RIC         1  2                                        C Record Identification Code

VERSION     3  1                                        C Version Number

BASEID      4  8  $BSIDFMT                              C Unique SP Identification Number

                               5,440             LOW-HIGH BASEID Count

M0010      12  6                                        C Agency Medicare Number

M0014      18  2                                        C Branch State

M0016      20 10                                        C Branch Identifier Number

M0018A     30 10                                        C Physician NPI

M0018B     40  1                                        C Physician NPI UK

M0030_ST   41  8                                        N Start of Care Date

M0032      49  1                                        C Resumption of Care Date Not Applicable

M0032_RO   50  8                                        N Resumption of Care Date

M0050      58  2                                        C Patient State

M0060      60 11                                        C Patient ZIP Code

M0066      71  8                                        N Patient Birth Date

M0069      79  1  $SEXFMT                               C Gender

                               1,795                    1 Male
                               3,645                    2 Female

M0080      80  2  $DISCIOA                              C Discipline of Person Completing Assess

                               4,809                   01 RN
                                 571                   02 PT
                                   8                   03 SLP/ST
                                  52                   04 OT

M0090      82  8                                        N Date Assessment Completed

M0100      90  2  $ACOMPOA                              C Assessment Reason

                               1,447                   01 S/R; Start; further visits planned
                                   0                   02 S/R; Start; no further visits planned
                                 366                   03 S/R; Resumption of care
                               1,597                   04 Follow-up; Recertification
                                  26                   05 Follow-up; Other
                                 539                   06 Transfer to inpat fac; Patient not disch
                                  89                   07 Transfer to inpat fac; Patient disch
                                  11                   08 Disch from agency; Death at home
                               1,365                   09 Disch from agency; Disch from agency
                                   0                   10 Disch from agency; No visits completed

M0102A     92  8                                        N Physician Ordered SOC ROC

M0102B    100  1                                        C Physician Ordered SOC ROC - NA

M0104     101  8                                        N Physician Date Of Referral

M0110     109  2  $EPSDFMT                              C Episode Timing

                               2,004                      Missing
                                 323                   NA No case mix group defined
                                  58                   UK Unknown
                               1,826                   01 Early
                               1,229                   02 Later

M0140AIN  111  1  $INDICOA                              C American Indian or Alaska Native

                               3,627                      Missing
                               1,800                    0 Not indicated
                                  13                    1 Indicated

M0140ASN  112  1  $INDICOA                              C Asian

                               3,627                      Missing
                               1,791                    0 Not indicated
                                  22                    1 Indicated

M0140BLK  113  1  $INDICOA                              C Black or African-American

                               3,627                      Missing
                               1,540                    0 Not indicated
                                 273                    1 Indicated

M0140HPI  114  1  $INDICOA                              C Native Hawiian or Pacific Islander

                               3,627                      Missing
                               1,810                    0 Not indicated
                                   3                    1 Indicated

M0140HSP  115  1  $INDICOA                              C Hispanic or Latino

                               3,627                      Missing
                               1,691                    0 Not indicated
                                 122                    1 Indicated

M0140UNK  116  1  $INDICOA                              C Unknown Race/Ethnicity

                               5,440                      Missing
                                   0                    0 Not indicated
                                   0                    1 Indicated

M0140WHT  117  1  $INDICOA                              C White

                               3,627                      Missing
                                 431                    0 Not indicated
                               1,382                    1 Indicated

M0150A    118  1  $INDICOA                              C Medicaid Fee-For-Service

                               4,885                    0 Not indicated
                                 555                    1 Indicated

M0150B    119  1  $INDICOA                              C Medicaid HMO/Managed Care

                               5,367                    0 Not indicated
                                  73                    1 Indicated

M0150C    120  1  $INDICOA                              C Medicare Fee-For-Service

                               1,126                    0 Not indicated
                               4,314                    1 Indicated

M0150D    121  1  $INDICOA                              C Medicare HMO/Managed Care

                               4,631                    0 Not indicated
                                 809                    1 Indicated

M0150E    122  1  $INDICOA                              C No Charge for Current Services

                               5,440                    0 Not indicated
                                   0                    1 Indicated

