Variable Format    Q#/Freq            Description/Label
 
BASEID   $BSIDFMT                      Unique SP Identification Number          
                          5,113        LOW-HIGH          BASEID Count                            
 
SURVEYYR SVYRFMT                       Survey Year                              
                          5,113                    2020  2020                                    
 
VERSION  VERSFMT                       Version Number                           
                          5,113                       1  Version 1                               
 
TRGT_DT  MMDDYYn8                      Target Date                              
                          5,113        MMDDYYYY          Date as MMDDYYYY                        
         Notes:  MDS linkage variable added in 2019
                 First available in 2019
 
SUB_DT   MMDDYYn8                      Submission Date                          
                          5,113        MMDDYYYY          Date as MMDDYYYY                        
 
SPEC_VCD                               Data Submission Spec Vers                
                          5,113        Range of values   Range of values                         
 
ITM_SVC                                Item Set Vers                            
                          5,113        Range of values   Range of values                         
 
PRCSD_TS MMDDYYn8                      Processed Timestamp                      
                          5,113        MMDDYYYY          Date as MMDDYYYY                        
 
Age                                    Res Age                                  
                          5,113        Range of values   Range of values                         
 
RSDT_MCI                               Res Match Criteria ID                    
                          5,113        Range of values   Range of values                         
 
CURCD                                  CBSA Urban/Rural                         
                          5,113        Range of values   Range of values                         
 
A0050    $M3RCTYP                      Type of Record                           
                          4,870        1                 Add a new record                        
                            243        2                 Modify existing record                  
 
A0200    $M3PROV                       Type of Provider                         
                          5,113        1                 Nursing home (SNF/NF)                   
 
A0310A   $M3OBRA                       Federal OBRA Rsn for Asmt                
                              4                          Missing                                 
                            480        01                Admission                               
                          1,715        02                Quarterly                               
                            400        03                Annual                                  
                            177        04                Significant change in status            
                          2,337        99                Not OBRA required                       
 
A0310B   $MCASS                        PPS Asmt                                 
                              4                          Missing                                 
                            630        01                Sched. 5-day assessment                 
                             29        08                Not PPS assessment                      
                          4,450        99                None of the above                       
 
A0310E   $M3YESNO                      First Asmt Since Most Rec Admsn          
                              4                          Missing                                 
                          4,326        0                 No                                      
                            783        1                 Yes                                     
 
A0310F   $M3REPO                       Entry/Dis                                
                              4                          Missing                                 
                            842        01                Entry                                   
                            460        10                Discharge, return not anticipated       
                            351        11                Discharge, return anticipated           
                            144        12                Death in facility                       
                          3,312        99                None of the above                       
 
A0310G   $M3DIS                        Planned Dis                              
                          4,302                          Missing                                 
                            430        1                 Planned                                 
                            381        2                 Unplanned                               
 
A0410    $M3SUBRQ                      Submission Req                           
                              2        2                 State but not federal required          
                          5,111        3                 Federal required                        
 
A0800    $M3GEND                       Sex                                   
                          1,725        1                 Male                                    
                          3,388        2                 Female                                  
 
A0900    MMDDYYn8                      Birth Date                               
                          5,113        MMDDYYYY          Date as MMDDYYYY                        
 
A1000A   $M3INDIC                      R/E: American Indian or Alaskan Native   
                              4        -                 Not assessed/no information             
                          5,091        0                 Not indicated                           
                             18        1                 Indicated                               
 
A1000B   $M3INDIC                      R/E: Asian                               
                              4        -                 Not assessed/no information             
                          4,994        0                 Not indicated                           
                            115        1                 Indicated                               
 
A1000C   $M3INDIC                      R/E: African American                    
                              4        -                 Not assessed/no information             
                          4,561        0                 Not indicated                           
                            548        1                 Indicated                               
 
A1000D   $M3INDIC                      R/E: Hispanic                            
                              4        -                 Not assessed/no information             
                          4,724        0                 Not indicated                           
                            385        1                 Indicated                               
 
A1000E   $M3INDIC                      R/E: Native Hawaiian/Pacific Islander    
                              4        -                 Not assessed/no information             
                          5,094        0                 Not indicated                           
                             15        1                 Indicated                               
 
A1000F   $M3INDIC                      R/E: White                               
                              4        -                 Not assessed/no information             
                          1,213        0                 Not indicated                           
                          3,896        1                 Indicated                               
 
A1100A   $M3YNDET                      Res Need Interpreter                     
                            986                          Missing                                 
                              4        -                 Not assessed/no information             
                          3,911        0                 No                                      
                            197        1                 Yes                                     
                             15        9                 Unable to determine                     
 
A1200    $M3MARTL                      Marital Stat                             
                            148        -                 Not assessed/no information             
                            950        1                 Never married                           
                          1,112        2                 Married                                 
                          2,257        3                 Widowed                                 
                             43        4                 Separated                               
                            603        5                 Divorced                                
 
A1300A                                 Medical Record Num                       
                            106                          Missing                                 
                          5,007        Range of values   Range of values                         
 
A1300D                                 Lifetime Occupation(s) Text              
                          2,430                          Missing                                 
                          2,683        Range of values   Range of values                         
 
A1500    $M3SMI                        (PASRR)                                  
                          4,056                          Missing                                 
                              1        -                 Not assessed/no information             
                            985        0                 No                                      
                             49        1                 Yes                                     
                             22        9                 Not a Medicaid-certified unit           
 
A1510A   $M3INDIC                      Serious Mntl Illness                     
                          5,063                          Missing                                 
                              1        -                 Not assessed/no information             
                             15        0                 Not indicated                           
                             34        1                 Indicated                               
 
A1510B   $M3INDIC                      Intellectual Disability                  
                          5,063                          Missing                                 
                              1        -                 Not assessed/no information             
                             39        0                 Not indicated                           
                             10        1                 Indicated                               
 
A1510C   $M3INDIC                      Oth Related Conds                        
                          5,063                          Missing                                 
                              1        -                 Not assessed/no information             
                             45        0                 Not indicated                           
                              4        1                 Indicated                               
 
A1550A   $M3INDIC                      ID/DD Stat: Down Syndrome                
                          4,633                          Missing                                 
                            480        0                 Not indicated                           
 
A1550B   $M3INDIC                      ID/DD Stat: Autism                       
                          4,633                          Missing                                 
                            480        0                 Not indicated                           
 
A1550C   $M3INDIC                      ID/DD Stat: Epilepsy                     
                          4,633                          Missing                                 
                            476        0                 Not indicated                           
                              4        1                 Indicated                               
 
A1550D   $M3INDIC                      ID/DD Stat: Oth Org ID/DD Cond           
                          4,633                          Missing                                 
                            480        0                 Not indicated                           
 
A1550E   $M3INDIC                      ID/DD Stat: ID/DD W No Org Cond          
                          4,633                          Missing                                 
                            477        0                 Not indicated                           
                              3        1                 Indicated                               
 
A1550Z   $M3INDIC                      ID/DD Stat: None of the Above            
                          4,633                          Missing                                 
                              7        0                 Not indicated                           
                            473        1                 Indicated                               
 
A1600    MMDDYYn8                      Entry Date                               
                             29                       .  Inapplicable                            
                          5,084        MMDDYYYY          Date as MMDDYYYY                        
 
A1700    $M3TYP                        Type of Entry                            
                             33                          Missing                                 
                          3,141        1                 Admission                               
                          1,939        2                 Reentry                                 
 
A1800    $M3ADFRM                      Entered From                             
                             33                          Missing                                 
                            437        01                Community                               
                            295        02                Another nursing home or swing bed       
                          4,232        03                Acute hospital                          
                             42        04                Psychiatric hospital                    
                             27        05                Inpatient rehabilitation facility       
                             19        07                Hospice                                 
                              1        09                Long Term Care Hospital (LTCH)          
                             27        99                Other                                   
 
A2000    MMDDYYn8                      Dis Date                                 
                          4,158                       .  Inapplicable                            
                            955        MMDDYYYY          Date as MMDDYYYY                        
 
A2100    $M3ADFRM                      Dis Stat                                 
                          4,158                          Missing                                 
                            411        01                Community                               
                             33        02                Another nursing home or swing bed       
                            352        03                Acute hospital                          
                              2        04                Psychiatric hospital                    
                              1        06                ID/DD facility                          
                              6        07                Hospice                                 
                            144        08                Deceased                                
                              6        99                Other                                   
 
A2300    MMDDYYn8                      Asmt Ref Date                            
                            986                       .  Inapplicable                            
                          4,127        MMDDYYYY          Date as MMDDYYYY                        
         Notes:  MDS linkage variable added in 2019
                 First available in 2019
 
A2400A   $M3YESNO                      Had a Mcare Stay Since Most Rec Admsn    
                              4                          Missing                                 
                          2,559        0                 No                                      
                          2,550        1                 Yes                                     
 
A2400B   MMDDYYn8                      Start Date of Most Rec Mcare Stay        
                          2,561                       .  Inapplicable                            
                          2,552        MMDDYYYY          Date as MMDDYYYY                        
 
A2400C   MMDDYYn8                      End Date of Most Rec Mcare Stay          
                          3,731                       .  Inapplicable                            
                          1,382        MMDDYYYY          Date as MMDDYYYY                        
 
B0100    $M3YESNO                      Comatose                                 
                          1,236                          Missing                                 
                              3        -                 Not assessed/no information             
                          3,852        0                 No                                      
                             22        1                 Yes                                     
 
B0200    $M3HEAR                       Hearing                                  
                          2,055                          Missing                                 
                             26        -                 Not assessed/no information             
                          2,111        0                 Adequate                                
                            630        1                 Minimal difficulty                      
                            255        2                 Moderate difficulty                     
                             36        3                 Highly impaired                         
 
B0300    $M3YESNO                      Hearing Aide                             
                          2,055                          Missing                                 
                              4        -                 Not assessed/no information             
                          2,786        0                 No                                      
                            268        1                 Yes                                     
 
B0600    $M3CLEAR                      Speech Clarity                           
                          2,055                          Missing                                 
                              6        -                 Not assessed/no information             
                          2,593        0                 Clear speech                            
                            363        1                 Unclear speech                          
                             96        2                 No speech                               
 
B0700    $M3UNDER                      Makes Self Understood                    
                          2,022                          Missing                                 
                              6        -                 Not assessed/no information             
                          1,847        0                 Understood                              
                            614        1                 Usually understood                      
                            364        2                 Sometimes understood                    
                            260        3                 Rarely/Never understood                 
 
B0800    $M3UNDRR                      Ability to Understand Oth                
                          2,055                          Missing                                 
                              6        -                 Not assessed/no information             
                          1,685        0                 Understands                             
                            747        1                 Usually understands                     
                            398        2                 Sometimes understands                   
                            222        3                 Rarely/Never understands                
 
B1000    $M3ADQT                       Vision                                   
                          2,055                          Missing                                 
                             45        -                 Not assessed/no information             
                          2,174        0                 Adequate                                
                            473        1                 Impaired                                
                            159        2                 Moderately impaired                     
                            152        3                 Highly impaired                         
                             55        4                 Severely impaired                       
 
B1200    $M3YESNO                      Corr Lenses                              
                          2,055                          Missing                                 
                              9        -                 Not assessed/no information             
                          1,484        0                 No                                      
                          1,565        1                 Yes                                     
 
C0100    $M3YESNO                      Brief Int for Mntl Stat Be Cond          
                          1,598                          Missing                                 
                             64        -                 Not assessed/no information             
                            358        0                 No                                      
                          3,093        1                 Yes                                     
 
C0200    $M3REP3W                      BIMS: Num of Words Rep After First Att   
                          1,956                          Missing                                 
                            104        -                 Not assessed/no information             
                            262        0                 None                                    
                             72        1                 One                                     
                            196        2                 Two                                     
                          2,523        3                 Three                                   
 
C0300A   $M31ORNT                      BIMS: Temp Ortn - Able to Rep Corr Yr    
                          1,956                          Missing                                 
                            107        -                 Not assessed/no information             
                          1,220        0                 Missed by >5 years or no answer         
                             92        1                 Missed by 2-5 years                     
                            108        2                 Missed by 1 year                        
                          1,630        3                 Correct                                 
 
C0300B   $M31ORNT                      BIMS: Temp Ortn - Able to Rep Corr Mon   
                          1,956                          Missing                                 
                            108        -                 Not assessed/no information             
                          1,168        0                 Missed by >5 years or no answer         
                            187        1                 Missed by 2-5 years                     
                          1,694        2                 Missed by 1 year                        
 
C0300C   $M31ORNT                      BIMS: Temp Ortn - Able to Rep Corr Day   
                          1,956                          Missing                                 
                            115        -                 Not assessed/no information             
                          1,622        0                 Missed by >5 years or no answer         
                          1,420        1                 Missed by 2-5 years                     
 
C0400A   $M3CUE                        BIMS: Rcl - Able to Rcl Sock             
                          1,956                          Missing                                 
                            155        -                 Not assessed/no information             
                          1,037        0                 No - could not recall                   
                            482        1                 Yes, after cueing                       
                          1,483        2                 Yes, no cue required                    
 
C0400B   $M3CUE                        BIMS: Rcl - Able to Rcl Blue             
                          1,956                          Missing                                 
                            155        -                 Not assessed/no information             
                            868        0                 No - could not recall                   
                            587        1                 Yes, after cueing                       
                          1,547        2                 Yes, no cue required                    
 
C0400C   $M3CUE                        BIMS: Rcl - Able to Rcl Bed              
                          1,956                          Missing                                 
                            154        -                 Not assessed/no information             
                          1,128        0                 No - could not recall                   
                            582        1                 Yes, after cueing                       
                          1,293        2                 Yes, no cue required                    
 
C0500                                  Brief Int for Mntl Stat (BIMS) Score Num 
                          1,956                          Missing                                 
                          3,157        Range of values   Range of values                         
 
C0600    $M3YESNO                      Staff to Cond Brief Int for Mntl Stat    
                          1,956                          Missing                                 
                             34        -                 Not assessed/no information             
                          2,876        0                 No                                      
                            247        1                 Yes                                     
 
C0700    $M3MEMRY                      SA of Mntl Stat - Short Term Memory      
                          4,134                          Missing                                 
                            117        -                 Not assessed/no information             
                            131        0                 Memory OK                               
                            731        1                 Memory problem                          
 
C0800    $M3MEMRY                      SA of Mntl Stat - Long Term Memory       
                          4,511                          Missing                                 
                             46        -                 Not assessed/no information             
                             34        0                 Memory OK                               
                            522        1                 Memory problem                          
 
C0900A   $M3INDIC                      SA of Mntl Stat - Rcls Cur Season        
                          4,511                          Missing                                 
                             25        -                 Not assessed/no information             
                            545        0                 Not indicated                           
                             32        1                 Indicated                               
 
C0900B   $M3INDIC                      SA of Mntl Stat - Rcls Loc of Room       
                          4,511                          Missing                                 
                             25        -                 Not assessed/no information             
                            468        0                 Not indicated                           
                            109        1                 Indicated                               
 
