times each week
                                   0                   6D Invalid entry, 6D
                                   0                   6H (Q6H) Every 6 hours
                                   0                   6W Six times each week
                                   0                   8H (Q8H) Every 8 hours

U03AA    1254  5  $AMOUNT                               C Drug 3; amount administered

                              23,659             LOW-HIGH Amount administered

U03PR    1259  2  PRNN                                  N Drug 3; PRN-number of doses

                              23,659                    . Missing
                                   0                 0-99 Number of doses

U03NDC   1261  9  $NDCDRUG                              C Drug 3; National Drug Code (NDC)

                              23,659             LOW-HIGH National Drug Code

U04RA    1270  2  ROUTE                                 N Drug 4; route of administration

                              23,659                    . Missing
                                   0                    1 By mouth (PO)
                                   0                    2 Sub lingual (SL)
                                   0                    3 Intramuscular (IM)
                                   0                    4 Intravenous (IV)
                                   0                    5 Subcutaneous (SQ)
                                   0                    6 Rectal (R)
                                   0                    7 Topical
                                   0                    8 Inhalation
                                   0                    9 Enteral tube
                                   0                   10 Other

U04FR    1272  2  $FREQU                                C Drug 4; frequency

                              23,659                      Missing
                                   0                   && Invalid entry, &&
                                   0                   -- Invalid entry, --
                                   0                    C Continuous
                                   0                    O Other
                                   0                   PR (PRN) As necessary
                                   0                   QO Every other day
                                   0                   Q0 Invalid entry, Q0
                                   0                   Q4 Invalid entry, Q4
                                   0                   0O Invalid entry, 0O
                                   0                   00 Invalid entry, 00
                                   0                    1 Invalid entry, One
                                   0                   1D (QD or HS) Once daily
                                   0                   1H (QH) Every hour
                                   0                   1M (Q mo) Once each month
                                   0                   1W (Q week) Once each week
                                   0                   1X Invalid entry, 1X
                                   0                   12 Invalid entry, 12
                                   0                   2D (BID) Two times daily
                                   0                   2H (Q2H) Every 2 hours
                                   0                   2M Twice each month
                                   0                   2W Two times each week
                                   0                   21 Invalid entry, 21
                                   0                   3D (TID) Three times daily
                                   0                   3H (Q3H) Every 3 hours
                                   0                   3P Invalid entry, 3P
                                   0                   3W Three times each week
                                   0                   4D (QID) Four times daily
                                   0                   4H (Q4H) Every 4 hours
                                   0                   4W Four times each week
                                   0                   5D Five times daily
                                   0                   5W Five times each week
                                   0                   6D Invalid entry, 6D
                                   0                   6H (Q6H) Every 6 hours
                                   0                   6W Six times each week
                                   0                   8H (Q8H) Every 8 hours

U04AA    1274  5  $AMOUNT                               C Drug 4; amount administered

                              23,659             LOW-HIGH Amount administered

U04PR    1279  2  PRNN                                  N Drug 4; PRN-number of doses

                              23,659                    . Missing
                                   0                 0-99 Number of doses

U04NDC   1281  9  $NDCDRUG                              C Drug 4; National Drug Code (NDC)

                              23,659             LOW-HIGH National Drug Code

U05RA    1290  2  ROUTE                                 N Drug 5; route of administration

                              23,659                    . Missing
                                   0                    1 By mouth (PO)
                                   0                    2 Sub lingual (SL)
                                   0                    3 Intramuscular (IM)
                                   0                    4 Intravenous (IV)
                                   0                    5 Subcutaneous (SQ)
                                   0                    6 Rectal (R)
                                   0                    7 Topical
                                   0                    8 Inhalation
                                   0                    9 Enteral tube
                                   0                   10 Other

U05FR    1292  2  $FREQU                                C Drug 5; frequency

                              23,659                      Missing
                                   0                   && Invalid entry, &&
                                   0                   -- Invalid entry, --
                                   0                    C Continuous
                                   0                    O Other
                                   0                   PR (PRN) As necessary
                                   0                   QO Every other day
                                   0                   Q0 Invalid entry, Q0
                                   0                   Q4 Invalid entry, Q4
                                   0                   0O Invalid entry, 0O
                                   0                   00 Invalid entry, 00
                                   0                    1 Invalid entry, One
                                   0                   1D (QD or HS) Once daily
                                   0                   1H (QH) Every hour
                                   0                   1M (Q mo) Once each month
                                   0                   1W (Q week) Once each week
                                   0                   1X Invalid entry, 1X
                                   0                   12 Invalid entry, 12
                                   0                   2D (BID) Two times daily
                                   0                   2H (Q2H) Every 2 hours
                                   0                   2M Twice each month
                                   0                   2W Two times each week
                                   0                   21 Invalid entry, 21
                                   0                   3D (TID) Three times daily
                                   0                   3H (Q3H) Every 3 hours
                                   0                   3P Invalid entry, 3P
                                   0                   3W Three times each week
                                   0                   4D (QID) Four times daily
                                   0                   4H (Q4H) Every 4 hours
                                   0                   4W Four times each week
                                   0                   5D Five times daily
                                   0                   5W Five times each week
                                   0                   6D Invalid entry, 6D
                                   0                   6H (Q6H) Every 6 hours
                                   0                   6W Six times each week
                                   0                   8H (Q8H) Every 8 hours

U05AA    1294  5  $AMOUNT                               C Drug 5; amount administered

                              23,659             LOW-HIGH Amount administered

U05PR    1299  2  PRNN                                  N Drug 5; PRN-number of doses

                              23,659                    . Missing
                                   0                 0-99 Number of doses

U05NDC   1301  9  $NDCDRUG                              C Drug 5; National Drug Code (NDC)