M0150F    123  1  $INDICOA                              C Other Government

                               5,421                    0 Not indicated
                                  19                    1 Indicated

M0150G    124  1  $INDICOA                              C Other Payment Source

                               5,393                    0 Not indicated
                                  47                    1 Indicated

M0150H    125  1  $INDICOA                              C Private HMO/Managed Care

                               5,427                    0 Not indicated
                                  13                    1 Indicated

M0150I    126  1  $INDICOA                              C Private Insurance

                               5,232                    0 Not indicated
                                 208                    1 Indicated

M0150J    127  1  $INDICOA                              C Self-Pay

                               5,409                    0 Not indicated
                                  31                    1 Indicated

M0150K    128  1  $INDICOA                              C Title Programs

                               5,432                    0 Not indicated
                                   8                    1 Indicated

M0150L    129  1  $INDICOA                              C Unknown Payment Source

                               3,627                      Missing
                               1,813                    0 Not indicated
                                   0                    1 Indicated

M0150M    130  1  $INDICOA                              C Workers Compensation

                               5,440                    0 Not indicated
                                   0                    1 Indicated

M0903     131  8                                        N Date of Last Home Visit

M0906     139  8                                        N Discharge/Transfer/Death Date

M1000A    147  1  $INDICOA                              C Discharged Past 14 Days From IPPS

                               3,627                      Missing
                                 915                    0 Not indicated
                                 898                    1 Indicated

M1000B    148  1  $INDICOA                              C Discharged Past 14 Days From IRF

                               3,627                      Missing
                               1,717                    0 Not indicated
                                  96                    1 Indicated

M1000C    149  1  $INDICOA                              C Discharged Past 14 Days From LTC

                               3,627                      Missing
                               1,789                    0 Not indicated
                                  24                    1 Indicated

M1000D    150  1  $INDICOA                              C Discharged Past 14 Days From LTCH

                               3,627                      Missing
                               1,795                    0 Not indicated
                                  18                    1 Indicated

M1000E    151  1  $INDICOA                              C Discharged Past 14 Days From Other

                               3,627                      Missing
                               1,802                    0 Not indicated
                                  11                    1 Indicated

M1000F    152  1  $INDICOA                              C Discharged Past 14 Days From Psych

                               3,627                      Missing
                               1,805                    0 Not indicated
                                   8                    1 Indicated

M1000G    153  1  $INDICOA                              C Discharged Past 14 Days From SNF/TCU

                               3,627                      Missing
                               1,548                    0 Not indicated
                                 265                    1 Indicated

M1000H    154  1  $INDICOA                              C Discharged Past 14 Days - NA

                               3,627                      Missing
                               1,263                    0 Not indicated
                                 550                    1 Indicated

M1005A    155  1                                        C Most Recent Inpat Discharge Date - UK

M1005B    156  8                                        N Most Recent Inpatient Discharge Date

M1010A    164  7                                        C Inpatient Diagnosis1 ICD Code

M1010B    171  7                                        C Inpatient Diagnosis2 ICD Code

M1010C    178  7                                        C Inpatient Diagnosis3 ICD Code

M1010D    185  7                                        C Inpatient Diagnosis4 ICD Code

M1010E    192  7                                        C Inpatient Diagnosis5 ICD Code

M1010F    199  7                                        C Inpatient Diagnosis6 ICD Code

M1012A    206  1                                        C Inpatient ICD Procedure Code - NA

M1012B    207  1                                        C Inpatient ICD Procedure Code - UK

M1012C    208  7                                        C Inpatient ICD Procedure1 Code

M1012D    215  7                                        C Inpatient ICD Procedure2 Code

M1012E    222  7                                        C Inpatient ICD Procedure3 Code

M1012F    229  7                                        C Inpatient ICD Procedure4 Code

M1016A    236  7                                        C Regimen Change - Diagnosis1 ICD Code

M1016B    243  7                                        C Regimen Change - Diagnosis2 ICD Code

M1016C    250  7                                        C Regimen Change - Diagnosis3 ICD Code

M1016D    257  7                                        C Regimen Change - Diagnosis4 ICD Code

M1016E    264  7                                        C Regimen Change - Diagnosis5 ICD Code

M1016F    271  7                                        C Regimen Change - Diagnosis6 ICD Code