C0900C   $M3INDIC                      SA of Mntl Stat - Rcls Staff Name        
                          4,511                          Missing                                 
                             25        -                 Not assessed/no information             
                            461        0                 Not indicated                           
                            116        1                 Indicated                               
 
C0900D   $M3INDIC                      SA of Mntl Stat - Rcls Nrs Home          
                          4,511                          Missing                                 
                             25        -                 Not assessed/no information             
                            495        0                 Not indicated                           
                             82        1                 Indicated                               
 
C0900Z   $M3INDIC                      SA of Mntl Stat - Rcls None of Above     
                          4,511                          Missing                                 
                             25        -                 Not assessed/no information             
                            178        0                 Not indicated                           
                            399        1                 Indicated                               
 
C1000    $M3DECIS                      Cog Skills for Decision Making           
                          4,134                          Missing                                 
                             97        -                 Not assessed/no information             
                             68        0                 Independent                             
                            102        1                 Modified independence                   
                            245        2                 Moderately impaired                     
                            467        3                 Severely impaired                       
 
D0100    $M3YESNO                      Res Mood Int Be Cond                     
                          1,598                          Missing                                 
                             82        -                 Not assessed/no information             
                            395        0                 No                                      
                          3,038        1                 Yes                                     
 
D0200A1  $M3YNNOR                      Res Mood Int - Interest Loss             
                          1,993                          Missing                                 
                            106        -                 Not assessed/no information             
                          2,502        0                 No                                      
                            331        1                 Yes                                     
                            181        9                 No Response                             
 
D0200A2  $M3DEPRB                      Res Mood Int - Interest Loss Freq        
                          2,174                          Missing                                 
                            106        -                 Not assessed/no information             
                          2,511        0                 Never or 1 day                          
                            125        1                 2 - 6 days                              
                             90        2                 7 - 11 days                             
                            107        3                 12-14 days                              
 
D0200B1  $M3YNNOR                      Res Mood Int - Feel Down                 
                          1,993                          Missing                                 
                            107        -                 Not assessed/no information             
                          2,036        0                 No                                      
                            803        1                 Yes                                     
                            174        9                 No Response                             
 
D0200B2  $M3DEPRB                      Res Mood Int - Feel Down Freq            
                          2,167                          Missing                                 
                            107        -                 Not assessed/no information             
                          2,057        0                 Never or 1 day                          
                            416        1                 2 - 6 days                              
                            184        2                 7 - 11 days                             
                            182        3                 12-14 days                              
 
D0200C1  $M3YNNOR                      Res Mood Int - Trouble Sleep             
                          1,993                          Missing                                 
                            106        -                 Not assessed/no information             
                          2,187        0                 No                                      
                            649        1                 Yes                                     
                            178        9                 No Response                             
 
D0200C2  $M3DEPRB                      Res Mood Int - Trouble Sleep Freq        
                          2,171                          Missing                                 
                            106        -                 Not assessed/no information             
                          2,201        0                 Never or 1 day                          
                            295        1                 2 - 6 days                              
                            168        2                 7 - 11 days                             
                            172        3                 12-14 days                              
 
D0200D1  $M3YNNOR                      Res Mood Int - Little Energy             
                          1,993                          Missing                                 
                            114        -                 Not assessed/no information             
                          1,842        0                 No                                      
                            992        1                 Yes                                     
                            172        9                 No Response                             
 
D0200D2  $M3DEPRB                      Res Mood Int - Little Energy Freq        
                          2,165                          Missing                                 
                            114        -                 Not assessed/no information             
                          1,852        0                 Never or 1 day                          
                            447        1                 2 - 6 days                              
                            286        2                 7 - 11 days                             
                            249        3                 12-14 days                              
 
D0200E1  $M3YNNOR                      Res Mood Int - Poor Appetite             
                          1,993                          Missing                                 
                            126        -                 Not assessed/no information             
                          2,387        0                 No                                      
                            443        1                 Yes                                     
                            164        9                 No Response                             
 
D0200E2  $M3DEPRB                      Res Mood Int - Poor Appetite Freq        
                          2,157                          Missing                                 
                            126        -                 Not assessed/no information             
                          2,390        0                 Never or 1 day                          
                            232        1                 2 - 6 days                              
                            118        2                 7 - 11 days                             
                             90        3                 12-14 days                              
 
D0200F1  $M3YNNOR                      Res Mood Int - Self Dprcn                
                          1,993                          Missing                                 
                            131        -                 Not assessed/no information             
                          2,599        0                 No                                      
                            224        1                 Yes                                     
                            166        9                 No Response                             
 
D0200F2  $M3DEPRB                      Res Mood Int - Self Dprcn Freq           
                          2,159                          Missing                                 
                            131        -                 Not assessed/no information             
                          2,606        0                 Never or 1 day                          
                            113        1                 2 - 6 days                              
                             55        2                 7 - 11 days                             
                             49        3                 12-14 days                              
 
D0200G1  $M3YNNOR                      Res Mood Int - Lack of Conc              
                          1,993                          Missing                                 
                            129        -                 Not assessed/no information             
                          2,438        0                 No                                      
                            386        1                 Yes                                     
                            167        9                 No Response                             
 
D0200G2  $M3DEPRB                      Res Mood Int - Lack of Conc Freq         
                          2,160                          Missing                                 
                            129        -                 Not assessed/no information             
                          2,445        0                 Never or 1 day                          
                            172        1                 2 - 6 days                              
                             97        2                 7 - 11 days                             
                            110        3                 12-14 days                              
 
D0200H1  $M3YNNOR                      Res Mood Int - Movement Diff             
                          1,993                          Missing                                 
                            130        -                 Not assessed/no information             
                          2,559        0                 No                                      
                            262        1                 Yes                                     
                            169        9                 No Response                             
 
D0200H2  $M3DEPRB                      Res Mood Int - Movement Diff Freq        
                          2,162                          Missing                                 
                            130        -                 Not assessed/no information             
                          2,560        0                 Never or 1 day                          
                            118        1                 2 - 6 days                              
                             65        2                 7 - 11 days                             
                             78        3                 12-14 days                              
 
D0200I1  $M3YNNOR                      Res Mood Int - Neg Stmnt                 
                          1,993                          Missing                                 
                            129        -                 Not assessed/no information             
                          2,798        0                 No                                      
                             28        1                 Yes                                     
                            165        9                 No Response                             
 
D0200I2  $M3DEPRB                      Res Mood Int - Neg Stmnt Freq            
                          2,158                          Missing                                 
                            129        -                 Not assessed/no information             
                          2,799        0                 Never or 1 day                          
                             21        1                 2 - 6 days                              
                              4        2                 7 - 11 days                             
                              2        3                 12-14 days                              
 
D0300                                  Res Mood Int - Tot Svrty Mood Score      
                          1,993                          Missing                                 
                          3,120        Range of values   Range of values                         
 
D0500A1  $M3YESNO                      SA of Res Mood - Interest Loss           
                          4,420                          Missing                                 
                             39        -                 Not assessed/no information             
                            548        0                 No                                      
                            106        1                 Yes                                     
 
D0500A2  $M3DEPRB                      SA of Res Mood - Interest Loss Freq      
                          4,420                          Missing                                 
                             39        -                 Not assessed/no information             
                            554        0                 Never or 1 day                          
                             37        1                 2 - 6 days                              
                             27        2                 7 - 11 days                             
                             36        3                 12-14 days                              
 
D0500B1  $M3YESNO                      SA of Res Mood - Feel Down               
                          4,420                          Missing                                 
                             39        -                 Not assessed/no information             
                            554        0                 No                                      
                            100        1                 Yes                                     
 
D0500B2  $M3DEPRB                      SA of Res Mood - Feel Down Freq          
                          4,420                          Missing                                 
                             39        -                 Not assessed/no information             
                            558        0                 Never or 1 day                          
                             46        1                 2 - 6 days                              
                             29        2                 7 - 11 days                             
                             21        3                 12-14 days                              
 
D0500C1  $M3YESNO                      SA of Res Mood - Trouble Sleep           
                          4,420                          Missing                                 
                             39        -                 Not assessed/no information             
                            531        0                 No                                      
                            123        1                 Yes                                     
 
D0500C2  $M3DEPRB                      SA of Res Mood - Trouble Sleep Freq      
                          4,420                          Missing                                 
                             39        -                 Not assessed/no information             
                            536        0                 Never or 1 day                          
                             37        1                 2 - 6 days                              
                             37        2                 7 - 11 days                             
                             44        3                 12-14 days                              
 
D0500D1  $M3YESNO                      SA of Res Mood - Little Energy           
                          4,420                          Missing                                 
                             38        -                 Not assessed/no information             
                            488        0                 No                                      
                            167        1                 Yes                                     
 
D0500D2  $M3DEPRB                      SA of Res Mood - Little Energy Freq      
                          4,420                          Missing                                 
                             38        -                 Not assessed/no information             
                            492        0                 Never or 1 day                          
                             72        1                 2 - 6 days                              
                             45        2                 7 - 11 days                             
                             46        3                 12-14 days                              
 
D0500E1  $M3YESNO                      SA of Res Mood - Poor Appetite           
                          4,420                          Missing                                 
                             45        -                 Not assessed/no information             
                            483        0                 No                                      
                            165        1                 Yes                                     
 
D0500E2  $M3DEPRB                      SA of Res Mood - Poor Appetite Freq      
                          4,420                          Missing                                 
                             45        -                 Not assessed/no information             
                            486        0                 Never or 1 day                          
                             70        1                 2 - 6 days                              
                             45        2                 7 - 11 days                             
                             47        3                 12-14 days                              
 
D0500F1  $M3YESNO                      SA of Res Mood - Self Dprcn              
                          4,420                          Missing                                 
                             45        -                 Not assessed/no information             
                            638        0                 No                                      
                             10        1                 Yes                                     
 
D0500F2  $M3DEPRB                      SA of Res Mood - Self Dprcn Freq         
                          4,420                          Missing                                 
                             45        -                 Not assessed/no information             
                            639        0                 Never or 1 day                          
                              3        1                 2 - 6 days                              
                              3        2                 7 - 11 days                             
                              3        3                 12-14 days                              
 
D0500G1  $M3YESNO                      SA of Res Mood - Conc                    
                          4,420                          Missing                                 
                             42        -                 Not assessed/no information             
                            428        0                 No                                      
                            223        1                 Yes                                     
 
D0500G2  $M3DEPRB                      SA of Res Mood - Conc Freq               
                          4,420                          Missing                                 
                             42        -                 Not assessed/no information             
                            431        0                 Never or 1 day                          
                             44        1                 2 - 6 days                              
                             36        2                 7 - 11 days                             
                            140        3                 12-14 days                              
 
D0500H1  $M3YESNO                      SA of Res Mood - Movement Diff           
                          4,420                          Missing                                 
                             39        -                 Not assessed/no information             
                            586        0                 No                                      
                             68        1                 Yes                                     
 
D0500H2  $M3DEPRB                      SA of Res Mood - Movement Diff Freq      
                          4,420                          Missing                                 
                             39        -                 Not assessed/no information             
                            588        0                 Never or 1 day                          
                             27        1                 2 - 6 days                              
                             12        2                 7 - 11 days                             
                             27        3                 12-14 days                              
 
D0500I1  $M3YESNO                      SA of Res Mood - Neg Stmnt               
                          4,420                          Missing                                 
                             46        -                 Not assessed/no information             
                            643        0                 No                                      
                              4        1                 Yes                                     
 
D0500I2  $M3DEPRB                      SA of Res Mood - Neg Stmnt Freq          
                          4,420                          Missing                                 
                             46        -                 Not assessed/no information             
                            643        0                 Never or 1 day                          
                              2        1                 2 - 6 days                              
                              2        2                 7 - 11 days                             
 
D0500J1  $M3YESNO                      SA of Res Mood - Short Temper            
                          4,420                          Missing                                 
                             39        -                 Not assessed/no information             
                            545        0                 No                                      
                            109        1                 Yes                                     
 
D0500J2  $M3DEPRB                      SA of Res Mood - Short Temper Freq       
                          4,420                          Missing                                 
                             39        -                 Not assessed/no information             
                            549        0                 Never or 1 day                          
                             69        1                 2 - 6 days                              
                             13        2                 7 - 11 days                             
                             23        3                 12-14 days                              
 
D0600                                  SA Tot Svrty Mood Score                  
                          4,420                          Missing                                 
                            693        Range of values   Range of values                         
 
E0100A   $M3INDIC                      Bhvr: Hallucinations                     
                          1,258                          Missing                                 
                             22        -                 Not assessed/no information             
                          3,751        0                 Not indicated                           
                             82        1                 Indicated                               
 
E0100B   $M3INDIC                      Bhvr: Delusion                           
                          1,258                          Missing                                 
                             22        -                 Not assessed/no information             
                          3,683        0                 Not indicated                           
                            150        1                 Indicated                               
 
E0100Z   $M3INDIC                      Bhvr: No Psychosis                       
                          1,258                          Missing                                 
                             22        -                 Not assessed/no information             
                            183        0                 Not indicated                           
                          3,650        1                 Indicated                               
 
E0200A   $M3BEHAV                      Bhvr: Phys Bhvral                        
                          1,258                          Missing                                 
                             24        -                 Not assessed/no information             
                          3,688        0                 Behavior not exhibited                  
                            117        1                 1 to 3 days                             
                             21        2                 4 to 6 days                             
                              5        3                 Behavior exhibited daily                
 
E0200B   $M3BEHAV                      Bhvr: Verbal Bhvral                      
                          1,258                          Missing                                 
                             23        -                 Not assessed/no information             
                          3,573        0                 Behavior not exhibited                  
                            210        1                 1 to 3 days                             
                             37        2                 4 to 6 days                             
                             12        3                 Behavior exhibited daily                
 
E0200C   $M3BEHAV                      Bhvr: Oth Bhvral                         
                          1,258                          Missing                                 
                             24        -                 Not assessed/no information             
                          3,649        0                 Behavior not exhibited                  
                            128        1                 1 to 3 days                             
                             32        2                 4 to 6 days                             
                             22        3                 Behavior exhibited daily                
 
E0300    $M3YESNO                      Overall Pres of Bhvral Sympt             
                          3,974                          Missing                                 
                              1        -                 Not assessed/no information             
                          1,013        0                 No                                      
                            125        1                 Yes                                     
 
E0500A   $M3YESNO                      Bhvr Imp on Res: Risk to Inj Self        
                          4,987                          Missing                                 
                              1        -                 Not assessed/no information             
                            109        0                 No                                      
                             16        1                 Yes                                     
 
E0500B   $M3YESNO                      Bhvr Imp on Res: Int W Care              
                          4,987                          Missing                                 
                              1        -                 Not assessed/no information             
                             86        0                 No                                      
                             39        1                 Yes                                     
 
E0500C   $M3YESNO                      Bhvr Imp on Res: Int W Part              
                          4,987                          Missing                                 
                              1        -                 Not assessed/no information             
                            105        0                 No                                      
                             20        1                 Yes                                     
 