                              23,659             LOW-HIGH National Drug Code

U06RA    1310  2  ROUTE                                 N Drug 6; route of administration

                              23,659                    . Missing
                                   0                    1 By mouth (PO)
                                   0                    2 Sub lingual (SL)
                                   0                    3 Intramuscular (IM)
                                   0                    4 Intravenous (IV)
                                   0                    5 Subcutaneous (SQ)
                                   0                    6 Rectal (R)
                                   0                    7 Topical
                                   0                    8 Inhalation
                                   0                    9 Enteral tube
                                   0                   10 Other

U06FR    1312  2  $FREQU                                C Drug 6; frequency

                              23,659                      Missing
                                   0                   && Invalid entry, &&
                                   0                   -- Invalid entry, --
                                   0                    C Continuous
                                   0                    O Other
                                   0                   PR (PRN) As necessary
                                   0                   QO Every other day
                                   0                   Q0 Invalid entry, Q0
                                   0                   Q4 Invalid entry, Q4
                                   0                   0O Invalid entry, 0O
                                   0                   00 Invalid entry, 00
                                   0                    1 Invalid entry, One
                                   0                   1D (QD or HS) Once daily
                                   0                   1H (QH) Every hour
                                   0                   1M (Q mo) Once each month
                                   0                   1W (Q week) Once each week
                                   0                   1X Invalid entry, 1X
                                   0                   12 Invalid entry, 12
                                   0                   2D (BID) Two times daily
                                   0                   2H (Q2H) Every 2 hours
                                   0                   2M Twice each month
                                   0                   2W Two times each week
                                   0                   21 Invalid entry, 21
                                   0                   3D (TID) Three times daily
                                   0                   3H (Q3H) Every 3 hours
                                   0                   3P Invalid entry, 3P
                                   0                   3W Three times each week
                                   0                   4D (QID) Four times daily
                                   0                   4H (Q4H) Every 4 hours
                                   0                   4W Four times each week
                                   0                   5D Five times daily
                                   0                   5W Five times each week
                                   0                   6D Invalid entry, 6D
                                   0                   6H (Q6H) Every 6 hours
                                   0                   6W Six times each week
                                   0                   8H (Q8H) Every 8 hours

U06AA    1314  5  $AMOUNT                               C Drug 6; amount administered

                              23,659             LOW-HIGH Amount administered

U06PR    1319  2  PRNN                                  N Drug 6; PRN-number of doses

                              23,659                    . Missing
                                   0                 0-99 Number of doses

U06NDC   1321  9  $NDCDRUG                              C Drug 7; National Drug Code (NDC)

                              23,659             LOW-HIGH National Drug Code

U07RA    1330  2  ROUTE                                 N Drug 7; route of administration

                              23,659                    . Missing
                                   0                    1 By mouth (PO)
                                   0                    2 Sub lingual (SL)
                                   0                    3 Intramuscular (IM)
                                   0                    4 Intravenous (IV)
                                   0                    5 Subcutaneous (SQ)
                                   0                    6 Rectal (R)
                                   0                    7 Topical
                                   0                    8 Inhalation
                                   0                    9 Enteral tube
                                   0                   10 Other

U07FR    1332  2  $FREQU                                C Drug 7; frequency

                              23,659                      Missing
                                   0                   && Invalid entry, &&
                                   0                   -- Invalid entry, --
                                   0                    C Continuous
                                   0                    O Other
                                   0                   PR (PRN) As necessary
                                   0                   QO Every other day
                                   0                   Q0 Invalid entry, Q0
                                   0                   Q4 Invalid entry, Q4
                                   0                   0O Invalid entry, 0O
                                   0                   00 Invalid entry, 00
                                   0                    1 Invalid entry, One
                                   0                   1D (QD or HS) Once daily
                                   0                   1H (QH) Every hour
                                   0                   1M (Q mo) Once each month
                                   0                   1W (Q week) Once each week
                                   0                   1X Invalid entry, 1X
                                   0                   12 Invalid entry, 12
                                   0                   2D (BID) Two times daily
                                   0                   2H (Q2H) Every 2 hours
                                   0                   2M Twice each month
                                   0                   2W Two times each week
                                   0                   21 Invalid entry, 21
                                   0                   3D (TID) Three times daily
                                   0                   3H (Q3H) Every 3 hours
                                   0                   3P Invalid entry, 3P
                                   0                   3W Three times each week
                                   0                   4D (QID) Four times daily
                                   0                   4H (Q4H) Every 4 hours
                                   0                   4W Four times each week
                                   0                   5D Five times daily
                                   0                   5W Five times each week
                                   0                   6D Invalid entry, 6D
                                   0                   6H (Q6H) Every 6 hours
                                   0                   6W Six times each week
                                   0                   8H (Q8H) Every 8 hours

U07AA    1334  5  $AMOUNT                               C Drug 7; amount administered

                              23,659             LOW-HIGH Amount administered

U07PR    1339  2  PRNN                                  N Drug 7; PRN-number of doses

                              23,659                    . Missing
                                   0                 0-99 Number of doses

U07NDC   1341  9  $NDCDRUG                              C Drug 7; National Drug Code (NDC)

                              23,659             LOW-HIGH National Drug Code

U08RA    1350  2  ROUTE                                 N Drug 8; route of administration

                              23,659                    . Missing
                                   0                    1 By mouth (PO)
                                   0                    2 Sub lingual (SL)
                                   0                    3 Intramuscular (IM)
                                   0                    4 Intravenous (IV)
                                   0                    5 Subcutaneous (SQ)
                                   0                    6 Rectal (R)
                                   0                    7 Topical
                                   0                    8 Inhalation
                                   0                    9 Enteral tube
                                   0                   10 Other