M1016G    278  1                                        C Regimen Change In Past 14 Days - NA

M1018A    279  1  $INDICOA                              C Prior Condition - Catheter

                               3,627                      Missing
                               1,769                    0 Not indicated
                                  44                    1 Indicated

M1018B    280  1  $INDICOA                              C Prior Condition - Disruptive Behavior

                               3,627                      Missing
                               1,790                    0 Not indicated
                                  23                    1 Indicated

M1018C    281  1  $INDICOA                              C Prior Condition - Impaired Decision

                               3,627                      Missing
                               1,479                    0 Not indicated
                                 334                    1 Indicated

M1018D    282  1  $INDICOA                              C Prior Condition - Intractable Pain

                               3,627                      Missing
                               1,601                    0 Not indicated
                                 212                    1 Indicated

M1018E    283  1  $INDICOA                              C Prior Condition - Memory Loss

                               3,627                      Missing
                               1,554                    0 Not indicated
                                 259                    1 Indicated

M1018F    284  1  $INDICOA                              C Prior Condition - NA

                               3,627                      Missing
                               1,678                    0 Not indicated
                                 135                    1 Indicated

M1018G    285  1  $INDICOA                              C Prior Condition - None Of The Above

                               3,627                      Missing
                               1,107                    0 Not indicated
                                 706                    1 Indicated

M1018H    286  1  $INDICOA                              C Prior Condition - UK

                               3,627                      Missing
                               1,804                    0 Not indicated
                                   9                    1 Indicated

M1018I    287  1  $INDICOA                              C Prior Condition - Urinary Incontinence

                               3,627                      Missing
                               1,153                    0 Not indicated
                                 660                    1 Indicated

M1020A    288  7                                        C Primary Diagnosis ICD Code

M1020B    295  2  $SEVEROA                              C Primary Diagnosis Severity

                               2,593                      Missing
                                   5                   00 Asymptomatic, not treatement needed
                                 107                   01 Symptoms contr with current therapy
                               1,308                   02 Symptoms contr with difficulty
                               1,253                   03 Symptoms poorly contr, freq dose adjust
                                 174                   04 Symptoms poorly contr, hist rehospitali

M1022A    297  7                                        C Other Diagnosis1 ICD Code

M1022B    304  2  $SEVEROA                              C Other Diagnosis1 Severity

                               2,259                      Missing
                                  16                   00 Asymptomatic, not treatement needed
                                 219                   01 Symptoms contr with current therapy
                               1,694                   02 Symptoms contr with difficulty
                               1,126                   03 Symptoms poorly contr, freq dose adjust
                                 126                   04 Symptoms poorly contr, hist rehospitali

M1022C    306  7                                        C Other Diagnosis2 ICD Code

M1022D    313  2  $SEVEROA                              C Other Diagnosis2 Severity

                               2,327                      Missing
                                  13                   00 Asymptomatic, not treatement needed
                                 363                   01 Symptoms contr with current therapy
                               1,797                   02 Symptoms contr with difficulty
                                 858                   03 Symptoms poorly contr, freq dose adjust
                                  82                   04 Symptoms poorly contr, hist rehospitali

M1022E    315  7                                        C Other Diagnosis3 ICD Code

M1022F    322  2  $SEVEROA                              C Other Diagnosis3 Severity

                               2,479                      Missing
                                   8                   00 Asymptomatic, not treatement needed
                                 473                   01 Symptoms contr with current therapy
                               1,761                   02 Symptoms contr with difficulty
                                 679                   03 Symptoms poorly contr, freq dose adjust
                                  40                   04 Symptoms poorly contr, hist rehospitali

M1022G    324  7                                        C Other Diagnosis4 ICD Code

M1022H    331  2  $SEVEROA                              C Other Diagnosis4 Severity

                               2,844                      Missing
                                  24                   00 Asymptomatic, not treatement needed
                                 468                   01 Symptoms contr with current therapy
                               1,583                   02 Symptoms contr with difficulty
                                 490                   03 Symptoms poorly contr, freq dose adjust
                                  31                   04 Symptoms poorly contr, hist rehospitali

M1022I    333  7                                        C Other Diagnosis5 ICD Code

M1022J    340  2  $SEVEROA                              C Other Diagnosis5 Severity