E0600A   $M3YESNO                      Bhvr Imp on Oth: Risk to Inj Oth         
                          4,987                          Missing                                 
                              1        -                 Not assessed/no information             
                            109        0                 No                                      
                             16        1                 Yes                                     
 
E0600B   $M3YESNO                      Bhvr Imp on Oth: Intrude On Priv of Oth  
                          4,987                          Missing                                 
                              1        -                 Not assessed/no information             
                            109        0                 No                                      
                             16        1                 Yes                                     
 
E0600C   $M3YESNO                      Bhvr Imp on Oth: Dis Care or Living Env  
                          4,987                          Missing                                 
                              1        -                 Not assessed/no information             
                            100        0                 No                                      
                             25        1                 Yes                                     
 
E0800    $M3BEHAV                      Rejection of Care: Pres and Freq         
                          1,258                          Missing                                 
                             25        -                 Not assessed/no information             
                          3,566        0                 Behavior not exhibited                  
                            201        1                 1 to 3 days                             
                             44        2                 4 to 6 days                             
                             19        3                 Behavior exhibited daily                
 
E0900    $M3BEHAV                      Wandering: Pres and Freq                 
                          1,258                          Missing                                 
                             25        -                 Not assessed/no information             
                          3,686        0                 Behavior not exhibited                  
                             76        1                 1 to 3 days                             
                             32        2                 4 to 6 days                             
                             36        3                 Behavior exhibited daily                
 
E1000A   $M3YESNO                      Wander Risk Imp                          
                          5,072                          Missing                                 
                              2        -                 Not assessed/no information             
                             33        0                 No                                      
                              6        1                 Yes                                     
 
E1000B   $M3YESNO                      Wandering Intrudes on Priv of Oth        
                          5,072                          Missing                                 
                              2        -                 Not assessed/no information             
                             32        0                 No                                      
                              7        1                 Yes                                     
 
E1100    $M3CHNG                       Change in Bhvr or Oth Sympt              
                          3,974                          Missing                                 
                              2        -                 Not assessed/no information             
                            705        0                 Same                                    
                             23        1                 Improved                                
                             42        2                 Worse                                   
                            367        3                 N/A                                     
 
F0300    $M3YESNO                      Should Dly and Act Pref Int Be Cond      
                          3,974                          Missing                                 
                             16        -                 Not assessed/no information             
                            112        0                 No                                      
                          1,011        1                 Yes                                     
 
F0400A   $M3IMPRT                      Int for Dly Pref: Chooses Clothes        
                          4,086                          Missing                                 
                             22        -                 Not assessed/no information             
                            510        1                 Very important                          
                            279        2                 Somewhat important                      
                            148        3                 Not very important                      
                             36        4                 Not important at all                    
                              6        5                 Important, but cannot do or no choice   
                             26        9                 No response or non-responsive           
 
F0400B   $M3IMPRT                      Int for Dly Pref: Care Personal Items    
                          4,086                          Missing                                 
                             22        -                 Not assessed/no information             
                            644        1                 Very important                          
                            232        2                 Somewhat important                      
                             84        3                 Not very important                      
                             11        4                 Not important at all                    
                              8        5                 Important, but cannot do or no choice   
                             26        9                 No response or non-responsive           
 
F0400C   $M3IMPRT                      Int for Dly Pref: Bathing Option         
                          4,086                          Missing                                 
                             23        -                 Not assessed/no information             
                            618        1                 Very important                          
                            247        2                 Somewhat important                      
                             82        3                 Not very important                      
                             19        4                 Not important at all                    
                             12        5                 Important, but cannot do or no choice   
                             26        9                 No response or non-responsive           
 
F0400D   $M3IMPRT                      Int for Dly Pref: Snack Between Meals    
                          4,086                          Missing                                 
                             22        -                 Not assessed/no information             
                            472        1                 Very important                          
                            308        2                 Somewhat important                      
                            155        3                 Not very important                      
                             41        4                 Not important at all                    
                              3        5                 Important, but cannot do or no choice   
                             26        9                 No response or non-responsive           
 
F0400E   $M3IMPRT                      Int for Dly Pref: Choose Bed Time        
                          4,086                          Missing                                 
                             23        -                 Not assessed/no information             
                            653        1                 Very important                          
                            224        2                 Somewhat important                      
                             83        3                 Not very important                      
                             13        4                 Not important at all                    
                              5        5                 Important, but cannot do or no choice   
                             26        9                 No response or non-responsive           
 
F0400F   $M3IMPRT                      Int for Dly Pref: Fam Involvement        
                          4,086                          Missing                                 
                             25        -                 Not assessed/no information             
                            775        1                 Very important                          
                            143        2                 Somewhat important                      
                             36        3                 Not very important                      
                             16        4                 Not important at all                    
                              6        5                 Important, but cannot do or no choice   
                             26        9                 No response or non-responsive           
 
F0400G   $M3IMPRT                      Int for Dly Pref: Priv Phone Time        
                          4,086                          Missing                                 
                             23        -                 Not assessed/no information             
                            364        1                 Very important                          
                            253        2                 Somewhat important                      
                            256        3                 Not very important                      
                             97        4                 Not important at all                    
                              7        5                 Important, but cannot do or no choice   
                             27        9                 No response or non-responsive           
 
F0400H   $M3IMPRT                      Int for Dly Pref: Lock Item              
                          4,086                          Missing                                 
                             23        -                 Not assessed/no information             
                            346        1                 Very important                          
                            207        2                 Somewhat important                      
                            270        3                 Not very important                      
                            152        4                 Not important at all                    
                              4        5                 Important, but cannot do or no choice   
                             25        9                 No response or non-responsive           
 
F0500A   $M3IMPRT                      Int for Act Pref: Reading Mat Available  
                          4,086                          Missing                                 
                             23        -                 Not assessed/no information             
                            365        1                 Very important                          
                            310        2                 Somewhat important                      
                            229        3                 Not very important                      
                             66        4                 Not important at all                    
                             10        5                 Important, but cannot do or no choice   
                             24        9                 No response or non-responsive           
 
F0500B   $M3IMPRT                      Int for Act Pref: Music                  
                          4,086                          Missing                                 
                             24        -                 Not assessed/no information             
                            482        1                 Very important                          
                            361        2                 Somewhat important                      
                            112        3                 Not very important                      
                             23        4                 Not important at all                    
                              1        5                 Important, but cannot do or no choice   
                             24        9                 No response or non-responsive           
 
F0500C   $M3IMPRT                      Int for Act Pref: Animal Pres            
                          4,086                          Missing                                 
                             23        -                 Not assessed/no information             
                            340        1                 Very important                          
                            283        2                 Somewhat important                      
                            249        3                 Not very important                      
                             99        4                 Not important at all                    
                              8        5                 Important, but cannot do or no choice   
                             25        9                 No response or non-responsive           
 
F0500D   $M3IMPRT                      Int for Act Pref: News                   
                          4,086                          Missing                                 
                             23        -                 Not assessed/no information             
                            452        1                 Very important                          
                            294        2                 Somewhat important                      
                            177        3                 Not very important                      
                             53        4                 Not important at all                    
                              2        5                 Important, but cannot do or no choice   
                             26        9                 No response or non-responsive           
 
F0500E   $M3IMPRT                      Int for Act Pref: Group Act              
                          4,086                          Missing                                 
                             23        -                 Not assessed/no information             
                            298        1                 Very important                          
                            422        2                 Somewhat important                      
                            202        3                 Not very important                      
                             51        4                 Not important at all                    
                              6        5                 Important, but cannot do or no choice   
                             25        9                 No response or non-responsive           
 
F0500F   $M3IMPRT                      Int for Act Pref: Favorite Act           
                          4,086                          Missing                                 
                             23        -                 Not assessed/no information             
                            606        1                 Very important                          
                            300        2                 Somewhat important                      
                             49        3                 Not very important                      
                              7        4                 Not important at all                    
                             17        5                 Important, but cannot do or no choice   
                             25        9                 No response or non-responsive           
 
F0500G   $M3IMPRT                      Int for Act Pref: Time Outdoors          
                          4,086                          Missing                                 
                             23        -                 Not assessed/no information             
                            553        1                 Very important                          
                            319        2                 Somewhat important                      
                             79        3                 Not very important                      
                             19        4                 Not important at all                    
                              9        5                 Important, but cannot do or no choice   
                             25        9                 No response or non-responsive           
 
F0500H   $M3IMPRT                      Int for Act Pref: Religion               
                          4,086                          Missing                                 
                             23        -                 Not assessed/no information             
                            453        1                 Very important                          
                            292        2                 Somewhat important                      
                            164        3                 Not very important                      
                             60        4                 Not important at all                    
                             10        5                 Important, but cannot do or no choice   
                             25        9                 No response or non-responsive           
 
F0600    $M3PRIRS                      Dly and Act Pref Primary Respondent      
                          4,086                          Missing                                 
                             22        -                 Not assessed/no information             
                            871        1                 Resident                                
                            108        2                 Family or significant other             
                             26        9                 Interview could not be completed        
 
F0700    $M3YESNO                      Cond SA of Dly and Act Pref              
                          4,086                          Missing                                 
                             16        -                 Not assessed/no information             
                            979        0                 No                                      
                             32        1                 Yes                                     
 
F0800A   $M3INDIC                      SA: Chooses Clothes                      
                          4,953                          Missing                                 
                             17        -                 Not assessed/no information             
                            100        0                 Not indicated                           
                             43        1                 Indicated                               
 
F0800B   $M3INDIC                      SA: Care Personal Item                   
                          4,953                          Missing                                 
                             19        -                 Not assessed/no information             
                            105        0                 Not indicated                           
                             36        1                 Indicated                               
 
F0800C   $M3INDIC                      SA: Tub Bath                             
                          4,953                          Missing                                 
                             20        -                 Not assessed/no information             
                            133        0                 Not indicated                           
                              7        1                 Indicated                               
 
F0800D   $M3INDIC                      SA: Shower                               
                          4,953                          Missing                                 
                             18        -                 Not assessed/no information             
                             43        0                 Not indicated                           
                             99        1                 Indicated                               
 
F0800E   $M3INDIC                      SA: Bed Bath                             
                          4,953                          Missing                                 
                             17        -                 Not assessed/no information             
                            101        0                 Not indicated                           
                             42        1                 Indicated                               
 
F0800F   $M3INDIC                      SA: Sponge Bath                          
                          4,953                          Missing                                 
                             19        -                 Not assessed/no information             
                            105        0                 Not indicated                           
                             36        1                 Indicated                               
 
F0800G   $M3INDIC                      SA: Snacks Between                       
                          4,953                          Missing                                 
                             19        -                 Not assessed/no information             
                             50        0                 Not indicated                           
                             91        1                 Indicated                               
 
F0800H   $M3INDIC                      SA: Bed Time                             
                          4,953                          Missing                                 
                             19        -                 Not assessed/no information             
                            124        0                 Not indicated                           
                             17        1                 Indicated                               
 
F0800I   $M3INDIC                      SA: Fam Involvement                      
                          4,953                          Missing                                 
                             18        -                 Not assessed/no information             
                             34        0                 Not indicated                           
                            108        1                 Indicated                               
 
F0800J   $M3INDIC                      SA: Priv Phone                           
                          4,953                          Missing                                 
                             20        -                 Not assessed/no information             
                            131        0                 Not indicated                           
                              9        1                 Indicated                               
 
F0800K   $M3INDIC                      SA: Lock Item                            
                          4,953                          Missing                                 
                             20        -                 Not assessed/no information             
                            121        0                 Not indicated                           
                             19        1                 Indicated                               
 
F0800L   $M3INDIC                      SA: Reading Mat Available                
                          4,953                          Missing                                 
                             19        -                 Not assessed/no information             
                            107        0                 Not indicated                           
                             34        1                 Indicated                               
 
F0800M   $M3INDIC                      SA: Music                                
                          4,953                          Missing                                 
                             18        -                 Not assessed/no information             
                             31        0                 Not indicated                           
                            111        1                 Indicated                               
 
F0800N   $M3INDIC                      SA: Animal Pres                          
                          4,953                          Missing                                 
                             21        -                 Not assessed/no information             
                             90        0                 Not indicated                           
                             49        1                 Indicated                               
 
F0800O   $M3INDIC                      SA: News                                 
                          4,953                          Missing                                 
                             18        -                 Not assessed/no information             
                            124        0                 Not indicated                           
                             18        1                 Indicated                               
 
F0800P   $M3INDIC                      SA: Group Act                            
                          4,953                          Missing                                 
                             19        -                 Not assessed/no information             
                             90        0                 Not indicated                           
                             51        1                 Indicated                               
 
F0800Q   $M3INDIC                      SA: Favorite Act                         
                          4,953                          Missing                                 
                             19        -                 Not assessed/no information             
                             57        0                 Not indicated                           
                             84        1                 Indicated                               
 
F0800R   $M3INDIC                      SA: Time Away Nrs Home                   
                          4,953                          Missing                                 
                             21        -                 Not assessed/no information             
                            131        0                 Not indicated                           
                              8        1                 Indicated                               
 
F0800S   $M3INDIC                      SA: Time Outdoors                        
                          4,953                          Missing                                 
                             21        -                 Not assessed/no information             
                             94        0                 Not indicated                           
                             45        1                 Indicated                               
 
F0800T   $M3INDIC                      SA: Part in Rel Act                      
                          4,953                          Missing                                 
                             21        -                 Not assessed/no information             
                             68        0                 Not indicated                           
                             71        1                 Indicated                               
 
F0800Z   $M3INDIC                      SA: None of Above Act                    
                          4,953                          Missing                                 
                             17        -                 Not assessed/no information             
                            133        0                 Not indicated                           
                             10        1                 Indicated                               
 
G0110A1  $M3ADLCT                      ADL Ass: Bed Mob Self Perf               
                          1,265                          Missing                                 
                              2        -                 Not assessed/no information             
                            251        0                 Independent                             
                            523        1                 Supervision                             
                            506        2                 Limited assistance                      
                          2,244        3                 Extensive assistance                    
                            307        4                 Total dependence                        
                             15        7                 Activity occurred only once or twice    
 
G0110A2  $M3ADLSP                      ADL Ass: Bed Mob Supp Prov               
                          2,033                          Missing                                 
                              2        -                 Not assessed/no information             
                            177        0                 No setup or physical help from staff    
                            252        1                 Setup help only                         
                          1,431        2                 One person physical assist              
                          1,218        3                 Two+ persons physical assist            
 
G0110B1  $M3ADLCT                      ADL Ass: Trans Self Perf                 
                          1,265                          Missing                                 
                              2        -                 Not assessed/no information             
                            218        0                 Independent                             
                            536        1                 Supervision                             
                            576        2                 Limited assistance                      
                          1,717        3                 Extensive assistance                    
                            581        4                 Total dependence                        
                            125        7                 Activity occurred only once or twice    
                             93        8                 Activity did not occur                  
 
G0110B2  $M3ADLSP                      ADL Ass: Trans Self Supp Prov            
                          2,033                          Missing                                 
                              2        -                 Not assessed/no information             
                            156        0                 No setup or physical help from staff    
                            252        1                 Setup help only                         
                          1,241        2                 One person physical assist              
                          1,348        3                 Two+ persons physical assist            
                             81        8                 ADL activity did not occur              
 