U08FR    1352  2  $FREQU                                C Drug 8; frequency

                              23,659                      Missing
                                   0                   && Invalid entry, &&
                                   0                   -- Invalid entry, --
                                   0                    C Continuous
                                   0                    O Other
                                   0                   PR (PRN) As necessary
                                   0                   QO Every other day
                                   0                   Q0 Invalid entry, Q0
                                   0                   Q4 Invalid entry, Q4
                                   0                   0O Invalid entry, 0O
                                   0                   00 Invalid entry, 00
                                   0                    1 Invalid entry, One
                                   0                   1D (QD or HS) Once daily
                                   0                   1H (QH) Every hour
                                   0                   1M (Q mo) Once each month
                                   0                   1W (Q week) Once each week
                                   0                   1X Invalid entry, 1X
                                   0                   12 Invalid entry, 12
                                   0                   2D (BID) Two times daily
                                   0                   2H (Q2H) Every 2 hours
                                   0                   2M Twice each month
                                   0                   2W Two times each week
                                   0                   21 Invalid entry, 21
                                   0                   3D (TID) Three times daily
                                   0                   3H (Q3H) Every 3 hours
                                   0                   3P Invalid entry, 3P
                                   0                   3W Three times each week
                                   0                   4D (QID) Four times daily
                                   0                   4H (Q4H) Every 4 hours
                                   0                   4W Four times each week
                                   0                   5D Five times daily
                                   0                   5W Five times each week
                                   0                   6D Invalid entry, 6D
                                   0                   6H (Q6H) Every 6 hours
                                   0                   6W Six times each week
                                   0                   8H (Q8H) Every 8 hours

U08AA    1354  5  $AMOUNT                               C Drug 8; amount administered

                              23,659             LOW-HIGH Amount administered

U08PR    1359  2  PRNN                                  N Drug 8; PRN-number of doses

                              23,659                    . Missing
                                   0                 0-99 Number of doses

U08NDC   1361  9  $NDCDRUG                              C Drug 8; National Drug Code (NDC)

                              23,659             LOW-HIGH National Drug Code

U09RA    1370  2  ROUTE                                 N Drug 9; route of administration

                              23,659                    . Missing
                                   0                    1 By mouth (PO)
                                   0                    2 Sub lingual (SL)
                                   0                    3 Intramuscular (IM)
                                   0                    4 Intravenous (IV)
                                   0                    5 Subcutaneous (SQ)
                                   0                    6 Rectal (R)
                                   0                    7 Topical
                                   0                    8 Inhalation
                                   0                    9 Enteral tube
                                   0                   10 Other

U09FR    1372  2  $FREQU                                C Drug 9; frequency

                              23,659                      Missing
                                   0                   && Invalid entry, &&
                                   0                   -- Invalid entry, --
                                   0                    C Continuous
                                   0                    O Other
                                   0                   PR (PRN) As necessary
                                   0                   QO Every other day
                                   0                   Q0 Invalid entry, Q0
                                   0                   Q4 Invalid entry, Q4
                                   0                   0O Invalid entry, 0O
                                   0                   00 Invalid entry, 00
                                   0                    1 Invalid entry, One
                                   0                   1D (QD or HS) Once daily
                                   0                   1H (QH) Every hour
                                   0                   1M (Q mo) Once each month
                                   0                   1W (Q week) Once each week
                                   0                   1X Invalid entry, 1X
                                   0                   12 Invalid entry, 12
                                   0                   2D (BID) Two times daily
                                   0                   2H (Q2H) Every 2 hours
                                   0                   2M Twice each month
                                   0                   2W Two times each week
                                   0                   21 Invalid entry, 21
                                   0                   3D (TID) Three times daily
                                   0                   3H (Q3H) Every 3 hours
                                   0                   3P Invalid entry, 3P
                                   0                   3W Three times each week
                                   0                   4D (QID) Four times daily
                                   0                   4H (Q4H) Every 4 hours
                                   0                   4W Four times each week
                                   0                   5D Five times daily
                                   0                   5W Five times each week
                                   0                   6D Invalid entry, 6D
                                   0                   6H (Q6H) Every 6 hours
                                   0                   6W Six times each week
                                   0                   8H (Q8H) Every 8 hours

U09AA    1374  5  $AMOUNT                               C Drug 9; amount administered

                              23,659             LOW-HIGH Amount administered

U09PR    1379  2  PRNN                                  N Drug 9; PRN-number of doses

                              23,659                    . Missing
                                   0                 0-99 Number of doses

U09NDC   1381  9  $NDCDRUG                              C Drug 9; National Drug Code (NDC)

                              23,659             LOW-HIGH National Drug Code

U10RA    1390  2  ROUTE                                 N Drug 10; route of administration

                              23,659                    . Missing
                                   0                    1 By mouth (PO)
                                   0                    2 Sub lingual (SL)
                                   0                    3 Intramuscular (IM)
                                   0                    4 Intravenous (IV)
                                   0                    5 Subcutaneous (SQ)
                                   0                    6 Rectal (R)
                                   0                    7 Topical
                                   0                    8 Inhalation
                                   0                    9 Enteral tube
                                   0                   10 Other

