RIC         1  2                                        C Record Identification Code

VERSION     3  1                                        C Version Number

BASEID      4  8  $BSIDFMT                              C Unique SP Identification Number

                               1,100             LOW-HIGH BASEID Count

STAYNUM    14  1                                        N Stay number for the year

REFBEGYY   15  2                                        C Reference beginning date year

REFBEGMM   17  2                                        C Reference beginning date month

REFBEGDD   19  2                                        C Reference beginning date day

REFENDYY   21  2                                        C Reference ending date year

REFENDMM   23  2                                        C Reference ending date month

REFENDDD   25  2                                        C Reference ending date day

ADMISYY    27  2                                        C Admission date year

ADMISMM    29  2                                        C Admission date month

ADMISDD    31  2                                        C Admission date day

DISCHYY    33  2                                        C Permanent discharge date year

DISCHMM    35  2                                        C Permanent discharge date month

DISCHDD    37  2                                        C Permanent discharge date day

STAYDAYS   39  3                                        N Number of days in the stay

FACILID    42  6                                        C Facility ID

                  Note: Randomly-assigned number

FACDESC    48  2  FACFMT                                N Facility description

                                   1                    . Inapplicable
                                  21                    1 Hospital
                                 660                    2 Nursing home
                                  10                    3 Retirement home
                                  98                    4 Domiciliary/personal care facility
                                   8                    5 Mental health facility
                                  24                    6 Inst for mentally retarded/devel disab
                                   0                    7 Mental health center
                                  86                    8 Life care/continuing care
                                 139                    9 Assisted living facility
                                   6                   10 Rehabilitation facility
                                  47                   91 Other place, specify

BEGSTAT    50  1  $BEGSTAT                              C Status at the beginning of the stay

                                   1                    - Don't know
                                 810                    0 Continuing SP
                                  84                    1 First time SP from home
                                 111                    2 First time SP from hosp
                                  41                    3 First time SP from nursing home
                                   3                    5 2nd stay 30-day split (in hosp)
                                   4                    6 2nd stay 30-day split (disch)
                                  41                    7 First time SP from other facility
                                   5                    9 Unknown reason

ENDSTAT    51  1  $ENDSTAT                              C Status at the end of the stay

                                   4                    - Don't know
                                 724                    0 SP is still a resident
                                  28                    1 SP was discharged home
                                  53                    2 SP was discharged to a hospital
                                  57                    3 SP was discharged to another facility
                                 217                    4 SP died in the facility
                                   4                    5 Stay split by 30-day hosp
                                   3                    6 Stay split by 30-day disch
                                   0                    7 SP was discharged to another facility
                                  10                    9 Unknown reason for end of stay

AMTTOT     52  9                                        N Total payment

AMTCARE    61  9                                        N Amount paid by Medicare

AMTCAID    70  9                                        N Amount paid by Medicaid

AMTVA      79  9                                        N Amount paid by Veterans Administration

AMTPRVU    88  9                                        N Amt paid by priv ins (unknown purchased)

AMTOOP     97  9                                        N Amount paid out-of-pocket (OOP)

AMTOTH    106  9                                        N Amount paid by other payor(s)

ANCITOT   115  9                                        N Ancillary total payment

ANCICARE  124  9                                        N Ancillary amount paid by Medicare

ANCICAID  133  9                                        N Ancillary amount paid by Medicaid

ANCIVA    142  9                                        N Ancillary amount paid by Veterans Adm.

ANCIPRVU  151  9                                        N Ancillary amount paid by private ins.

ANCIOOP   160  9                                        N Ancillary amount paid by person/family

ANCIOTH   169  9                                        N Ancillary amount paid by other sources

TOTCARE   178  9                                        N Amount paid by Medicare for all services

TOTALL    187  9                                        N Total amt paid (incl. Medicare payments)

DENTNUM   196  3                                        N Number of dental visits

EMNUM     199  3                                        N Number of emergency room visits

OPNUM     202  3                                        N Number of clinic/outpatient visits

MDNUM     205  3                                        N Number of medical doctor visits

MHNUMVIS  208  3                                        N # of mental health professional visits

DIETFLG   211  2  YES2FMT                               N Type of health professional: dietician

                                 482                    1 Yes
                                 618                    2 No

OPTHLFLG  213  2  YES2FMT                               N Type of physician: ophthalmologist

                                 140                    1 Yes
                                 960                    2 No

OPTOMFLG  215  2  YES2FMT                               N Type of health professional: optometrist

                                 122                    1 Yes
                                 978                    2 No

PODIAFLG  217  2  YES2FMT                               N Type of health professional: podiatrist

                                 641                    1 Yes
                                 459                    2 No

EDHABFLG  219  2  YES2FMT                               N Received educational/habitational svcs.

