RIC         1  2                                        C Record Identification Code

VERSION     3  1                                        C Version Number

BASEID      4  8  $BSIDFMT                              C Unique SP Identification Number

                                 959             LOW-HIGH BASEID Count

FACILID    12  6  $FIDFMT                               C Provider Identification Number

                                 959             LOW-HIGH PROV Count

                  Note: Randomly-assigned number

FACOWNED   18  2  OWNDES                      FA31      N Description of ownership of facility

                                   3                    . Inapplicable
                                   2                   -8 Don't know
                                 633                    1 For profit (indiv,partership,corp)
                                 254                    2 Private non-profit (religious,NP corp)
                                  39                    3 City/county government
                                  20                    4 State government
                                   6                    5 Veterans Administration
                                   0                    6 Other federal agency
                                   2                   91 Other specify

PLACTYPE   20  2  PLACFMT                     FA1, FA5  N Facility description

                                  65                    3 Continuing Care Retirement Community
                                 590                    4 Nursing home
                                  12                    5 Retirement community
                                  18                    6 Hospital
                                 121                    8 Assisted living
                                  17                    9 Board & care home
                                   3                   10 Domiciliary care facility
                                  17                   11 Personal care facility
                                   7                   12 Rest home/retirement home
                                   0                   14 Independent living units
                                  10                   15 Mental health center psychiatric setting
                                  20                   16 Mentally ret/developmentally disabled
                                  10                   17 Rehabilitation facility
                                  27                   18 Adult/group home
                                  42                   91 Other

                  Note: First available in 2000

FACLONGT   22  2  YES2FMT                     FA8       N Does facility provide long term care?

                                 959                    1 Yes
                                   0                    2 No

FACLTBED   24  4  BEDSFMT                               N Number of long term beds only

                                   1                   -8 Don't know
                                   0                    0 No beds of this type
                                 958                      Number of beds

FACTOBED   28  4  BEDSFMT                     FA19      N Total number of beds in facility

                                   1                   -8 Don't know
                                   0                    0 No beds of this type
                                 958                      Number of beds

MANDMBED   32  4  BEDSFMT                     FA43      N # of beds certified for Mcare & Mcaid

                                  46                    . Inapplicable
                                   9                   -8 Don't know
                                 357                    0 No beds of this type
                                 547                      Number of beds

                  Note: First available in 1997

MCAREBED   36  4  BEDSFMT                     FA45      N Number of Medicare-only certified beds

                                  46                    . Inapplicable
                                   9                   -8 Don't know
                                   1                   -7 Refused
                                 826                    0 No beds of this type
                                  77                      Number of beds

                  Note: First available in 1997

MCAIDBED   40  4  BEDSFMT                     FA44      N Number of Medicaid-only certified beds

                                  46                    . Inapplicable
                                  10                   -8 Don't know
                                 837                    0 No beds of this type
                                  66                      Number of beds

                  Note: First available in 1997

ICFMRBED   44  4  BEDSFMT                     FA45b     N Number of ICF/MR certified beds

                                  46                    . Inapplicable
                                   6                   -8 Don't know
                                   1                   -7 Refused
                                 884                    0 No beds of this type
                                  22                      Number of beds

                  Note: First available in 1997

CERTBEDS   48  4  BEDSFMT                     FA46      N Total Number of uncertified beds

                                  46                    . Inapplicable
                                  10                   -8 Don't know
                                   1                   -7 Refused
                                 682                    0 No beds of this type
                                 220                      Number of beds

                  Note: Derived -- sum of MNORBED, OLTCBED, and NLTCBEDS

MNORMBED   52  4  BEDSFMT                     FA45a     N Beds not certified, but licensed for NH

                                  46                    . Inapplicable
                                   2                   -8 Don't know
                                 889                    0 No beds of this type
                                  22                      Number of beds

                  Note: First available in 1997

OTLTCBED   56  4  BEDSFMT                     FA45c     N Number of other long term care beds

                                  46                    . Inapplicable
                                  10                   -8 Don't know
                                   1                   -7 Refused
                                 698                    0 No beds of this type
                                 204                      Number of beds

                  Note: First available in 1997

NLTCBEDS   60  4  BEDSFMT                     FA46      N # of beds where certification is unknown

                                 817                    0 No beds of this type
                                 142                      Number of beds

                  Note: First available in 1997

ROOMCARE   64  2  YES2FMT                     FA22c     N Facility provide nursing/medical care?

                                  46                    . Missing
                                 842                    1 Yes
                                  71                    2 No

SUPRVMED   66  2  YES2FMT                     FA22c     N Facil supervises self-administered meds?

                                  46                    . Missing
                                 912                    1 Yes
                                   1                    2 No

FHLPBATH   68  2  YES2FMT                     FA22c     N Does facility provide help w/bathing?

                                  46                    . Missing
                                 904                    1 Yes
                                   9                    2 No

FHLPDRES   70  2  YES2FMT                     FA22c     N Does facility provide help w/dressing?

                                  46                    . Missing
                                 900                    1 Yes
                                  13                    2 No

FHLPSHOP   72  2  YES2FMT                     FA22c     N Does facility provide help w/shopping?

                                  46                    . Missing
                                 901                    1 Yes
                                  12                    2 No

FHLPWALK   74  2  YES2FMT                     FA22c     N Does facility provide help w/walking?

                                  46                    . Missing
                                 891                    1 Yes
                                  22                    2 No

FHLPEAT    76  2  YES2FMT                     FA22c     N Does facility provide help w/eating?

                                  46                    . Missing
                                 881                    1 Yes
                                  32                    2 No

FHLPCOMM   78  2  YES2FMT                     FA22c     N Does facil provide help w/communication?

                                  46                    . Missing
                                 897                    1 Yes
                                  16                    2 No

FHLPNURS   80  2  YES2FMT                     FA22a     N Does facil provide 24-hour nursing care?

                                 905                    1 Yes
                                  54                    2 No

MCARERES   82  4  RESFMT                      FA48      N # of residents w/ Mcare as primary payor

                                  54                    . Inapplicable
                                   2                   -9 Not ascertained
                                  34                   -8 Don't know
                                   1                   -7 Refused
                                 340                    0 None
                                 528                      Number of residents

                  Note: First available in 2000

MCAIDRES   86  4  RESFMT                      FA47      N # of residents w/ Medicaid payment

                                  59                    . Inapplicable
                                   4                   -9 Not ascertained
                                  37                   -8 Don't know
                                   1                   -7 Refused
                                 323                    0 None
                                 535                      Number of residents

                  Note: First available in 2000

PRPAYRES   90  4  RESFMT                      FA49      N # of residents who have private pay only

                                  45                   -8 Don't know
                                   1                   -7 Refused
                                  90                    0 None
                                 823                      Number of residents

                  Note: First available in 2000

MIDNTRES   94  4  RESFMT                      FA52      N Midnight census count last night

                                   1                   -9 Not ascertained
                                  19                   -8 Don't know
                                   2                   -7 Refused
                                   1                    0 None
                                 936                      Number of residents

                  Note: First available in 2000

SPIDCNT    98  2  SPFMT                                 N Number of SPs in facility

                                 766                    1 One sample person
                                 120                    2 Two sample people
                                  42                    3 Three sample people
                                  24                    4 Four sample people
                                   0                    5 Five sample people
                                   0                    6 Six sample people
                                   7                    7 Seven sample people
                                   0                    8 Eight sample people
                                   0                    9 Nine sample people
                                   0                   10 Ten sample people

                  Note: Determined from administrative records.