U10FR    1392  2  $FREQU                                C Drug 10; frequency

                              23,659                      Missing
                                   0                   && Invalid entry, &&
                                   0                   -- Invalid entry, --
                                   0                    C Continuous
                                   0                    O Other
                                   0                   PR (PRN) As necessary
                                   0                   QO Every other day
                                   0                   Q0 Invalid entry, Q0
                                   0                   Q4 Invalid entry, Q4
                                   0                   0O Invalid entry, 0O
                                   0                   00 Invalid entry, 00
                                   0                    1 Invalid entry, One
                                   0                   1D (QD or HS) Once daily
                                   0                   1H (QH) Every hour
                                   0                   1M (Q mo) Once each month
                                   0                   1W (Q week) Once each week
                                   0                   1X Invalid entry, 1X
                                   0                   12 Invalid entry, 12
                                   0                   2D (BID) Two times daily
                                   0                   2H (Q2H) Every 2 hours
                                   0                   2M Twice each month
                                   0                   2W Two times each week
                                   0                   21 Invalid entry, 21
                                   0                   3D (TID) Three times daily
                                   0                   3H (Q3H) Every 3 hours
                                   0                   3P Invalid entry, 3P
                                   0                   3W Three times each week
                                   0                   4D (QID) Four times daily
                                   0                   4H (Q4H) Every 4 hours
                                   0                   4W Four times each week
                                   0                   5D Five times daily
                                   0                   5W Five times each week
                                   0                   6D Invalid entry, 6D
                                   0                   6H (Q6H) Every 6 hours
                                   0                   6W Six times each week
                                   0                   8H (Q8H) Every 8 hours

U10AA    1394  5  $AMOUNT                               C Drug 10; amount administered

                              23,659             LOW-HIGH Amount administered

U10PR    1399  2  PRNN                                  N Drug 10; PRN-number of doses

                              23,659                    . Missing
                                   0                 0-99 Number of doses

U10NDC   1401  9  $NDCDRUG                              C Drug 10; National Drug Code (NDC)

                              23,659             LOW-HIGH National Drug Code

U11RA    1410  2  ROUTE                                 N Drug 11; route of administration

                              23,659                    . Missing
                                   0                    1 By mouth (PO)
                                   0                    2 Sub lingual (SL)
                                   0                    3 Intramuscular (IM)
                                   0                    4 Intravenous (IV)
                                   0                    5 Subcutaneous (SQ)
                                   0                    6 Rectal (R)
                                   0                    7 Topical
                                   0                    8 Inhalation
                                   0                    9 Enteral tube
                                   0                   10 Other

U11FR    1412  2  $FREQU                                C Drug 11; frequency

                              23,659                      Missing
                                   0                   && Invalid entry, &&
                                   0                   -- Invalid entry, --
                                   0                    C Continuous
                                   0                    O Other
                                   0                   PR (PRN) As necessary
                                   0                   QO Every other day
                                   0                   Q0 Invalid entry, Q0
                                   0                   Q4 Invalid entry, Q4
                                   0                   0O Invalid entry, 0O
                                   0                   00 Invalid entry, 00
                                   0                    1 Invalid entry, One
                                   0                   1D (QD or HS) Once daily
                                   0                   1H (QH) Every hour
                                   0                   1M (Q mo) Once each month
                                   0                   1W (Q week) Once each week
                                   0                   1X Invalid entry, 1X
                                   0                   12 Invalid entry, 12
                                   0                   2D (BID) Two times daily
                                   0                   2H (Q2H) Every 2 hours
                                   0                   2M Twice each month
                                   0                   2W Two times each week
                                   0                   21 Invalid entry, 21
                                   0                   3D (TID) Three times daily
                                   0                   3H (Q3H) Every 3 hours
                                   0                   3P Invalid entry, 3P
                                   0                   3W Three times each week
                                   0                   4D (QID) Four times daily
                                   0                   4H (Q4H) Every 4 hours
                                   0                   4W Four times each week
                                   0                   5D Five times daily
                                   0                   5W Five times each week
                                   0                   6D Invalid entry, 6D
                                   0                   6H (Q6H) Every 6 hours
                                   0                   6W Six times each week
                                   0                   8H (Q8H) Every 8 hours

U11AA    1414  5  $AMOUNT                               C Drug 11; amount administered

                              23,659             LOW-HIGH Amount administered

U11PR    1419  2  PRNN                                  N Drug 11; PRN-number of doses

                              23,659                    . Missing
                                   0                 0-99 Number of doses

U11NDC   1421  9  $NDCDRUG                              C Drug 11; National Drug Code (NDC)

                              23,659             LOW-HIGH National Drug Code

U12RA    1430  2  ROUTE                                 N Drug 12; route of administration

                              23,659                    . Missing
                                   0                    1 By mouth (PO)
                                   0                    2 Sub lingual (SL)
                                   0                    3 Intramuscular (IM)
                                   0                    4 Intravenous (IV)
                                   0                    5 Subcutaneous (SQ)
                                   0                    6 Rectal (R)
                                   0                    7 Topical
                                   0                    8 Inhalation
                                   0                    9 Enteral tube
                                   0                   10 Other

U12FR    1432  2  $FREQU                                C Drug 12; frequency

                              23,659                      Missing
                                   0                   && Invalid entry, &&
                                   0                   -- Invalid entry, --
                                   0                    C Continuous
                                   0                    O Other
                                   0                   PR (PRN) As necessary
                                   0                   QO Every other day
                                   0                   Q0 Invalid entry, Q0
                                   0                   Q4 Invalid entry, Q4
                                   0                   0O Invalid entry, 0O
                                   0                   00 Invalid entry, 00
                                   0                    1 Invalid entry, One
                                   0                   1D (QD or HS) Once daily
                                   0                   1H (QH) Every hour
                                   0                   1M (Q mo) Once each month
                                   0                   1W (Q week) Once each week
                                   0                   1X Invalid entry, 1X
                                   0                   12 Invalid entry, 12
                                   0                   2D (BID) Two times daily
                                   0                   2H (Q2H) Every 2 hours
                                   0                   2M Twice each month
                                   0                   2W Two times each week
                                   0                   21 Invalid entry, 21
                                   0                   3D (TID) Three times daily
                                   0                   3H (Q3H) Every 3 hours
                                   0                   3P Invalid entry, 3P
                                   0                   3W Three times each week
                                   0                   4D (QID) Four times daily
                                   0                   4H (Q4H) Every 4 hours
                                   0                   4W Four times each week
                                   0                   5D Five times daily
                                   0                   5W Five times each week
                                   0                   6D Invalid entry, 6D
                                   0                   6H (Q6H) Every 6 hours
                                   0                   6W Six times each week
                                   0                   8H (Q8H) Every 8 hours