G0110C1  $M3ADLCT                      ADL Ass: Wlk In Room Self Perf           
                          1,269                          Missing                                 
                              5        -                 Not assessed/no information             
                            227        0                 Independent                             
                            654        1                 Supervision                             
                            503        2                 Limited assistance                      
                            370        3                 Extensive assistance                    
                              5        4                 Total dependence                        
                            243        7                 Activity occurred only once or twice    
                          1,837        8                 Activity did not occur                  
 
G0110C2  $M3ADLSP                      ADL Ass: Wlk In Room Supp Prov           
                          2,037                          Missing                                 
                              4        -                 Not assessed/no information             
                            208        0                 No setup or physical help from staff    
                            333        1                 Setup help only                         
                            867        2                 One person physical assist              
                            114        3                 Two+ persons physical assist            
                          1,550        8                 ADL activity did not occur              
 
G0110D1  $M3ADLCT                      ADL Ass: Wlk In Corr Self Perf           
                          1,269                          Missing                                 
                              5        -                 Not assessed/no information             
                            183        0                 Independent                             
                            590        1                 Supervision                             
                            398        2                 Limited assistance                      
                            268        3                 Extensive assistance                    
                              3        4                 Total dependence                        
                            303        7                 Activity occurred only once or twice    
                          2,094        8                 Activity did not occur                  
 
G0110D2  $M3ADLSP                      ADL Ass: Wlk In Corr Self Supp Prov      
                          2,037                          Missing                                 
                              4        -                 Not assessed/no information             
                            203        0                 No setup or physical help from staff    
                            309        1                 Setup help only                         
                            731        2                 One person physical assist              
                             82        3                 Two+ persons physical assist            
                          1,747        8                 ADL activity did not occur              
 
G0110E1  $M3ADLCT                      ADL Ass: Loc On Self Perf                
                          1,269                          Missing                                 
                              5        -                 Not assessed/no information             
                            316        0                 Independent                             
                            912        1                 Supervision                             
                            526        2                 Limited assistance                      
                            996        3                 Extensive assistance                    
                            523        4                 Total dependence                        
                            268        7                 Activity occurred only once or twice    
                            298        8                 Activity did not occur                  
 
G0110E2  $M3ADLSP                      ADL Ass: Loc On Supp Prov                
                          2,037                          Missing                                 
                              3        -                 Not assessed/no information             
                            234        0                 No setup or physical help from staff    
                            446        1                 Setup help only                         
                          2,000        2                 One person physical assist              
                            152        3                 Two+ persons physical assist            
                            241        8                 ADL activity did not occur              
 
G0110F1  $M3ADLCT                      ADL Ass: Loc Off Self Perf               
                          1,269                          Missing                                 
                              6        -                 Not assessed/no information             
                            235        0                 Independent                             
                            676        1                 Supervision                             
                            366        2                 Limited assistance                      
                            708        3                 Extensive assistance                    
                            503        4                 Total dependence                        
                            508        7                 Activity occurred only once or twice    
                            842        8                 Activity did not occur                  
 
G0110F2  $M3ADLSP                      ADL Ass: Loc Off Supp Prov               
                          2,037                          Missing                                 
                              4        -                 Not assessed/no information             
                            206        0                 No setup or physical help from staff    
                            382        1                 Setup help only                         
                          1,678        2                 One person physical assist              
                             87        3                 Two+ persons physical assist            
                            719        8                 ADL activity did not occur              
 
G0110G1  $M3ADLCT                      ADL Ass: Dress Self Perf                 
                          1,269                          Missing                                 
                              3        -                 Not assessed/no information             
                            120        0                 Independent                             
                            371        1                 Supervision                             
                            563        2                 Limited assistance                      
                          2,328        3                 Extensive assistance                    
                            431        4                 Total dependence                        
                             22        7                 Activity occurred only once or twice    
                              6        8                 Activity did not occur                  
 
G0110G2  $M3ADLSP                      ADL Ass: Dress Supp Prov                 
                          2,037                          Missing                                 
                              3        -                 Not assessed/no information             
                             73        0                 No setup or physical help from staff    
                            173        1                 Setup help only                         
                          2,280        2                 One person physical assist              
                            543        3                 Two+ persons physical assist            
                              4        8                 ADL activity did not occur              
 
G0110H1  $M3ADLCT                      ADL Ass: Eating Self Perf                
                          1,265                          Missing                                 
                              1        -                 Not assessed/no information             
                            886        0                 Independent                             
                          1,803        1                 Supervision                             
                            282        2                 Limited assistance                      
                            545        3                 Extensive assistance                    
                            310        4                 Total dependence                        
                             17        7                 Activity occurred only once or twice    
                              4        8                 Activity did not occur                  
 
G0110H2  $M3ADLSP                      ADL Ass: Eating Supp Prov                
                          2,033                          Missing                                 
                              1        -                 Not assessed/no information             
                             68        0                 No setup or physical help from staff    
                          1,690        1                 Setup help only                         
                          1,311        2                 One person physical assist              
                              7        3                 Two+ persons physical assist            
                              3        8                 ADL activity did not occur              
 
G0110I1  $M3ADLCT                      ADL Ass: Toileting Self Perf             
                          1,265                          Missing                                 
                              1        -                 Not assessed/no information             
                            158        0                 Independent                             
                            403        1                 Supervision                             
                            498        2                 Limited assistance                      
                          2,126        3                 Extensive assistance                    
                            642        4                 Total dependence                        
                             16        7                 Activity occurred only once or twice    
                              4        8                 Activity did not occur                  
 
G0110I2  $M3ADLSP                      ADL Ass: Toileting Supp Prov             
                          2,033                          Missing                                 
                              1        -                 Not assessed/no information             
                            106        0                 No setup or physical help from staff    
                            193        1                 Setup help only                         
                          1,765        2                 One person physical assist              
                          1,011        3                 Two+ persons physical assist            
                              4        8                 ADL activity did not occur              
 
G0110J1  $M3ADLCT                      ADL Ass: Personal Hygiene Self Perf      
                          1,269                          Missing                                 
                              1        -                 Not assessed/no information             
                            143        0                 Independent                             
                            512        1                 Supervision                             
                            602        2                 Limited assistance                      
                          2,105        3                 Extensive assistance                    
                            460        4                 Total dependence                        
                             18        7                 Activity occurred only once or twice    
                              3        8                 Activity did not occur                  
 
G0110J2  $M3ADLSP                      ADL Ass: Personal Hygiene Supp Prov      
                          2,037                          Missing                                 
                              1        -                 Not assessed/no information             
                             74        0                 No setup or physical help from staff    
                            230        1                 Setup help only                         
                          2,410        2                 One person physical assist              
                            359        3                 Two+ persons physical assist            
                              2        8                 ADL activity did not occur              
 
G0120A   $M3ADLCT                      ADL Ass: Bathing Self Perf               
                          1,269                          Missing                                 
                              9        -                 Not assessed/no information             
                             77        0                 Independent                             
                            145        1                 Supervision                             
                            170        2                 Limited assistance                      
                          1,509        3                 Extensive assistance                    
                          1,668        4                 Total dependence                        
                            266        8                 Activity did not occur                  
 
G0120B   $M3ADLSP                      ADL Ass: Bathing Supp Prov               
                          2,037                          Missing                                 
                              6        -                 Not assessed/no information             
                             24        0                 No setup or physical help from staff    
                            120        1                 Setup help only                         
                          2,259        2                 One person physical assist              
                            472        3                 Two+ persons physical assist            
                            195        8                 ADL activity did not occur              
 
G0300A   $M3BAL                        Blnce Dur Seated to Standing Pos         
                          2,037                          Missing                                 
                             12        -                 Not assessed/no information             
                            189        0                 Steady at all times                     
                            638        1                 Not steady, but able to stabilize w/o as
                          1,532        2                 Not steady, only able to stabilize w/ as
                            705        8                 Activity did not occur                  
 
G0300B   $M3BAL                        Blnce Dur Wlking                         
                          2,037                          Missing                                 
                             19        -                 Not assessed/no information             
                            196        0                 Steady at all times                     
                            659        1                 Not steady, but able to stabilize w/o as
                            725        2                 Not steady, only able to stabilize w/ as
                          1,477        8                 Activity did not occur                  
 
G0300C   $M3BAL                        Blnce When Turning Around                
                          2,037                          Missing                                 
                             29        -                 Not assessed/no information             
                            189        0                 Steady at all times                     
                            628        1                 Not steady, but able to stabilize w/o as
                            686        2                 Not steady, only able to stabilize w/ as
                          1,544        8                 Activity did not occur                  
 
G0300D   $M3BAL                        Blnce Moving On and Off Toilet           
                          2,037                          Missing                                 
                             12        -                 Not assessed/no information             
                            185        0                 Steady at all times                     
                            582        1                 Not steady, but able to stabilize w/o as
                          1,463        2                 Not steady, only able to stabilize w/ as
                            834        8                 Activity did not occur                  
 
G0300E   $M3BAL                        Blnce W Surface to Surface Trans         
                          2,037                          Missing                                 
                             12        -                 Not assessed/no information             
                            195        0                 Steady at all times                     
                            611        1                 Not steady, but able to stabilize w/o as
                          2,117        2                 Not steady, only able to stabilize w/ as
                            141        8                 Activity did not occur                  
 
G0400A   $M3RANGE                      Func Lim in ROM: Upper Ext Mtn           
                          2,037                          Missing                                 
                             12        -                 Not assessed/no information             
                          2,377        0                 No impairment                           
                            409        1                 Impairment on one side                  
                            278        2                 Impairment on both sides                
 
G0400B   $M3RANGE                      Func Lim in ROM: Lower Ext Mtn           
                          2,037                          Missing                                 
                             11        -                 Not assessed/no information             
                          2,124        0                 No impairment                           
                            460        1                 Impairment on one side                  
                            481        2                 Impairment on both sides                
 
G0600A   $M3INDIC                      Mob Devices: Cane                        
                          2,037                          Missing                                 
                              2        -                 Not assessed/no information             
                          3,036        0                 Not indicated                           
                             38        1                 Indicated                               
 
G0600B   $M3INDIC                      Mob Devices: Wlker                       
                          2,037                          Missing                                 
                              2        -                 Not assessed/no information             
                          1,972        0                 Not indicated                           
                          1,102        1                 Indicated                               
 
G0600C   $M3INDIC                      Mob Devices: Wheelchair                  
                          2,037                          Missing                                 
                              2        -                 Not assessed/no information             
                            776        0                 Not indicated                           
                          2,298        1                 Indicated                               
 
G0600D   $M3INDIC                      Mob Devices: Limb Prosthesis             
                          2,037                          Missing                                 
                              2        -                 Not assessed/no information             
                          3,069        0                 Not indicated                           
                              5        1                 Indicated                               
 
G0600Z   $M3INDIC                      Mob Devices: None of Above               
                          2,037                          Missing                                 
                              2        -                 Not assessed/no information             
                          2,599        0                 Not indicated                           
                            475        1                 Indicated                               
 
G0900A   $M3YNDET                      Func Rehab Pot: Res Increased Ind        
                          4,633                          Missing                                 
                              2        -                 Not assessed/no information             
                             23        0                 No                                      
                            418        1                 Yes                                     
                             37        9                 Unable to determine                     
 
G0900B   $M3YESNO                      Func Rehab Pot: Staff Increased Ind      
                          4,633                          Missing                                 
                              4        -                 Not assessed/no information             
                             35        0                 No                                      
                            441        1                 Yes                                     
 
H0100A   $M3INDIC                      Bldr and Bwl App: Indwelling Cath        
                          1,269                          Missing                                 
                          3,617        0                 Not indicated                           
                            227        1                 Indicated                               
 
H0100B   $M3INDIC                      Bldr and Bwl App: Ext Cath               
                          1,269                          Missing                                 
                          3,838        0                 Not indicated                           
                              6        1                 Indicated                               
 
H0100C   $M3INDIC                      Bldr and Bwl App: Ostomy                 
                          1,240                          Missing                                 
                          3,789        0                 Not indicated                           
                             84        1                 Indicated                               
 
H0100D   $M3INDIC                      Bldr and Bwl App: Imt Cath               
                          1,240                          Missing                                 
                          3,862        0                 Not indicated                           
                             11        1                 Indicated                               
 
H0100Z   $M3INDIC                      Bldr and Bwl App: No Urny App            
                          1,240                          Missing                                 
                            306        0                 Not indicated                           
                          3,567        1                 Indicated                               
 
H0200A   $M3YNDET                      Urny Toil Prog: Trial Toileting Prog     
                          2,037                          Missing                                 
                          2,844        0                 No                                      
                            224        1                 Yes                                     
                              8        9                 Unable to determine                     
 
H0200B   $M3TOILT                      Urny Toil Prog: Resp To Toileting Prog   
                          5,045                          Missing                                 
                             32        0                 No improvement                          
                             17        1                 Decreased wetness                       
                              9        2                 Completely dry                          
                             10        9                 Unable to determine                     
 
H0200C   $M3YESNO                      Urny Toil Prog: Cur Toileting Prog       
                          4,848                          Missing                                 
                            119        0                 No                                      
                            146        1                 Yes                                     
 
H0300    $M3CONT                       Urny Continence                          
                          1,269                          Missing                                 
                              2        -                 Not assessed/no information             
                            726        0                 Always continent                        
                            751        1                 Occasionally incontinent                
                            955        2                 Frequently incontinent                  
                          1,205        3                 Always incontinent                      
                            205        9                 Not rated                               
 
H0400    $M3CONT                       Bwl Continence                           
                          1,269                          Missing                                 
                              2        -                 Not assessed/no information             
                          1,282        0                 Always continent                        
                            379        1                 Occasionally incontinent                
                            835        2                 Frequently incontinent                  
                          1,238        3                 Always incontinent                      
                            108        9                 Not rated                               
 
H0500    $M3YESNO                      Bwl Toileting Prog                       
                          2,004                          Missing                                 
                          3,031        0                 No                                      
                             78        1                 Yes                                     
 
H0600    $M3YESNO                      Constipation                             
                          3,968                          Missing                                 
                              5        -                 Not assessed/no information             
                          1,098        0                 No                                      
                             42        1                 Yes                                     
 
I0100    $M3INDIC                      Actv Diag: Cancer                        
                          2,037                          Missing                                 
                          2,826        0                 Not indicated                           
                            250        1                 Indicated                               
 
I0200    $M3INDIC                      Actv Diag: Anemia                        
                          2,037                          Missing                                 
                          2,037        0                 Not indicated                           
                          1,039        1                 Indicated                               
 
I0300    $M3INDIC                      Actv Diag: Dysrhythmia                   
                          3,968                          Missing                                 
                            855        0                 Not indicated                           
                            290        1                 Indicated                               
 
I0400    $M3INDIC                      Actv Diag: Coronary Artery Dis (CAD)     
                          2,037                          Missing                                 
                          2,331        0                 Not indicated                           
                            745        1                 Indicated                               
 