                                   8                   -8 Don't know
                                 209                    1 Yes
                                 883                    2 No

HABFLG    221  2  YES2FMT                               N Received habitational services

                                   8                   -8 Don't know
                                 194                    1 Yes
                                 898                    2 No

EDUCFLG   223  2  YES2FMT                               N Received educational services

                                   8                   -8 Don't know
                                 134                    1 Yes
                                 958                    2 No

AMBUSERV  225  2  YES2FMT                               N Used ambulance service

                                 402                    1 Yes
                                 698                    2 No

BEDPADS   227  2  YES2FMT                               N Received bed pads

                                 681                    1 Yes
                                 419                    2 No

CATHETER  229  2  YES2FMT                               N Received catheter or catheter supplies

                                 134                    1 Yes
                                 966                    2 No

CATHIRRI  231  2  YES2FMT                               N Catheterization and irrigation

                                 122                    1 Yes
                                 978                    2 No

CHNGBAND  233  2  YES2FMT                               N Apply or change dressing

                                 460                    1 Yes
                                 640                    2 No

CLOTHDPR  235  2  YES2FMT                               N Received cloth diapers

                                  62                    1 Yes
                               1,038                    2 No

COMMODE   237  2  YES2FMT                               N Received bedside commode

                                  86                    1 Yes
                               1,014                    2 No

DIABSUPP  239  2  YES2FMT                               N Used diabetic supplies

                                 241                    1 Yes
                                 859                    2 No

DIAPRSUP  241  2  YES2FMT                               N Used disposable diapers

                                 753                    1 Yes
                                 347                    2 No

EQUIPSUP  243  2  YES2FMT                               N Used equipment or supplies

                                  12                    1 Yes
                               1,088                    2 No

EYEGLASS  245  2  YES2FMT                               N Used eyeglasses

                                 254                    1 Yes
                                 846                    2 No

FEEDSERV  247  2  YES2FMT                               N Received feeding services

                                 304                    1 Yes
                                 796                    2 No

FEEDSUPP  249  2  YES2FMT                               N Received feeding supplies

                                  75                    1 Yes
                               1,025                    2 No

GERCHAIR  251  2  YES2FMT                               N Received geri-chair

                                  91                    1 Yes
                               1,009                    2 No

GTUBESUP  253  2  YES2FMT                               N Received gastrointestinal tube & suppl.

                                  52                    1 Yes
                               1,048                    2 No

GTUBEUSE  255  2  YES2FMT                               N Received gastrointestinal tube serivces

                                  56                    1 Yes
                               1,044                    2 No

HEARAID   257  2  YES2FMT                               N Used hearing aid

                                  51                    1 Yes
                               1,049                    2 No

HOSPBED   259  2  YES2FMT                               N Received hospital bed

                                 381                    1 Yes
                                 719                    2 No

HOTPACKS  261  2  YES2FMT                               N Received hot pack & hot pack services

                                  61                    1 Yes
                               1,039                    2 No

INCNCARE  263  2  YES2FMT                               N Received incontinence care

                                 765                    1 Yes
                                 335                    2 No

INJCTION  265  2  YES2FMT                               N Received injections

                                 381                    1 Yes
                                 719                    2 No

IVSUPP    267  2  YES2FMT                               N Received IV therapy supplies

                                  61                    1 Yes
                               1,039                    2 No

IVUSE     269  2  YES2FMT                               N Received IV therapy services

                                  66                    1 Yes
                               1,034                    2 No

MATTRESS  271  2  YES2FMT                               N Received special mattress

                                 411                    1 Yes
                                 689                    2 No

NEBULIZR  273  2  YES2FMT                               N Received nebulizer

                                 131                    1 Yes
                                 969                    2 No

ORTHITEM  275  2  YES2FMT                               N Used orthopedic items

                                 162                    1 Yes
                                 938                    2 No

OSTOMSUP  277  2  YES2FMT                               N Used ostomy supplies

                                  33                    1 Yes
                               1,067                    2 No

OXYGEN    279  2  YES2FMT                               N Used oxygen

                                 253                    1 Yes
                                 847                    2 No

PACEMCHK  281  2  YES2FMT                               N Pacemaker check/monitoring services

                                  41                    1 Yes
                               1,059                    2 No

PROSTHES  283  2  YES2FMT                               N Used prosthesis

                                   7                    1 Yes
                               1,093                    2 No

RESTRAIN  285  2  YES2FMT                               N Received restraints

                                 100                    1 Yes
                               1,000                    2 No

SKINSERV  287  2  YES2FMT                               N Rec'd skin ulcer prevention/care svcs.

                                 698                    1 Yes
                                 402                    2 No

SUCTSERV  289  2  YES2FMT                               N Received respiratory tract suctioning

                                  38                    1 Yes
                               1,062                    2 No

SUCTSUPP  291  2  YES2FMT                               N Received suction machine and supplies

                                  45                    1 Yes
                               1,055                    2 No

TEDHOSE   293  2  YES2FMT                               N Received support (ted) hose and supplies

                                 130                    1 Yes
                                 970                    2 No

TUBEFEED  295  2  YES2FMT                               N Received tube feeding

                                  73                    1 Yes
                               1,027                    2 No

TURNPOS   299  2  YES2FMT                               N Received turning and positioning

                                 565                    1 Yes
                                 535                    2 No

WHEEWALK  301  2  YES2FMT                               N Received wheel chair or walker

                                 497                    1 Yes
                                 603                    2 No