U12AA    1434  5  $AMOUNT                               C Drug 12; amount administered

                              23,659             LOW-HIGH Amount administered

U12PR    1439  2  PRNN                                  N Drug 12; PRN-number of doses

                              23,659                    . Missing
                                   0                 0-99 Number of doses

U12NDC   1441  9  $NDCDRUG                              C Drug 12; National Drug Code (NDC)

                              23,659             LOW-HIGH National Drug Code

U13RA    1450  2  ROUTE                                 N Drug 13; route of administration

                              23,659                    . Missing
                                   0                    1 By mouth (PO)
                                   0                    2 Sub lingual (SL)
                                   0                    3 Intramuscular (IM)
                                   0                    4 Intravenous (IV)
                                   0                    5 Subcutaneous (SQ)
                                   0                    6 Rectal (R)
                                   0                    7 Topical
                                   0                    8 Inhalation
                                   0                    9 Enteral tube
                                   0                   10 Other

U13FR    1452  2  $FREQU                                C Drug 13; frequency

                              23,659                      Missing
                                   0                   && Invalid entry, &&
                                   0                   -- Invalid entry, --
                                   0                    C Continuous
                                   0                    O Other
                                   0                   PR (PRN) As necessary
                                   0                   QO Every other day
                                   0                   Q0 Invalid entry, Q0
                                   0                   Q4 Invalid entry, Q4
                                   0                   0O Invalid entry, 0O
                                   0                   00 Invalid entry, 00
                                   0                    1 Invalid entry, One
                                   0                   1D (QD or HS) Once daily
                                   0                   1H (QH) Every hour
                                   0                   1M (Q mo) Once each month
                                   0                   1W (Q week) Once each week
                                   0                   1X Invalid entry, 1X
                                   0                   12 Invalid entry, 12
                                   0                   2D (BID) Two times daily
                                   0                   2H (Q2H) Every 2 hours
                                   0                   2M Twice each month
                                   0                   2W Two times each week
                                   0                   21 Invalid entry, 21
                                   0                   3D (TID) Three times daily
                                   0                   3H (Q3H) Every 3 hours
                                   0                   3P Invalid entry, 3P
                                   0                   3W Three times each week
                                   0                   4D (QID) Four times daily
                                   0                   4H (Q4H) Every 4 hours
                                   0                   4W Four times each week
                                   0                   5D Five times daily
                                   0                   5W Five times each week
                                   0                   6D Invalid entry, 6D
                                   0                   6H (Q6H) Every 6 hours
                                   0                   6W Six times each week
                                   0                   8H (Q8H) Every 8 hours

U13AA    1454  5  $AMOUNT                               C Drug 13; amount administered

                              23,659             LOW-HIGH Amount administered

U13PR    1459  2  PRNN                                  N Drug 13; PRN-number of doses

                              23,659                    . Missing
                                   0                 0-99 Number of doses

U13NDC   1461  9  $NDCDRUG                              C Drug 13; National Drug Code (NDC)

                              23,659             LOW-HIGH National Drug Code

U14RA    1470  2  ROUTE                                 N Drug 14; route of administration

                              23,659                    . Missing
                                   0                    1 By mouth (PO)
                                   0                    2 Sub lingual (SL)
                                   0                    3 Intramuscular (IM)
                                   0                    4 Intravenous (IV)
                                   0                    5 Subcutaneous (SQ)
                                   0                    6 Rectal (R)
                                   0                    7 Topical
                                   0                    8 Inhalation
                                   0                    9 Enteral tube
                                   0                   10 Other

U14FR    1472  2  $FREQU                                C Drug 14; frequency

                              23,659                      Missing
                                   0                   && Invalid entry, &&
                                   0                   -- Invalid entry, --
                                   0                    C Continuous
                                   0                    O Other
                                   0                   PR (PRN) As necessary
                                   0                   QO Every other day
                                   0                   Q0 Invalid entry, Q0
                                   0                   Q4 Invalid entry, Q4
                                   0                   0O Invalid entry, 0O
                                   0                   00 Invalid entry, 00
                                   0                    1 Invalid entry, One
                                   0                   1D (QD or HS) Once daily
                                   0                   1H (QH) Every hour
                                   0                   1M (Q mo) Once each month
                                   0                   1W (Q week) Once each week
                                   0                   1X Invalid entry, 1X
                                   0                   12 Invalid entry, 12
                                   0                   2D (BID) Two times daily
                                   0                   2H (Q2H) Every 2 hours
                                   0                   2M Twice each month
                                   0                   2W Two times each week
                                   0                   21 Invalid entry, 21
                                   0                   3D (TID) Three times daily
                                   0                   3H (Q3H) Every 3 hours
                                   0                   3P Invalid entry, 3P
                                   0                   3W Three times each week
                                   0                   4D (QID) Four times daily
                                   0                   4H (Q4H) Every 4 hours
                                   0                   4W Four times each week
                                   0                   5D Five times daily
                                   0                   5W Five times each week
                                   0                   6D Invalid entry, 6D
                                   0                   6H (Q6H) Every 6 hours
                                   0                   6W Six times each week
                                   0                   8H (Q8H) Every 8 hours

U14AA    1474  5  $AMOUNT                               C Drug 14; amount administered