I0500    $M3INDIC                      Actv Diag: Deep Vein Thrombosis (DVT)    
                          3,968                          Missing                                 
                          1,093        0                 Not indicated                           
                             52        1                 Indicated                               
 
I0600    $M3INDIC                      Actv Diag: Heart Failure (CHF)           
                          2,037                          Missing                                 
                          2,271        0                 Not indicated                           
                            805        1                 Indicated                               
 
I0700    $M3INDIC                      Actv Diag: Hypertension                  
                          2,037                          Missing                                 
                            613        0                 Not indicated                           
                          2,463        1                 Indicated                               
 
I0800    $M3INDIC                      Actv Diag: Hypotension                   
                          2,037                          Missing                                 
                          2,981        0                 Not indicated                           
                             95        1                 Indicated                               
 
I0900    $M3INDIC                      Actv Diag: (PVD)                         
                          1,269                          Missing                                 
                          3,320        0                 Not indicated                           
                            524        1                 Indicated                               
 
I1100    $M3INDIC                      Actv Diag: Cirrhosis                     
                          3,968                          Missing                                 
                          1,136        0                 Not indicated                           
                              9        1                 Indicated                               
 
I1200    $M3INDIC                      Actv Diag:  (GERD)                       
                          3,968                          Missing                                 
                            682        0                 Not indicated                           
                            463        1                 Indicated                               
 
I1300    $M3INDIC                      Actv Diag: Ulcrative Colitis             
                          2,008                          Missing                                 
                          3,056        0                 Not indicated                           
                             49        1                 Indicated                               
 
I1400    $M3INDIC                      Actv Diag: (BPH)                         
                          3,968                          Missing                                 
                          1,033        0                 Not indicated                           
                            112        1                 Indicated                               
 
I1500    $M3INDIC                      Actv Diag: (ESRD)                        
                          2,037                          Missing                                 
                          2,419        0                 Not indicated                           
                            657        1                 Indicated                               
 
I1550    $M3INDIC                      Actv Diag: Neurogenic Bldr               
                          1,269                          Missing                                 
                          3,750        0                 Not indicated                           
                             94        1                 Indicated                               
 
I1650    $M3INDIC                      Actv Diag: Obstructive Uropathy          
                          1,269                          Missing                                 
                          3,736        0                 Not indicated                           
                            108        1                 Indicated                               
 
I1700    $M3INDIC                      Actv Diag: (MDRO)                        
                          2,008                          Missing                                 
                          3,077        0                 Not indicated                           
                             28        1                 Indicated                               
 
I2000    $M3INDIC                      Actv Diag: Pneumonia                     
                          2,004                          Missing                                 
                          2,964        0                 Not indicated                           
                            145        1                 Indicated                               
 
I2100    $M3INDIC                      Actv Diag: Septicemia                    
                          2,004                          Missing                                 
                          3,039        0                 Not indicated                           
                             70        1                 Indicated                               
 
I2200    $M3INDIC                      Actv Diag: Tuberculosis                  
                          2,037                          Missing                                 
                          3,076        0                 Not indicated                           
 
I2300    $M3INDIC                      Actv Diag: Urny Tract Infn (UTI)         
                          1,269                          Missing                                 
                          3,640        0                 Not indicated                           
                            204        1                 Indicated                               
 
I2400    $M3INDIC                      Actv Diag: Viral Hepatitis               
                          2,037                          Missing                                 
                          3,050        0                 Not indicated                           
                             26        1                 Indicated                               
 
I2500    $M3INDIC                      Wound Infn                               
                          2,008                          Missing                                 
                          3,086        0                 Not indicated                           
                             19        1                 Indicated                               
 
I2900    $M3INDIC                      Actv Diag: Diabetes Mellitus (DM)        
                          1,236                          Missing                                 
                          2,500        0                 Not indicated                           
                          1,377        1                 Indicated                               
 
I3100    $M3INDIC                      Actv Diag: Hyponatremia                  
                          2,037                          Missing                                 
                          2,970        0                 Not indicated                           
                            106        1                 Indicated                               
 
I3200    $M3INDIC                      Actv Diag: Hyperkalemia                  
                          2,037                          Missing                                 
                          3,043        0                 Not indicated                           
                             33        1                 Indicated                               
 
I3300    $M3INDIC                      Actv Diag: Hyperlipidemia                
                          2,037                          Missing                                 
                          1,541        0                 Not indicated                           
                          1,535        1                 Indicated                               
 
I3400    $M3INDIC                      Actv Diag: Thyroid                       
                          3,968                          Missing                                 
                            824        0                 Not indicated                           
                            321        1                 Indicated                               
 
I3700    $M3INDIC                      Actv Diag: Arthritis                     
                          3,968                          Missing                                 
                            770        0                 Not indicated                           
                            375        1                 Indicated                               
 
I3800    $M3INDIC                      Actv Diag: Osteoporosis                  
                          3,968                          Missing                                 
                          1,004        0                 Not indicated                           
                            141        1                 Indicated                               
 
I3900    $M3INDIC                      Actv Diag: Hip Fracture                  
                          2,037                          Missing                                 
                          2,991        0                 Not indicated                           
                             85        1                 Indicated                               
 
I4000    $M3INDIC                      Actv Diag: Oth Fracture                  
                          2,037                          Missing                                 
                          2,883        0                 Not indicated                           
                            193        1                 Indicated                               
 
I4200    $M3INDIC                      Actv Diag: Alzheimers Disease            
                          2,037                          Missing                                 
                          2,580        0                 Not indicated                           
                            496        1                 Indicated                               
 
I4300    $M3INDIC                      Actv Diag: Aphasia                       
                          2,004                          Missing                                 
                          2,921        0                 Not indicated                           
                            188        1                 Indicated                               
 
I4400    $M3INDIC                      Actv Diag: Cerebral Palsy                
                          2,004                          Missing                                 
                          3,077        0                 Not indicated                           
                             32        1                 Indicated                               
 
I4500    $M3INDIC                      Actv Diag: (CVA or TIA or Stroke)        
                          2,008                          Missing                                 
                          2,555        0                 Not indicated                           
                            550        1                 Indicated                               
 
I4800    $M3INDIC                      Actv Diag: Dementia                      
                          2,037                          Missing                                 
                          1,570        0                 Not indicated                           
                          1,506        1                 Indicated                               
 
I4900    $M3INDIC                      Actv Diag: Hemiplegia                    
                          2,004                          Missing                                 
                          2,760        0                 Not indicated                           
                            349        1                 Indicated                               
 
I5000    $M3INDIC                      Actv Diag: Paraplegia                    
                          2,037                          Missing                                 
                          3,060        0                 Not indicated                           
                             16        1                 Indicated                               
 
I5100    $M3INDIC                      Actv Diag: Quadriplegia                  
                          2,004                          Missing                                 
                          3,082        0                 Not indicated                           
                             27        1                 Indicated                               
 
I5200    $M3INDIC                      Actv Diag: Multiple Sclerosis            
                          2,004                          Missing                                 
                          3,080        0                 Not indicated                           
                             29        1                 Indicated                               
 
I5250    $M3INDIC                      Actv Diag: Huntingtons                   
                          1,269                          Missing                                 
                          3,838        0                 Not indicated                           
                              6        1                 Indicated                               
 
I5300    $M3INDIC                      Actv Diag: Parkinsons                    
                          2,004                          Missing                                 
                          2,936        0                 Not indicated                           
                            173        1                 Indicated                               
 
I5350    $M3INDIC                      Tourettes                                
                          1,269                          Missing                                 
                          3,844        0                 Not indicated                           
 
I5400    $M3INDIC                      Actv Diag: Seizure                       
                          2,037                          Missing                                 
                          2,755        0                 Not indicated                           
                            321        1                 Indicated                               
 
I5500    $M3INDIC                      Actv Diag: Traumatic Brain Inj (TBI)     
                          2,008                          Missing                                 
                          3,055        0                 Not indicated                           
                             50        1                 Indicated                               
 
I5600    $M3INDIC                      Actv Diag: Malnutrition                  
                          1,240                          Missing                                 
                          3,270        0                 Not indicated                           
                            603        1                 Indicated                               
 
I5700    $M3INDIC                      Actv Diag: Anxiety Disorder              
                          1,269                          Missing                                 
                              1        -                 Not assessed/no information             
                          2,567        0                 Not indicated                           
                          1,276        1                 Indicated                               
 
I5800    $M3INDIC                      Actv Diag: Depression                    
                          2,037                          Missing                                 
                          1,513        0                 Not indicated                           
                          1,563        1                 Indicated                               
 
I5900    $M3INDIC                      Actv Diag: Manic Depression              
                          1,269                          Missing                                 
                          3,645        0                 Not indicated                           
                            199        1                 Indicated                               
 
I5950    $M3INDIC                      Actv Diag: Psychotic                     
                          1,269                          Missing                                 
                          3,470        0                 Not indicated                           
                            374        1                 Indicated                               
 
I6000    $M3INDIC                      Actv Diag: Schizophrenia                 
                          1,269                          Missing                                 
                          3,561        0                 Not indicated                           
                            283        1                 Indicated                               
 
I6100    $M3INDIC                      Actv Diag:  (PTSD)                       
                          1,269                          Missing                                 
                          3,820        0                 Not indicated                           
                             24        1                 Indicated                               
 
I6200    $M3INDIC                      Actv Diag: Asth, COPD, Chron Lung Dis    
                          2,004                          Missing                                 
                          2,369        0                 Not indicated                           
                            740        1                 Indicated                               
 
I6300    $M3INDIC                      Actv Diag: Resp Failure                  
                          2,004                          Missing                                 
                          2,935        0                 Not indicated                           
                            174        1                 Indicated                               
 
I6500    $M3INDIC                      Actv Diag: Cataracts, Glauc or Mac Deg   
                          3,968                          Missing                                 
                            955        0                 Not indicated                           
                            190        1                 Indicated                               
 
I7900    $M3INDIC                      Actv Diag: No Actv Disease               
                          3,935                          Missing                                 
                          1,174        0                 Not indicated                           
                              4        1                 Indicated                               
 
I8000A                                 Addl Actv Diag: ICD 1                    
                          1,368                          Missing                                 
                          3,745        Range of values   Range of values                         
 
I8000B                                 Addl Actv Diag: ICD 2                    
                          1,461                          Missing                                 
                          3,652        Range of values   Range of values                         
 
I8000C                                 Addl Actv Diag: ICD 3                    
                          1,602                          Missing                                 
                          3,511        Range of values   Range of values                         
 
I8000D                                 Addl Actv Diag: ICD 4                    
                          1,766                          Missing                                 
                          3,347        Range of values   Range of values                         
 
I8000E                                 Addl Actv Diag: ICD 5                    
                          1,988                          Missing                                 
                          3,125        Range of values   Range of values                         
 
I8000F                                 Addl Actv Diag: ICD 6                    
                          2,205                          Missing                                 
                          2,908        Range of values   Range of values                         
 
I8000G                                 Addl Actv Diag: ICD 7                    
                          2,463                          Missing                                 
                          2,650        Range of values   Range of values                         
 
I8000H                                 Addl Actv Diag: ICD 8                    
                          2,757                          Missing                                 
                          2,356        Range of values   Range of values                         
 
I8000I                                 Addl Actv Diag: ICD 9                    
                          3,072                          Missing                                 
                          2,041        Range of values   Range of values                         
 
I8000J                                  Addl Actv Diag: ICD 10                  
                          3,377                          Missing                                 
                          1,736        Range of values   Range of values                         
 
J0100A   $M3YESNO                      Pain management: Scheduled Pain Med      
                          1,269                          Missing                                 
                          2,180        0                 No                                      
                          1,664        1                 Yes                                     
 
J0100B   $M3YESNO                      Pain management: PRN Pain Med            
                          1,269                          Missing                                 
                              1        -                 Not assessed/no information             
                          2,686        0                 No                                      
                          1,157        1                 Yes                                     
 
J0100C   $M3YESNO                      Pain management: Oth Pain Intervention   
                          1,269                          Missing                                 
                             13        -                 Not assessed/no information             
                          3,258        0                 No                                      
                            573        1                 Yes                                     
 
J0200    $M3YESNO                      Should Pain Asmt be Cond                 
                          1,631                          Missing                                 
                             24        -                 Not assessed/no information             
                            309        0                 No                                      
                          3,149        1                 Yes                                     
 
J0300    $M3YNANS                      Pain Asmt Int: Pain Pres                 
                          1,940                          Missing                                 
                             85        -                 Not assessed/no information             
                          2,025        0                 No                                      
                            894        1                 Yes                                     
                            169        9                 Unable to answer                        
 
J0400    $M31PAIN                      Pain Asmt Int: Pain Freq                 
                          4,134                          Missing                                 
                             87        -                 Not assessed/no information             
                             42        1                 Almost constantly                       
                            189        2                 Frequently                              
                            561        3                 Occasionally                            
                             85        4                 Rarely                                  
                             15        9                 Unable to answer                        
 
J0500A   $M3YNANS                      Pain Asmt Int: Pain Effect Sleep         
                          4,134                          Missing                                 
                             88        -                 Not assessed/no information             
                            758        0                 No                                      
                            118        1                 Yes                                     
                             15        9                 Unable to answer                        
 
J0500B   $M3YNANS                      Pain Asmt Int: Pain Effect Act           
                          4,134                          Missing                                 
                             87        -                 Not assessed/no information             
                            678        0                 No                                      
                            196        1                 Yes                                     
                             18        9                 Unable to answer                        
 
J0600A                                 Pain Intensity Numeric Rating Scale Num  
                          4,465                          Missing                                 
                            648        Range of values   Range of values                         
 
J0600B   $M32PAIN                      Pain Intensity Verbal Descr Scale Num    
                          4,684                          Missing                                 
                             87        -                 Not assessed/no information             
                            163        1                 Mild                                    
                            156        2                 Moderate                                
                             12        3                 Severe                                  
                             11        9                 Unable to answer                        
 
J0700    $M3YESNO                      Staff Cond Pain Asmt                     
                          4,301                          Missing                                 
                            799        0                 No                                      
                             13        1                 Yes                                     
 
J0800A   $M3INDIC                      SA for Pain: Nonverbal Sound             
                          4,644                          Missing                                 
                            438        0                 Not indicated                           
                             31        1                 Indicated                               
 
J0800B   $M3INDIC                      SA for Pain: Vocal Complaint             
                          4,644                          Missing                                 
                            443        0                 Not indicated                           
                             26        1                 Indicated                               
 
J0800C   $M3INDIC                      SA for Pain: Facial Expression           
                          4,644                          Missing                                 
                            426        0                 Not indicated                           
                             43        1                 Indicated                               
 
J0800D   $M3INDIC                      SA for Pain: Protective Movement         
                          4,644                          Missing                                 
                            451        0                 Not indicated                           
                             18        1                 Indicated                               
 
J0800Z   $M3INDIC                      SA for Pain: None Above Signs of Pain    
                          4,644                          Missing                                 
                             77        0                 Not indicated                           
                            392        1                 Indicated                               
 