                              23,659             LOW-HIGH Amount administered

U14PR    1479  2  PRNN                                  N Drug 14; PRN-number of doses

                              23,659                    . Missing
                                   0                 0-99 Number of doses

U14NDC   1481  9  $NDCDRUG                              C Drug 14; National Drug Code (NDC)

                              23,659             LOW-HIGH National Drug Code

U15RA    1490  2  ROUTE                                 N Drug 15; route of administration

                              23,659                    . Missing
                                   0                    1 By mouth (PO)
                                   0                    2 Sub lingual (SL)
                                   0                    3 Intramuscular (IM)
                                   0                    4 Intravenous (IV)
                                   0                    5 Subcutaneous (SQ)
                                   0                    6 Rectal (R)
                                   0                    7 Topical
                                   0                    8 Inhalation
                                   0                    9 Enteral tube
                                   0                   10 Other

U15FR    1492  2  $FREQU                                C Drug 15; frequency

                              23,659                      Missing
                                   0                   && Invalid entry, &&
                                   0                   -- Invalid entry, --
                                   0                    C Continuous
                                   0                    O Other
                                   0                   PR (PRN) As necessary
                                   0                   QO Every other day
                                   0                   Q0 Invalid entry, Q0
                                   0                   Q4 Invalid entry, Q4
                                   0                   0O Invalid entry, 0O
                                   0                   00 Invalid entry, 00
                                   0                    1 Invalid entry, One
                                   0                   1D (QD or HS) Once daily
                                   0                   1H (QH) Every hour
                                   0                   1M (Q mo) Once each month
                                   0                   1W (Q week) Once each week
                                   0                   1X Invalid entry, 1X
                                   0                   12 Invalid entry, 12
                                   0                   2D (BID) Two times daily
                                   0                   2H (Q2H) Every 2 hours
                                   0                   2M Twice each month
                                   0                   2W Two times each week
                                   0                   21 Invalid entry, 21
                                   0                   3D (TID) Three times daily
                                   0                   3H (Q3H) Every 3 hours
                                   0                   3P Invalid entry, 3P
                                   0                   3W Three times each week
                                   0                   4D (QID) Four times daily
                                   0                   4H (Q4H) Every 4 hours
                                   0                   4W Four times each week
                                   0                   5D Five times daily
                                   0                   5W Five times each week
                                   0                   6D Invalid entry, 6D
                                   0                   6H (Q6H) Every 6 hours
                                   0                   6W Six times each week
                                   0                   8H (Q8H) Every 8 hours

U15AA    1494  5  $AMOUNT                               C Drug 15; amount administered

                              23,659             LOW-HIGH Amount administered

U15PR    1499  2  PRNN                                  N Drug 15; PRN-number of doses

                              23,659                    . Missing
                                   0                 0-99 Number of doses

U15NDC   1501  9  $NDCDRUG                              C Drug 15; National Drug Code (NDC)

                              23,659             LOW-HIGH National Drug Code

U16RA    1510  2  ROUTE                                 N Drug 16; route of administration

                              23,659                    . Missing
                                   0                    1 By mouth (PO)
                                   0                    2 Sub lingual (SL)
                                   0                    3 Intramuscular (IM)
                                   0                    4 Intravenous (IV)
                                   0                    5 Subcutaneous (SQ)
                                   0                    6 Rectal (R)
                                   0                    7 Topical
                                   0                    8 Inhalation
                                   0                    9 Enteral tube
                                   0                   10 Other

U16FR    1512  2  $FREQU                                C Drug 16; frequency

                              23,659                      Missing
                                   0                   && Invalid entry, &&
                                   0                   -- Invalid entry, --
                                   0                    C Continuous
                                   0                    O Other
                                   0                   PR (PRN) As necessary
                                   0                   QO Every other day
                                   0                   Q0 Invalid entry, Q0
                                   0                   Q4 Invalid entry, Q4
                                   0                   0O Invalid entry, 0O
                                   0                   00 Invalid entry, 00
                                   0                    1 Invalid entry, One
                                   0                   1D (QD or HS) Once daily
                                   0                   1H (QH) Every hour
                                   0                   1M (Q mo) Once each month
                                   0                   1W (Q week) Once each week
                                   0                   1X Invalid entry, 1X
                                   0                   12 Invalid entry, 12
                                   0                   2D (BID) Two times daily
                                   0                   2H (Q2H) Every 2 hours
                                   0                   2M Twice each month
                                   0                   2W Two times each week
                                   0                   21 Invalid entry, 21
                                   0                   3D (TID) Three times daily
                                   0                   3H (Q3H) Every 3 hours
                                   0                   3P Invalid entry, 3P
                                   0                   3W Three times each week
                                   0                   4D (QID) Four times daily
                                   0                   4H (Q4H) Every 4 hours
                                   0                   4W Four times each week
                                   0                   5D Five times daily
                                   0                   5W Five times each week
                                   0                   6D Invalid entry, 6D
                                   0                   6H (Q6H) Every 6 hours
                                   0                   6W Six times each week
                                   0                   8H (Q8H) Every 8 hours

U16AA    1514  5  $AMOUNT                               C Drug 16; amount administered

                              23,659             LOW-HIGH Amount administered

U16PR    1519  2  PRNN                                  N Drug 16; PRN-number of doses

                              23,659                    . Missing
                                   0                 0-99 Number of doses

U16NDC   1521  9  $NDCDRUG                              C Drug 16; National Drug Code (NDC)

                              23,659             LOW-HIGH National Drug Code

U17RA    1530  2  ROUTE                                 N Drug 17; route of administration

                              23,659                    . Missing
                                   0                    1 By mouth (PO)
                                   0                    2 Sub lingual (SL)
                                   0                    3 Intramuscular (IM)
                                   0                    4 Intravenous (IV)
                                   0                    5 Subcutaneous (SQ)
                                   0                    6 Rectal (R)
                                   0                    7 Topical
                                   0                    8 Inhalation
                                   0                    9 Enteral tube
                                   0                   10 Other

U17FR    1532  2  $FREQU                                C Drug 17; frequency

                              23,659                      Missing
                                   0                   && Invalid entry, &&
                                   0                   -- Invalid entry, --
                                   0                    C Continuous
                                   0                    O Other
                                   0                   PR (PRN) As necessary
                                   0                   QO Every other day
                                   0                   Q0 Invalid entry, Q0
                                   0                   Q4 Invalid entry, Q4
                                   0                   0O Invalid entry, 0O
                                   0                   00 Invalid entry, 00
                                   0                    1 Invalid entry, One
                                   0                   1D (QD or HS) Once daily
                                   0                   1H (QH) Every hour
                                   0                   1M (Q mo) Once each month
                                   0                   1W (Q week) Once each week
                                   0                   1X Invalid entry, 1X
                                   0                   12 Invalid entry, 12
                                   0                   2D (BID) Two times daily
                                   0                   2H (Q2H) Every 2 hours
                                   0                   2M Twice each month
                                   0                   2W Two times each week
                                   0                   21 Invalid entry, 21
                                   0                   3D (TID) Three times daily
                                   0                   3H (Q3H) Every 3 hours
                                   0                   3P Invalid entry, 3P
                                   0                   3W Three times each week
                                   0                   4D (QID) Four times daily
                                   0                   4H (Q4H) Every 4 hours
                                   0                   4W Four times each week
                                   0                   5D Five times daily
                                   0                   5W Five times each week
                                   0                   6D Invalid entry, 6D
                                   0                   6H (Q6H) Every 6 hours
                                   0                   6W Six times each week
                                   0                   8H (Q8H) Every 8 hours

U17AA    1534  5  $AMOUNT                               C Drug 17; amount administered

                              23,659             LOW-HIGH Amount administered

U17PR    1539  2  PRNN                                  N Drug 17; PRN-number of doses

                              23,659                    . Missing
                                   0                 0-99 Number of doses

U17NDC   1541  9  $NDCDRUG                              C Drug 17; National Drug Code (NDC)

                              23,659             LOW-HIGH National Drug Code

U18RA    1550  2  ROUTE                                 N Drug 18; route of administration

                              23,659                    . Missing
                                   0                    1 By mouth (PO)
                                   0                    2 Sub lingual (SL)
                                   0                    3 Intramuscular (IM)
                                   0                    4 Intravenous (IV)
                                   0                    5 Subcutaneous (SQ)
                                   0                    6 Rectal (R)
                                   0                    7 Topical
                                   0                    8 Inhalation
                                   0                    9 Enteral tube
                                   0                   10 Other

U18FR    1552  2  $FREQU                                C Drug 18; frequency

                              23,659                      Missing
                                   0                   && Invalid entry, &&
                                   0                   -- Invalid entry, --
                                   0                    C Continuous
                                   0                    O Other
                                   0                   PR (PRN) As necessary
                                   0                   QO Every other day
                                   0                   Q0 Invalid entry, Q0
                                   0                   Q4 Invalid entry, Q4
                                   0                   0O Invalid entry, 0O
                                   0                   00 Invalid entry, 00
                                   0                    1 Invalid entry, One
                                   0                   1D (QD or HS) Once daily
                                   0                   1H (QH) Every hour
                                   0                   1M (Q mo) Once each month
                                   0                   1W (Q week) Once each week
                                   0                   1X Invalid entry, 1X
                                   0                   12 Invalid entry, 12
                                   0                   2D (BID) Two times daily
                                   0                   2H (Q2H) Every 2 hours
                                   0                   2M Twice each month
                                   0                   2W Two times each week
                                   0                   21 Invalid entry, 21
                                   0                   3D (TID) Three times daily
                                   0                   3H (Q3H) Every 3 hours
                                   0                   3P Invalid entry, 3P
                                   0                   3W Three times each week
                                   0                   4D (QID) Four times daily
                                   0                   4H (Q4H) Every 4 hours
                                   0                   4W Four times each week
                                   0                   5D Five times daily
                                   0                   5W Five times each week
                                   0                   6D Invalid entry, 6D
                                   0                   6H (Q6H) Every 6 hours
                                   0                   6W Six times each week
                                   0                   8H (Q8H) Every 8 hours

U18AA    1554  5  $AMOUNT                               C Drug 18; amount administered

                              23,659             LOW-HIGH Amount administered

U18PR    1559  2  PRNN                                  N Drug 18; PRN-number of doses

                              23,659                    . Missing
                                   0                 0-99 Number of doses

U18NDC   1561  9  $NDCDRUG                              C Drug 18; National Drug Code (NDC)

                              23,659             LOW-HIGH National Drug Code

VA01A    1570  2  INDIC                                 N Delirium, triggered

                              18,608                    . Missing
                               4,170                    0 Not indicated
                                 881                    1 Indicated

VA01B    1572  2  INDIC                                 N Delirium, care planning

                              19,172                    . Missing
                               4,092                    0 Not indicated
                                 395                    1 Indicated

VA02A    1574  2  INDIC                                 N Cognitive loss, triggered

                              18,599                    . Missing
                               1,101                    0 Not indicated
                               3,959                    1 Indicated

VA02B    1576  2  INDIC                                 N Cognitive loss, care planning

                              18,737                    . Missing
                               1,725                    0 Not indicated
                               3,197                    1 Indicated

VA03A    1578  2  INDIC                                 N Visual function, triggered