J0850    $M3PAINI                      SA for Pain: Nonverbal Sound             
                          5,036                          Missing                                 
                              2        -                 Not assessed/no information             
                             43        1                 Indicators of pain 1-2 days             
                             24        2                 Indicators of pain 3-4 days             
                              8        3                 Indicators of pain daily                
 
J1100A   $M3INDIC                      Shortness of Breath W Exertion           
                          1,269                          Missing                                 
                              2        -                 Not assessed/no information             
                          3,483        0                 Not indicated                           
                            359        1                 Indicated                               
 
J1100B   $M3INDIC                      Shortness of Breath When Sitting         
                          1,269                          Missing                                 
                              2        -                 Not assessed/no information             
                          3,681        0                 Not indicated                           
                            161        1                 Indicated                               
 
J1100C   $M3INDIC                      Shortness of Breath When Lying Flat      
                          1,236                          Missing                                 
                              2        -                 Not assessed/no information             
                          3,425        0                 Not indicated                           
                            450        1                 Indicated                               
 
J1100Z   $M3INDIC                      None of Above Shortness of Breath        
                          1,236                          Missing                                 
                              1        -                 Not assessed/no information             
                            624        0                 Not indicated                           
                          3,252        1                 Indicated                               
 
J1300    $M3YESNO                      Tobacco Use                              
                          3,968                          Missing                                 
                              1        -                 Not assessed/no information             
                          1,108        0                 No                                      
                             36        1                 Yes                                     
 
J1400    $M3YESNO                      Life Prognosis Less Than Six Mons        
                          1,269                          Missing                                 
                              4        -                 Not assessed/no information             
                          3,651        0                 No                                      
                            189        1                 Yes                                     
 
J1550A   $M3INDIC                      Prob Conds: Fever                        
                          1,236                          Missing                                 
                          3,753        0                 Not indicated                           
                            124        1                 Indicated                               
 
J1550B   $M3INDIC                      Prob Conds: Vomiting                     
                          1,236                          Missing                                 
                          3,825        0                 Not indicated                           
                             52        1                 Indicated                               
 
J1550C   $M3INDIC                      Prob Conds: Dehydration                  
                          1,265                          Missing                                 
                          3,836        0                 Not indicated                           
                             12        1                 Indicated                               
 
J1550D   $M3INDIC                      Prob Conds: Internal Bleeding            
                          1,265                          Missing                                 
                          3,842        0                 Not indicated                           
                              6        1                 Indicated                               
 
J1550Z   $M3INDIC                      Prob Conds: None of Above                
                          1,236                          Missing                                 
                            178        0                 Not indicated                           
                          3,699        1                 Indicated                               
 
J1700A   $M3YNDET                      Fall History on Admsn: Fall 30 Day       
                          4,334                          Missing                                 
                              2        -                 Not assessed/no information             
                            452        0                 No                                      
                            294        1                 Yes                                     
                             31        9                 Unable to determine                     
 
J1700B   $M3YNDET                      Fall History on Admsn: Fall 31-180 Day   
                          4,334                          Missing                                 
                              4        -                 Not assessed/no information             
                            512        0                 No                                      
                            185        1                 Yes                                     
                             78        9                 Unable to determine                     
 
J1700C   $M3YNDET                      Fall History on Admsn: Fall Six Mon      
                          4,334                          Missing                                 
                              2        -                 Not assessed/no information             
                            608        0                 No                                      
                            139        1                 Yes                                     
                             30        9                 Unable to determine                     
 
J1800    $M3YESNO                      Falls Since Admsn or Prior Asmt          
                          1,019                          Missing                                 
                          3,472        0                 No                                      
                            622        1                 Yes                                     
 
J1900A   $M3FALLS                      Falls Since Adm/Prior Asmt W No Inj      
                          4,491                          Missing                                 
                            131        0                 None                                    
                            355        1                 One                                     
                            136        2                 Two or more                             
 
J1900B   $M3FALLS                      Falls Since Adm/Prior Asmt W Inj Ex Maj  
                          4,491                          Missing                                 
                            423        0                 None                                    
                            159        1                 One                                     
                             40        2                 Two or more                             
 
J1900C   $M3FALLS                      Falls Since Adm/Prior Asmt W Maj Inj     
                          4,491                          Missing                                 
                            594        0                 None                                    
                             28        1                 One                                     
 
K0100A   $M3INDIC                      Swall Disorder: Loss Mouth Eating        
                          2,008                          Missing                                 
                              5        -                 Not assessed/no information             
                          3,029        0                 Not indicated                           
                             71        1                 Indicated                               
 
K0100B   $M3INDIC                      Swall Disorder: Hold Food Mouth          
                          2,008                          Missing                                 
                              5        -                 Not assessed/no information             
                          2,990        0                 Not indicated                           
                            110        1                 Indicated                               
 
K0100C   $M3INDIC                      Swall Disorder: Choke Drinking Meal      
                          2,008                          Missing                                 
                              5        -                 Not assessed/no information             
                          2,952        0                 Not indicated                           
                            148        1                 Indicated                               
 
K0100D   $M3INDIC                      Swall Disorder: Complaint Swall          
                          2,008                          Missing                                 
                              5        -                 Not assessed/no information             
                          2,976        0                 Not indicated                           
                            124        1                 Indicated                               
 
K0100Z   $M3INDIC                      Swall Disorder: None of Above            
                          2,008                          Missing                                 
                              5        -                 Not assessed/no information             
                            302        0                 Not indicated                           
                          2,798        1                 Indicated                               
 
K0200A                                 Height Num                               
                          1,269                          Missing                                 
                          3,844        Range of values   Range of values                         
 
K0200B                                 Weight Num                               
                          1,269                          Missing                                 
                          3,844        Range of values   Range of values                         
 
K0300    $M3WGHT                       Weight Loss                              
                          1,236                          Missing                                 
                              9        -                 Not assessed/no information             
                          3,511        0                 No or unknown                           
                             56        1                 Yes, on physician-prescribed regimen    
                            301        2                 Yes, not on physician-prescribed regimen
 
K0310    $M3WGHT                       Weight Gain                              
                          1,269                          Missing                                 
                             11        -                 Not assessed/no information             
                          3,681        0                 No or unknown                           
                             43        1                 Yes, on physician-prescribed regimen    
                            109        2                 Yes, not on physician-prescribed regimen
 
K0510A1  $M3INDIC                      Nutr App: Prior Par/IV Feeding           
                          4,663                          Missing                                 
                              4        -                 Not assessed/no information             
                            351        0                 Not indicated                           
                             95        1                 Indicated                               
 
K0510A2  $M3INDIC                      Nutr App: Post Par/IV Feeding            
                          1,236                          Missing                                 
                              2        -                 Not assessed/no information             
                          3,792        0                 Not indicated                           
                             83        1                 Indicated                               
 
K0510B1  $M3INDIC                      Nutr App: Prior Feeding Tube             
                          4,663                          Missing                                 
                              5        -                 Not assessed/no information             
                            431        0                 Not indicated                           
                             14        1                 Indicated                               
 
K0510B2  $M3INDIC                      Nutr App: Post Feeding Tube              
                          1,236                          Missing                                 
                              2        -                 Not assessed/no information             
                          3,730        0                 Not indicated                           
                            145        1                 Indicated                               
 
K0510C2  $M3INDIC                      Nutr App: Post Mech Alt Diet             
                          1,584                          Missing                                 
                          2,271        0                 Not indicated                           
                          1,258        1                 Indicated                               
 
K0510D2  $M3INDIC                      Nutr App: Post Ther Diet                 
                          1,613                          Missing                                 
                              1        -                 Not assessed/no information             
                          1,864        0                 Not indicated                           
                          1,635        1                 Indicated                               
 
K0510Z1  $M3INDIC                      Nutr App: Prior None of Above            
                          4,690                          Missing                                 
                              3        -                 Not assessed/no information             
                            106        0                 Not indicated                           
                            314        1                 Indicated                               
 
K0510Z2  $M3INDIC                      Nutr App: Post None of Above             
                          1,580                          Missing                                 
                          2,446        0                 Not indicated                           
                          1,087        1                 Indicated                               
 
L0200A   $M3INDIC                      Dental Stat: Broken Denture              
                          2,037                          Missing                                 
                             21        -                 Not assessed/no information             
                          3,028        0                 Not indicated                           
                             27        1                 Indicated                               
 
L0200B   $M3INDIC                      Dental Stat: No Teeth                    
                          3,968                          Missing                                 
                              2        -                 Not assessed/no information             
                            947        0                 Not indicated                           
                            196        1                 Indicated                               
 
L0200C   $M3INDIC                      Dental Stat: Abnormal Mouth Tiss         
                          3,968                          Missing                                 
                              2        -                 Not assessed/no information             
                          1,139        0                 Not indicated                           
                              4        1                 Indicated                               
 
L0200D   $M3INDIC                      Dental Stat: Cavity                      
                          3,968                          Missing                                 
                              1        -                 Not assessed/no information             
                          1,065        0                 Not indicated                           
                             79        1                 Indicated                               
 
L0200E   $M3INDIC                      Dental Stat: Inflamed Gum                
                          3,968                          Missing                                 
                              1        -                 Not assessed/no information             
                          1,142        0                 Not indicated                           
                              2        1                 Indicated                               
 
L0200F   $M3INDIC                      Dental Stat: Mouth or Facial Pain        
                          2,037                          Missing                                 
                             21        -                 Not assessed/no information             
                          3,025        0                 Not indicated                           
                             30        1                 Indicated                               
 
L0200G   $M3INDIC                      Dental Stat: Unable to Examine           
                          3,968                          Missing                                 
                          1,129        0                 Not indicated                           
                             16        1                 Indicated                               
 
L0200Z   $M3INDIC                      Dental Stat: None of Above               
                          3,968                          Missing                                 
                              1        -                 Not assessed/no information             
                            303        0                 Not indicated                           
                            841        1                 Indicated                               
 
M0100A   $M3INDIC                      Det of Press Ulcr Risk: Ulcr Visible     
                          1,269                          Missing                                 
                              6        -                 Not assessed/no information             
                          3,514        0                 Not indicated                           
                            324        1                 Indicated                               
 
M0100B   $M3INDIC                      Det of Press Ulcr Risk: Frml Asmt/Instr  
                          2,037                          Missing                                 
                            569        0                 Not indicated                           
                          2,507        1                 Indicated                               
 
M0100C   $M3INDIC                      Det of Press Ulcr Risk: Clinical Asmt    
                          2,037                          Missing                                 
                            195        0                 Not indicated                           
                          2,881        1                 Indicated                               
 
M0100Z   $M3INDIC                      Det of Press Ulcr Risk: None of Above    
                          2,037                          Missing                                 
                          3,024        0                 Not indicated                           
                             52        1                 Indicated                               
 
M0150    $M3YESNO                      Press Ulcr Risk                          
                          2,037                          Missing                                 
                              1        -                 Not assessed/no information             
                            382        0                 No                                      
                          2,693        1                 Yes                                     
 
M0210    $M3YESNO                      One or More S1 or Higher UPU             
                            986                          Missing                                 
                          3,822        0                 No                                      
                            305        1                 Yes                                     
 
M0300A                                 Stage 1 Press Ulcr Num                   
                          4,904                          Missing                                 
                            209        Range of values   Range of values                         
 
M0300B1                                Stage 2 Press Ulcr Num                   
                          4,808                          Missing                                 
                            305        Range of values   Range of values                         
 
M0300B2                                Stage 2 Press Ulcr Present on Admsn Num  
                          5,005                          Missing                                 
                            108        Range of values   Range of values                         
 
M0300C1                                Stage 3 Press Ulcr Num                   
                          4,808                          Missing                                 
                            305        Range of values   Range of values                         
 
M0300C2                                Stage 3 Press Ulcr Present on Admsn Num  
                          5,052                          Missing                                 
                             61        Range of values   Range of values                         
 
M0300D1                                Stage 4 Press Ulcr Num                   
                          4,808                          Missing                                 
                            305        Range of values   Range of values                         
 
M0300D2                                Stage 4 Press Ulcr Present on Admsn Num  
                          5,082                          Missing                                 
                             31        Range of values   Range of values                         
 
M0300E1                                UPU Due To Drsng Num                     
                          4,809                          Missing                                 
                            304        Range of values   Range of values                         
 
M0300F1                                UPU W Slough or Eschar Num               
                          4,808                          Missing                                 
                            305        Range of values   Range of values                         
 
M0300F2                                UPU W Slough or Eschar on Admsn Num      
                          5,033                          Missing                                 
                             80        Range of values   Range of values                         
 
M0300G1                                UPU W Deep Tiss Inj Num                  
                          4,809                          Missing                                 
                            304        Range of values   Range of values                         
 
M0300G2                                UPU W Deep Tiss Inj on Admsn Num         
                          5,040                          Missing                                 
                             73        Range of values   Range of values                         
 
M1030                                  Venous and Arterial Ulcr Num             
                          2,004                          Missing                                 
                          3,109        Range of values   Range of values                         
 
M1040A   $M3INDIC                      Oth Foot Skin Probs: Foot Infn           
                          2,004                          Missing                                 
                          3,097        0                 Not indicated                           
                             12        1                 Indicated                               
 
M1040B   $M3INDIC                      Oth Foot Skin Probs: Diab Foot Ulcr      
                          2,004                          Missing                                 
                          3,079        0                 Not indicated                           
                             30        1                 Indicated                               
 
M1040C   $M3INDIC                      Oth Foot Skin Probs: Oth Open Les Foot   
                          2,004                          Missing                                 
                          3,103        0                 Not indicated                           
                              6        1                 Indicated                               
 
M1040D   $M3INDIC                      O/S/P: Oth Than Ulcrs, Rashes, Cuts      
                          2,004                          Missing                                 
                          3,073        0                 Not indicated                           
                             36        1                 Indicated                               
 
M1040E   $M3INDIC                      O/S/P: Surgical Wound(s)                 
                          2,004                          Missing                                 
                          2,938        0                 Not indicated                           
                            171        1                 Indicated                               
 
M1040F   $M3INDIC                      O/S/P: Burn(s)                           
                          2,004                          Missing                                 
                          3,109        0                 Not indicated                           
 
M1040G   $M3INDIC                      O/S/P: Skin Tear(s)                      
                          2,037                          Missing                                 
                              1        -                 Not assessed/no information             
                          2,932        0                 Not indicated                           
                            143        1                 Indicated                               
 
M1040H   $M3INDIC                      O/S/P: Moisture Assoc Skin Dmge          
                          2,037                          Missing                                 
                          2,882        0                 Not indicated                           
                            194        1                 Indicated                               
 
M1040Z   $M3INDIC                      O/S/P: None of Above                     
                          2,004                          Missing                                 
                              1        -                 Not assessed/no information             
                            526        0                 Not indicated                           
                          2,582        1                 Indicated                               
 
M1200A   $M3INDIC                      S/U Trtmts: Press Reducng Device in Chr  
                          2,004                          Missing                                 
                              5        -                 Not assessed/no information             
                          1,074        0                 Not indicated                           
                          2,030        1                 Indicated                               
 
M1200B   $M3INDIC                      S/U Trtmts: Press Reducng Device in Bed  
                          2,004                          Missing                                 
                            478        0                 Not indicated                           
                          2,631        1                 Indicated                               
 
M1200C   $M3INDIC                      S/U Trtmts: Turning/RePosing Prog        
                          2,004                          Missing                                 
                          2,643        0                 Not indicated                           
                            466        1                 Indicated                               
 
M1200D   $M3INDIC                      S/U Trtmts: Nutrition/Hydration          
                          2,004                          Missing                                 
                          2,669        0                 Not indicated                           
                            440        1                 Indicated                               
 
M1200E   $M3INDIC                      S/U Trtmts: Ulcr Care                    
                          2,004                          Missing                                 
                              1        -                 Not assessed/no information             
                          2,912        0                 Not indicated                           
                            196        1                 Indicated                               
 
M1200F   $M3INDIC                      S/U Trtmts: Surgical Wound Care          
                          2,004                          Missing                                 
                          2,962        0                 Not indicated                           
                            147        1                 Indicated                               
 
M1200G   $M3INDIC                      S/U Trtmts: App Nonsurgical Drsng        
                          2,004                          Missing                                 
                              1        -                 Not assessed/no information             
                          2,699        0                 Not indicated                           
                            409        1                 Indicated                               
 
M1200H   $M3INDIC                      S/U Trtmts: App Ointments/Meds           
                          2,004                          Missing                                 
                          1,597        0                 Not indicated                           
                          1,512        1                 Indicated                               
 
M1200I   $M3INDIC                      S/U Trtmts: App Drsngs to Foot           
                          2,004                          Missing                                 
                          2,953        0                 Not indicated                           
                            156        1                 Indicated                               
 
M1200Z   $M3INDIC                      S/U Trtmts: None of Above                
                          2,004                          Missing                                 
                          2,902        0                 Not indicated                           
                            207        1                 Indicated                               
 
N0300                                  Num of Days Injections of Any Type       
                          2,033                          Missing                                 
                          3,080        Range of values   Range of values                         
 
N0350A                                 Num of Days Insulin Injections           
                          4,264                          Missing                                 
                            849        Range of values   Range of values                         
 
N0350B                                 Num of Days Insulin Orders Changed       
                          4,264                          Missing                                 
                            849        Range of values   Range of values                         
 
N0410A                                 Meds Rcd: Antipsychotic Num Days         
                          1,269                          Missing                                 
                          3,844        Range of values   Range of values                         
 
N0410B                                 Meds Rcd: Antianxiety Num Days           
                          1,269                          Missing                                 
                          3,844        Range of values   Range of values                         
 
N0410C                                 Meds Rcd: Antidepressant Num Days        
                          1,269                          Missing                                 
                          3,844        Range of values   Range of values                         
 
N0410D                                 Meds Rcd: Hypnotic Num Days              
                          1,269                          Missing                                 
                          3,844        Range of values   Range of values                         
 
N0410E                                 Meds Rcd: Anticoagulant Num Days         
                          1,269                          Missing                                 
                          3,844        Range of values   Range of values                         
 
N0410F                                 Meds Rcd: Antibiotic Num Days            
                          1,269                          Missing                                 
                          3,844        Range of values   Range of values                         
 
N0410G                                 Meds Rcd: Diuretic Num Days              
                          1,269                          Missing                                 
                          3,844        Range of values   Range of values                         
 
O0100A1  $M3INDIC                      Spcl T/P: ChemOthapy Pre-admit           
                          4,376                          Missing                                 
                            733        0                 Not indicated                           
                              4        1                 Indicated                               
 
O0100A2  $M3INDIC                      Spcl T/P: ChemOthapy Post-admit          
                          2,004                          Missing                                 
                              9        -                 Not assessed/no information             
                          3,088        0                 Not indicated                           
                             12        1                 Indicated                               
 
O0100B1  $M3INDIC                      Spcl T/P: Radiation Pre-admit            
                          4,376                          Missing                                 
                            735        0                 Not indicated                           
                              2        1                 Indicated                               
 
O0100B2  $M3INDIC                      Spcl T/P: Radiation Post-admit           
                          2,004                          Missing                                 
                              9        -                 Not assessed/no information             
                          3,098        0                 Not indicated                           
                              2        1                 Indicated                               
 
O0100C1  $M3INDIC                      Spcl T/P: Oxygen Pre-admit               
                          4,376                          Missing                                 
                              1        -                 Not assessed/no information             
                            524        0                 Not indicated                           
                            212        1                 Indicated                               
 
O0100C2  $M3INDIC                      Spcl T/P: Oxygen Post-admit              
                          2,004                          Missing                                 
                              9        -                 Not assessed/no information             
                          2,631        0                 Not indicated                           
                            469        1                 Indicated                               
 
O0100D1  $M3INDIC                      Spcl T/P: Suctioning Pre-admit           
                          4,376                          Missing                                 
                            728        0                 Not indicated                           
                              9        1                 Indicated                               
 
O0100D2  $M3INDIC                      Spcl T/P: Suctioning Post-admit          
                          2,004                          Missing                                 
                              9        -                 Not assessed/no information             
                          3,079        0                 Not indicated                           
                             21        1                 Indicated                               
 
O0100E1  $M3INDIC                      Spcl T/P: Tracheostomy Pre-admit         
                          4,376                          Missing                                 
                            728        0                 Not indicated                           
                              9        1                 Indicated                               
 
O0100E2  $M3INDIC                      Spcl T/P: Tracheostomy Post-admit        
                          2,004                          Missing                                 
                              9        -                 Not assessed/no information             
                          3,076        0                 Not indicated                           
                             24        1                 Indicated                               
 
O0100F1  $M3INDIC                      Spcl T/P: Ventilator Pre-admit           
                          4,376                          Missing                                 
                            725        0                 Not indicated                           
                             12        1                 Indicated                               
 
O0100F2  $M3INDIC                      Spcl T/P: Ventilator Post-admit          
                          2,004                          Missing                                 
                              9        -                 Not assessed/no information             
                          3,087        0                 Not indicated                           
                             13        1                 Indicated                               
 
O0100G1  $M3INDIC                      Spcl T/P: Cont Pos Arwy Press Pre-A      
                          4,577                          Missing                                 
                            521        0                 Not indicated                           
                             15        1                 Indicated                               
 
O0100G2  $M3INDIC                      Spcl T/P: Cont Pos Arwy Press Post-A     
                          3,968                          Missing                                 
                              3        -                 Not assessed/no information             
                          1,117        0                 Not indicated                           
                             25        1                 Indicated                               
 
O0100H1  $M3INDIC                      Spcl T/P: Intravenous Med Pre-admit      
                          4,376                          Missing                                 
                            341        0                 Not indicated                           
                            396        1                 Indicated                               
 
O0100H2  $M3INDIC                      Spcl T/P: Intravenous Med Post-admit     
                          2,004                          Missing                                 
                              9        -                 Not assessed/no information             
                          2,987        0                 Not indicated                           
                            113        1                 Indicated                               
 
O0100I1  $M3INDIC                      Spcl T/P: Transfusion Pre-admit          
                          4,376                          Missing                                 
                            713        0                 Not indicated                           
                             24        1                 Indicated                               
 
O0100I2  $M3INDIC                      Spcl T/P: Transfusion Post-admit         
                          2,004                          Missing                                 
                              9        -                 Not assessed/no information             
                          3,092        0                 Not indicated                           
                              8        1                 Indicated                               
 
O0100J1  $M3INDIC                      Spcl T/P: Dialysis Pre-admit             
                          4,376                          Missing                                 
                            708        0                 Not indicated                           
                             29        1                 Indicated                               
 
O0100J2  $M3INDIC                      Spcl T/P: Dialysis Post-admit            
                          2,004                          Missing                                 
                              9        -                 Not assessed/no information             
                          3,037        0                 Not indicated                           
                             63        1                 Indicated                               
 
O0100K1  $M3INDIC                      Spcl T/P: Hospice Pre-admit              
                          4,577                          Missing                                 
                            528        0                 Not indicated                           
                              8        1                 Indicated                               
 
O0100K2  $M3INDIC                      Spcl T/P: Hospice Post-admit             
                          1,269                          Missing                                 
                             16        -                 Not assessed/no information             
                          3,612        0                 Not indicated                           
                            216        1                 Indicated                               
 
O0100M1  $M3INDIC                      Spcl T/P: Isolation Pre-admit            
                          4,577                          Missing                                 
                              1        -                 Not assessed/no information             
                            523        0                 Not indicated                           
                             12        1                 Indicated                               
 
O0100M2  $M3INDIC                      Spcl T/P: Isolation Post-admit           
                          2,004                          Missing                                 
                              9        -                 Not assessed/no information             
                          2,943        0                 Not indicated                           
                            157        1                 Indicated                               
 
O0100Z1  $M3INDIC                      Spcl T/P: None Above Pre-A Trtmt Prior   
                          4,576                          Missing                                 
                            336        0                 Not indicated                           
                            201        1                 Indicated                               
 
O0100Z2  $M3INDIC                      Spcl T/P: None Above Trtmt Post-admit    
                          3,935                          Missing                                 
                              3        -                 Not assessed/no information             
                            378        0                 Not indicated                           
                            797        1                 Indicated                               
 
O0250A   $M3YESNO                      Influenza Rcd                            
                          1,269                          Missing                                 
                             28        -                 Not assessed/no information             
                          1,617        0                 No                                      
                          2,199        1                 Yes                                     
 
O0250B   MMDDYYn8                      Influenza Rcd Date                       
                          2,914                       .  Inapplicable                            
                          2,199        MMDDYYYY          Date as MMDDYYYY                        
 
O0250C   $M3FLRSN                      Rsn Influenza Not Rcd                    
                          3,468                          Missing                                 
                             39        -                 Not assessed/no information             
                            180        1                 Resident not in facility                
                            692        2                 Received outside the facility           
                             26        3                 Not eligible                            
                            500        4                 Offered and declined                    
                             91        5                 Not offered                             
                             10        6                 Inability to obtain vaccine             
                            107        9                 None of the above                       
 
O0300A   $M3YESNO                      Pneumococcal Vaccination                 
                          1,269                          Missing                                 
                             46        -                 Not assessed/no information             
                          1,063        0                 No                                      
                          2,735        1                 Yes                                     
 
O0300B   $M3PNRSN                      Rsn Pneumococcal Vaccination Not Rcd     
                          4,004                          Missing                                 
                             86        -                 Not assessed/no information             
                             39        1                 Not eligible                            
                            778        2                 Offered and declined                    
                            206        3                 Not offered                             
 
O0400A1                                Speech Ther/Aud Individual Minutes Num   
                          2,033                          Missing                                 
                          3,080        Range of values   Range of values                         
 
O0400A2                                Speech Ther/Aud ConCur Minutes Num       
                          2,033                          Missing                                 
                          3,080        Range of values   Range of values                         
 
O0400A3                                Speech Ther/Aud Group Minutes Num        
                          2,033                          Missing                                 
                          3,080        Range of values   Range of values                         
 
O0400A4                                Num of Days Speech Ther/Aud Admin        
                          4,616                          Missing                                 
                            497        Range of values   Range of values                         
 
O0400A5  MMDDYYn8                      Speech Ther/Audiology Start Date         
                          3,604                       .  Inapplicable                            
                          1,509        MMDDYYYY          Date as MMDDYYYY                        
 
O0400A6  MMDDYYn8                      Speech Ther/Audiology End Date           
                          4,078                       .  Inapplicable                            
                          1,035        MMDDYYYY          Date as MMDDYYYY                        
 
O0400B1                                Occupational Ther Individual Minutes Num 
                          2,033                          Missing                                 
                          3,080        Range of values   Range of values                         
 
O0400B2                                Occupational Ther ConCur Minutes Num     
                          2,033                          Missing                                 
                          3,080        Range of values   Range of values                         
 
O0400B3                                Occupational Ther Group Minutes Num      
                          2,033                          Missing                                 
                          3,080        Range of values   Range of values                         
 
O0400B4                                Num of Days Occ Ther Administered        
                          4,040                          Missing                                 
                          1,073        Range of values   Range of values                         
 
O0400B5  MMDDYYn8                      Occupational Ther Start Date             
                          2,577                       .  Inapplicable                            
                          2,536        MMDDYYYY          Date as MMDDYYYY                        
 
O0400B6  MMDDYYn8                      Occupational Ther End Date               
                          3,639                       .  Inapplicable                            
                          1,474        MMDDYYYY          Date as MMDDYYYY                        
 
O0400C1                                Phys Ther Individual Minutes Num         
                          2,033                          Missing                                 
                          3,080        Range of values   Range of values                         
 
O0400C2                                Phys Ther ConCur Minutes Num             
                          2,033                          Missing                                 
                          3,080        Range of values   Range of values                         
 
O0400C3                                Phys Ther Group Minutes Num              
                          2,033                          Missing                                 
                          3,080        Range of values   Range of values                         
 
O0400C4                                Num of Days Phys Ther Administered       
                          3,986                          Missing                                 
                          1,127        Range of values   Range of values                         
 
O0400C5  MMDDYYn8                      Phys Ther Start Date                     
                          2,514                       .  Inapplicable                            
                          2,599        MMDDYYYY          Date as MMDDYYYY                        
 
O0400C6  MMDDYYn8                      Phys Ther End Date                       
                          3,609                       .  Inapplicable                            
                          1,504        MMDDYYYY          Date as MMDDYYYY                        
 
O0400D1                                Resp Ther Minutes Num                    
                          3,968                          Missing                                 
                          1,145        Range of values   Range of values                         
 
O0400D2                                Num of Days Resp Ther Administered       
                          3,130                          Missing                                 
                          1,983        Range of values   Range of values                         
 
O0400E1                                Psych Ther Minutes Num                   
                          3,968                          Missing                                 
                          1,145        Range of values   Range of values                         
 
O0400E2                                Num of Days Psych Ther Administered      
                          3,194                          Missing                                 
                          1,919        Range of values   Range of values                         
 
O0400F1                                Rec Ther Minutes Num                     
                          3,968                          Missing                                 
                          1,145        Range of values   Range of values                         
 
O0400F2                                Num of Days Rec Ther Administered        
                          5,109                          Missing                                 
                              4        Range of values   Range of values                         
 
O0450A   $M3YESNO                      Has Ther Resumed                         
                          5,109                          Missing                                 
                              4        0                 No                                      
 
O0500A                                 Rest Nrs: Passive Range of Mtn Num       
                          2,004                          Missing                                 
                          3,109        Range of values   Range of values                         
 
O0500B                                 Rest Nrs: Actv Range of Mtn Num          
                          2,004                          Missing                                 
                          3,109        Range of values   Range of values                         
 
O0500C                                 Rest Nrs: Splint/Brace Ass Num           
                          2,004                          Missing                                 
                          3,109        Range of values   Range of values                         
 
O0500D                                 Rest Nrs: Bed Mob Training Num           
                          2,004                          Missing                                 
                          3,109        Range of values   Range of values                         
 
O0500E                                 Rest Nrs: Trans Training Num             
                          2,004                          Missing                                 
                          3,109        Range of values   Range of values                         
 