                              18,608                    . Missing
                               3,068                    0 Not indicated
                               1,983                    1 Indicated

VA03B    1580  2  INDIC                                 N Visual function, care planning

                              18,998                    . Missing
                               3,279                    0 Not indicated
                               1,382                    1 Indicated

VA04A    1582  2  INDIC                                 N Communication, triggered

                              18,598                    . Missing
                               2,234                    0 Not indicated
                               2,827                    1 Indicated

VA04B    1584  2  INDIC                                 N Communication, care planning

                              18,946                    . Missing
                               2,519                    0 Not indicated
                               2,194                    1 Indicated

VA05A    1586  2  INDIC                                 N ADL funct/Rehab potential, triggered

                              18,598                    . Missing
                                  50                    0 Not indicated
                               5,011                    1 Indicated

VA05B    1588  2  INDIC                                 N ADL funct/Rehab potential, care planning

                              18,641                    . Missing
                                 659                    0 Not indicated
                               4,359                    1 Indicated

VA06A    1590  2  INDIC                                 N Urinary incontinence, triggered

                              18,598                    . Missing
                               1,560                    0 Not indicated
                               3,501                    1 Indicated

VA06B    1592  2  INDIC                                 N Urinary incontinence, care planning

                              18,785                    . Missing
                               1,893                    0 Not indicated
                               2,981                    1 Indicated

VA07A    1594  2  INDIC                                 N Psychosocial well-being, triggered

                              18,602                    . Missing
                               3,289                    0 Not indicated
                               1,768                    1 Indicated

VA07B    1596  2  INDIC                                 N Psychosocial well-being, care planning

                              19,035                    . Missing
                               3,311                    0 Not indicated
                               1,313                    1 Indicated

VA08A    1598  2  INDIC                                 N Mood state, triggered

                              18,599                    . Missing
                               2,807                    0 Not indicated
                               2,253                    1 Indicated

VA08B    1600  2  INDIC                                 N Mood state, care planning

                              19,006                    . Missing
                               2,801                    0 Not indicated
                               1,852                    1 Indicated

VA09A    1602  2  INDIC                                 N Behavioral symptoms, triggered

                              18,601                    . Missing
                               3,769                    0 Not indicated
                               1,289                    1 Indicated

VA09B    1604  2  INDIC                                 N Behavioral symptoms, care planning

                              19,075                    . Missing
                               3,516                    0 Not indicated
                               1,068                    1 Indicated

VA10A    1606  2  INDIC                                 N Activities, triggered

                              18,599                    . Missing
                               4,334                    0 Not indicated
                                 726                    1 Indicated

VA10B    1608  2  INDIC                                 N Activities, care planning

                              19,147                    . Missing
                               3,869                    0 Not indicated
                                 643                    1 Indicated

VA11A    1610  2  INDIC                                 N Falls, triggered

                              18,598                    . Missing
                               1,367                    0 Not indicated
                               3,694                    1 Indicated

VA11B    1612  2  INDIC                                 N Falls, care planning

                              18,811                    . Missing
                               1,595                    0 Not indicated
                               3,253                    1 Indicated

VA12A    1614  2  INDIC                                 N Nutritional status, triggered

                              18,604                    . Missing
                                 902                    0 Not indicated
                               4,153                    1 Indicated

VA12B    1616  2  INDIC                                 N Nutritional status, care planning

                              18,759                    . Missing
                               1,447                    0 Not indicated
                               3,453                    1 Indicated

VA13A    1618  2  INDIC                                 N Feeding tubes, triggered

                              18,598                    . Missing
                               4,833                    0 Not indicated
                                 228                    1 Indicated

VA13B    1620  2  INDIC                                 N Feeding tubes, care planning

                              19,218                    . Missing
                               4,242                    0 Not indicated
                                 199                    1 Indicated

VA14A    1622  2  INDIC                                 N Dehydration/Fluid mainten, triggered

                              18,599                    . Missing
                               2,427                    0 Not indicated
                               2,633                    1 Indicated

VA14B    1624  2  INDIC                                 N Dehydration/Fluid mainten, care planning

                              18,967                    . Missing
                               2,642                    0 Not indicated
                               2,050                    1 Indicated

VA15A    1626  2  INDIC                                 N Dental care, triggered

                              18,600                    . Missing
                               3,647                    0 Not indicated
                               1,412                    1 Indicated

VA15B    1628  2  INDIC                                 N Dental care, care planning

                              19,032                    . Missing
                               3,747                    0 Not indicated
                                 880                    1 Indicated

VA16A    1630  2  INDIC                                 N Pressure ulcers, triggered

                              18,600                    . Missing
                               1,008                    0 Not indicated
                               4,051                    1 Indicated

VA16B    1632  2  INDIC                                 N Pressure ulcers, care planning

                              18,745                    . Missing
                               1,474                    0 Not indicated
                               3,440                    1 Indicated

VA17A    1634  2  INDIC                                 N Psychotropic drug use, triggered

                              18,599                    . Missing
                               2,132                    0 Not indicated
                               2,928                    1 Indicated

VA17B    1636  2  INDIC                                 N Psychotropic drug use, care planning

                              18,906                    . Missing
                               2,348                    0 Not indicated
                               2,405                    1 Indicated

VA18A    1638  2  INDIC                                 N Physical restraints, triggered

                              18,598                    . Missing
                               4,813                    0 Not indicated
                                 248                    1 Indicated

VA18B    1640  2  INDIC                                 N Physical restraints, care planning

                              19,217                    . Missing
                               4,224                    0 Not indicated
                                 218                    1 Indicated

VB2      1642 10                                        N Signature date, RAP assessment

VB4      1652 10                                        N Signature date, care planning

DEATH_DA 1662 10                                        N FU-DEATH-DA