O0500F                                 Rest Nrs: Wlking Training Num            
                          2,004                          Missing                                 
                          3,109        Range of values   Range of values                         
 
O0500G                                 Rest Nrs: Drsng/Grooming Training Num    
                          2,004                          Missing                                 
                          3,109        Range of values   Range of values                         
 
O0500H                                 Rest Nrs: Eating/Swall Training Num      
                          2,004                          Missing                                 
                          3,109        Range of values   Range of values                         
 
O0500I                                 Rest Nrs: Amp/Prosthes Care Training Num 
                          2,004                          Missing                                 
                          3,109        Range of values   Range of values                         
 
O0500J                                 Rest Nrs: Communication Training Num     
                          2,004                          Missing                                 
                          3,109        Range of values   Range of values                         
 
O0600                                  Physician Exam Day Num                   
                          2,033                          Missing                                 
                          3,080        Range of values   Range of values                         
 
O0700                                  Physician Order Day Num                  
                          2,033                          Missing                                 
                          3,080        Range of values   Range of values                         
 
P0100A   $M3USED                       Phys Rstrnts in Bed: Bed Rail            
                          1,269                          Missing                                 
                          3,831        0                 Not used                                
                              1        1                 Used less than daily                    
                             12        2                 Used daily                              
 
P0100B   $M3USED                       Phys Rstrnts in Bed: Trunk Rstrnt Bed    
                          1,269                          Missing                                 
                          3,842        0                 Not used                                
                              2        2                 Used daily                              
 
P0100C   $M3USED                       Phys Rstrnts in Bed: Limb Rstrnt Bed     
                          1,269                          Missing                                 
                          3,843        0                 Not used                                
                              1        1                 Used less than daily                    
 
P0100D   $M3USED                       Phys Rstrnts in Bed: Oth Rstrnt Bed      
                          1,269                          Missing                                 
                          3,838        0                 Not used                                
                              3        1                 Used less than daily                    
                              3        2                 Used daily                              
 
P0100E   $M3USED                       Phys Rstrnts Chair: Trunk Rstrnt Chair   
                          1,269                          Missing                                 
                          3,843        0                 Not used                                
                              1        2                 Used daily                              
 
P0100F   $M3USED                       Phys Rstrnts Chair: Limb Rstrnt Chair    
                          1,269                          Missing                                 
                          3,842        0                 Not used                                
                              2        1                 Used less than daily                    
 
P0100G   $M3USED                       Phys Rstrnts Chair: Chair Prevent Rise   
                          1,269                          Missing                                 
                          3,844        0                 Not used                                
 
P0100H   $M3USED                       Phys Rstrnts Chair: Oth Rstrnt Chair     
                          1,269                          Missing                                 
                          3,841        0                 Not used                                
                              3        1                 Used less than daily                    
 
Q0100A   $M3YESNO                      Res Part in Asmt                         
                          2,037                          Missing                                 
                             12        -                 Not assessed/no information             
                            476        0                 No                                      
                          2,588        1                 Yes                                     
 
Q0100B   $M3FAMPR                      Fam Part in Asmt                         
                          2,037                          Missing                                 
                             11        -                 Not assessed/no information             
                          2,110        0                 No                                      
                            940        1                 Yes                                     
                             15        9                 No family or significant other available
 
Q0100C   $M3GUAPR                      Guardian Part in Asmt                    
                          2,037                          Missing                                 
                             12        -                 Not assessed/no information             
                          2,261        0                 No                                      
                            270        1                 Yes                                     
                            533        9                 No guardian or legally auth rep availabl
 
Q0300A   $M3OGOAL                      Res Overall Goal                         
                          4,354                          Missing                                 
                              7        -                 Not assessed/no information             
                            443        1                 Discharged to the community             
                            262        2                 Remain in this facility                 
                             27        3                 Discharged to another facility          
                             20        9                 Unknown or uncertain                    
 
Q0300B   $M3SOURC                      Overall Goal Source                      
                          4,354                          Missing                                 
                              7        -                 Not assessed/no information             
                            538        1                 Resident                                
                            180        2                 Family or sig other                     
                             26        3                 Guardian or legally auth rep            
                              8        9                 Unknown or uncertain                    
 
Q0400A   $M3YESNO                      Dis Plan                                 
                          1,269                          Missing                                 
                             26        -                 Not assessed/no information             
                          2,818        0                 No                                      
                          1,000        1                 Yes                                     
 
Q0490    $M3NOINF                      Ress Pref Answering Q0500B               
                          3,256                          Missing                                 
                             11        -                 Not assessed/no information             
                            986        0                 No                                      
                            860        1                 Yes                                     
 
Q0500B   $M3WNTLK                      Staff Asked Res or Fam Abt Rtn To Comm   
                          3,435                          Missing                                 
                             17        -                 Not assessed/no information             
                          1,578        0                 No                                      
                             35        1                 Yes                                     
                             48        9                 Unknown or uncertain                    
 
Q0550A   $M3NOINF                      Pref In Answering Q0550B                 
                          3,435                          Missing                                 
                             18        -                 Not assessed/no information             
                          1,476        0                 No                                      
                            137        1                 Yes                                     
                             47        8                 Information not available               
 
Q0550B   $M3SOURC                      Source Answering Q0550A                  
                          3,435                          Missing                                 
                             18        -                 Not assessed/no information             
                            831        1                 Resident                                
                            630        2                 Family or sig other                     
                            126        3                 Guardian or legally auth rep            
                             73        9                 Unknown or uncertain                    
 
Q0600    $M3REFER                      Local Contact Agency Referral            
                          1,269                          Missing                                 
                             27        -                 Not assessed/no information             
                          3,595        0                 No - referral not needed                
                             91        1                 No - referral may be needed             
                            131        2                 Yes                                     
 
V0100A   $M3CASS                       Prior Asmt Federal OBRA Rsn for Asmt     
                          4,573                                                                  
                              8        01                5 day sched assessment                  
                            445        02                14 day sched assessment                 
                             11        03                30 day sched assessment                 
                             15        04                60 day sched assessment                 
                             61        99                None of above                           
 
V0100B   $M3CASS                       Prior Asmt PPS Rsn for Asmt              
                          4,574                                                                  
                             77        01                5 day sched assessment                  
                            462        99                None of above                           
 
V0100C   MMDDYYn8                      Prior Asmt Ref Date                      
                          4,573                       .  Inapplicable                            
                            540        MMDDYYYY          Date as MMDDYYYY                        
 
V0100D                                 Prior Asmt (BIMS) Summary Score Num      
                          4,646                          Missing                                 
                            467        Range of values   Range of values                         
 
V0100E                                 Prior Asmt  (PHQ-9) Tot Svrty Score Num  
                          4,654                          Missing                                 
                            459        Range of values   Range of values                         
 
V0100F                                 Prior Asmt  (PHQ-9) Tot Svrty Score Num  
                          4,981                          Missing                                 
                            132        Range of values   Range of values                         
 
V200A01A $M3INDIC                      Dlrm Care Area Trigger                   
                          4,056                          Missing                                 
                            981        0                 Not indicated                           
                             76        1                 Indicated                               
 
V200A01B $M3INDIC                      Dlrm Adrsd in Care Plan                  
                          4,056                          Missing                                 
                            579        -                 Not assessed/no information             
                            446        0                 Not indicated                           
                             32        1                 Indicated                               
 
V200A02A $M3INDIC                      Dementia Care Area Trigger               
                          4,056                          Missing                                 
                            383        0                 Not indicated                           
                            674        1                 Indicated                               
 
V200A02B $M3INDIC                      Dementia Adrsd in Care Plan              
                          4,056                          Missing                                 
                            238        -                 Not assessed/no information             
                            186        0                 Not indicated                           
                            633        1                 Indicated                               
 
V200A03A $M3INDIC                      Visual Func Care Area Trigger            
                          4,056                          Missing                                 
                            699        0                 Not indicated                           
                            358        1                 Indicated                               
 
V200A03B $M3INDIC                      Visual Func Adrsd in Care Plan           
                          4,056                          Missing                                 
                            435        -                 Not assessed/no information             
                            305        0                 Not indicated                           
                            317        1                 Indicated                               
 
V200A04A $M3INDIC                      Communication Care Area Trigger          
                          4,056                          Missing                                 
                            513        0                 Not indicated                           
                            544        1                 Indicated                               
 
V200A04B $M3INDIC                      Communication Adrsd in Care Plan         
                          4,056                          Missing                                 
                            318        -                 Not assessed/no information             
                            231        0                 Not indicated                           
                            508        1                 Indicated                               
 
V200A05A $M3INDIC                      ADL Care Area Trigger                    
                          4,056                          Missing                                 
                            292        0                 Not indicated                           
                            765        1                 Indicated                               
 
V200A05B $M3INDIC                      ADL Adrsd in Care Plan                   
                          4,056                          Missing                                 
                            163        -                 Not assessed/no information             
                            125        0                 Not indicated                           
                            769        1                 Indicated                               
 
V200A06A $M3INDIC                      Urny Care Area Trigger                   
                          4,056                          Missing                                 
                             71        0                 Not indicated                           
                            986        1                 Indicated                               
 
V200A06B $M3INDIC                      Urny Adrsd in Care Plan                  
                          4,056                          Missing                                 
                             53        -                 Not assessed/no information             
                             95        0                 Not indicated                           
                            909        1                 Indicated                               
 
V200A07A $M3INDIC                      Psychosocial Care Area Trigger           
                          4,056                          Missing                                 
                            830        0                 Not indicated                           
                            227        1                 Indicated                               
 
V200A07B $M3INDIC                      Psychosocial Adrsd in Care Plan          
                          4,056                          Missing                                 
                            482        -                 Not assessed/no information             
                            373        0                 Not indicated                           
                            202        1                 Indicated                               
 
V200A08A $M3INDIC                      Mood Care Area Trigger                   
                          4,056                          Missing                                 
                            862        0                 Not indicated                           
                            195        1                 Indicated                               
 
V200A08B $M3INDIC                      Mood Adrsd in Care Plan                  
                          4,056                          Missing                                 
                            492        -                 Not assessed/no information             
                            393        0                 Not indicated                           
                            172        1                 Indicated                               
 
V200A09A $M3INDIC                      Bhvral Care Area Trigger                 
                          4,056                          Missing                                 
                            897        0                 Not indicated                           
                            160        1                 Indicated                               
 
V200A09B $M3INDIC                      Bhvral Adrsd in Care Plan                
                          4,056                          Missing                                 
                            529        -                 Not assessed/no information             
                            376        0                 Not indicated                           
                            152        1                 Indicated                               
 
V200A10A $M3INDIC                      Act Care Area Trigger                    
                          4,056                          Missing                                 
                            865        0                 Not indicated                           
                            192        1                 Indicated                               
 
V200A10B $M3INDIC                      Act Adrsd in Care Plan                   
                          4,056                          Missing                                 
                            495        -                 Not assessed/no information             
                            367        0                 Not indicated                           
                            195        1                 Indicated                               
 
V200A11A $M3INDIC                      Fall Care Area Trigger                   
                          4,056                          Missing                                 
                             32        0                 Not indicated                           
                          1,025        1                 Indicated                               
 
V200A11B $M3INDIC                      Fall Adrsd in Care Plan                  
                          4,056                          Missing                                 
                             31        -                 Not assessed/no information             
                             45        0                 Not indicated                           
                            981        1                 Indicated                               
 
V200A12A $M3INDIC                      Nutr Care Area Trigger                   
                          4,056                          Missing                                 
                            108        0                 Not indicated                           
                            949        1                 Indicated                               
 
V200A12B $M3INDIC                      Nutr Adrsd in Care Plan                  
                          4,056                          Missing                                 
                             64        -                 Not assessed/no information             
                             91        0                 Not indicated                           
                            902        1                 Indicated                               
 
V200A13A $M3INDIC                      Feeding Tube Care Area Trigger           
                          4,056                          Missing                                 
                          1,023        0                 Not indicated                           
                             34        1                 Indicated                               
 
V200A13B $M3INDIC                      Feeding Tube Adrsd in Care Plan          
                          4,056                          Missing                                 
                            601        -                 Not assessed/no information             
                            423        0                 Not indicated                           
                             33        1                 Indicated                               
 
V200A14A $M3INDIC                      Dehydration Care Area Trigger            
                          4,056                          Missing                                 
                            765        0                 Not indicated                           
                            292        1                 Indicated                               
 
V200A14B $M3INDIC                      Dehydration Adrsd in Care Plan           
                          4,056                          Missing                                 
                            428        -                 Not assessed/no information             
                            367        0                 Not indicated                           
                            262        1                 Indicated                               
 
V200A15A $M3INDIC                      Dental Care Area Trigger                 
                          4,056                          Missing                                 
                            792        0                 Not indicated                           
                            265        1                 Indicated                               
 
V200A15B $M3INDIC                      Dental Adrsd in Care Plan                
                          4,056                          Missing                                 
                            469        -                 Not assessed/no information             
                            347        0                 Not indicated                           
                            241        1                 Indicated                               
 
V200A16A $M3INDIC                      Press Ulcr Care Area Trigger             
                          4,056                          Missing                                 
                             25        0                 Not indicated                           
                          1,032        1                 Indicated                               
 
V200A16B $M3INDIC                      Press Ulcr Adrsd in Care Plan            
                          4,056                          Missing                                 
                             21        -                 Not assessed/no information             
                             71        0                 Not indicated                           
                            965        1                 Indicated                               
 
V200A17A $M3INDIC                      Psychotropic Drug Care Area Trigger      
                          4,056                          Missing                                 
                            446        0                 Not indicated                           
                            611        1                 Indicated                               
 
V200A17B $M3INDIC                      Psychotropic Drug Adrsd in Care Plan     
                          4,056                          Missing                                 
                            267        -                 Not assessed/no information             
                            200        0                 Not indicated                           
                            590        1                 Indicated                               
 
V200A18A $M3INDIC                      Rstrnt Care Area Trigger                 
                          4,056                          Missing                                 
                          1,051        0                 Not indicated                           
                              6        1                 Indicated                               
 
V200A18B $M3INDIC                      Rstrnt Adrsd in Care Plan                
                          4,056                          Missing                                 
                            614        -                 Not assessed/no information             
                            437        0                 Not indicated                           
                              6        1                 Indicated                               
 
V200A19A $M3INDIC                      Pain Care Area Trigger                   
                          4,056                          Missing                                 
                            887        0                 Not indicated                           
                            170        1                 Indicated                               
 
V200A19B $M3INDIC                      Pain Adrsd in Care Plan                  
                          4,056                          Missing                                 
                            496        -                 Not assessed/no information             
                            380        0                 Not indicated                           
                            181        1                 Indicated                               
 
V200A20A $M3INDIC                      Rtn to Comm Care Area Trigger            
                          4,056                          Missing                                 
                          1,008        0                 Not indicated                           
                             49        1                 Indicated                               
 
V200A20B $M3INDIC                      Rtn to Comm Adrsd in Care Plan           
                          4,056                          Missing                                 
                            581        -                 Not assessed/no information             
                            424        0                 Not indicated                           
                             52        1                 Indicated                               
 