                               3,442                      Missing
                                  21                   00 Asymptomatic, not treatement needed
                                 381                   01 Symptoms contr with current therapy
                               1,264                   02 Symptoms contr with difficulty
                                 314                   03 Symptoms poorly contr, freq dose adjust
                                  18                   04 Symptoms poorly contr, hist rehospitali

M1024A    342  7                                        C Case Mix Dx - Primary ICD, Col3

M1024B    349  7                                        C Case Mix Dx - Primary ICD, Col4

M1024C    356  7                                        C Case Mix Dx - Secndry ICD1, Col3

M1024D    363  7                                        C Case Mix Dx - Secndry ICD1, Col4

M1024E    370  7                                        C Case Mix Dx - Secndry ICD2, Col3

M1024F    377  7                                        C Case Mix Dx - Secndry ICD2, Col4

M1024G    384  7                                        C Case Mix Dx - Secndry ICD3, Col3

M1024H    391  7                                        C Case Mix Dx - Secndry ICD3, Col4

M1024I    398  7                                        C Case Mix Dx - Secndry ICD4, Col3

M1024J    405  7                                        C Case Mix Dx - Secndry ICD4, Col4

M1024K    412  7                                        C Case Mix Dx - Secndry ICD5, Col3

M1024L    419  7                                        C Case Mix Dx - Secndry ICD5, Col4

M1030A    426  1  $INDICOA                              C Therapies In Home - Enteral Nutrition

                               2,004                      Missing
                               3,386                    0 Not indicated
                                  50                    1 Indicated

M1030B    427  1  $INDICOA                              C Therapies In Home - IV Infusion

                               2,004                      Missing
                               3,341                    0 Not indicated
                                  95                    1 Indicated

M1030C    428  1  $INDICOA                              C Therapies In Home - None Above

                               2,004                      Missing
                                 148                    0 Not indicated
                               3,288                    1 Indicated

M1030D    429  1  $INDICOA                              C Therapies In Home - Parenteral Nutrition

                               2,004                      Missing
                               3,430                    0 Not indicated
                                   6                    1 Indicated

M1032A    430  1  $INDICOA                              C Risk For Hosp - Mental, Emotional, Behav

                               3,627                      Missing
                               1,519                    0 Not indicated
                                 294                    1 Indicated

M1032B    431  1  $INDICOA                              C Risk For Hosp - Frailty Indicators

                               3,627                      Missing
                               1,270                    0 Not indicated
                                 543                    1 Indicated

M1032C    432  1  $INDICOA                              C Risk For Hosp - History Of Falls

                               3,627                      Missing
                               1,259                    0 Not indicated
                                 554                    1 Indicated

M1032D    433  1  $INDICOA                              C Risk For Hosp - > 1 Hospital In 12 Mo

                               3,627                      Missing
                               1,130                    0 Not indicated
                                 683                    1 Indicated

M1032E    434  1  $INDICOA                              C Risk For Hosp - None Of The Above

                               3,627                      Missing
                               1,717                    0 Not indicated
                                  96                    1 Indicated

M1032F    435  1  $INDICOA                              C Risk For Hosp - Taking 5 Or More Meds

                               3,627                      Missing
                                 327                    0 Not indicated
                               1,486                    1 Indicated

M1032G    436  1  $INDICOA                              C Risk For Hospitalization - Other

                               3,627                      Missing
                               1,641                    0 Not indicated
                                 172                    1 Indicated

M1034     437  2  $STATUOA                              C Overall Status

                               3,627                      Missing
                                   4                   UK Unknown
                                 289                   00 SP is stable with no heightened risk
                                 940                   01 SP is temporarily facing high health ris
                                 504                   02 SP is likely to remain in fragile health
                                  76                   03 SP has serious progressive conditions

M1036A    439  1  $INDICOA                              C High Risk Factor - Alcohol Dependency

                               3,627                      Missing
                               1,775                    0 Not indicated
                                  38                    1 Indicated

M1036B    440  1  $INDICOA                              C High Risk Factor - Drug Dependency

                               3,627                      Missing
                               1,794                    0 Not indicated
                                  19                    1 Indicated

M1036C    441  1  $INDICOA                              C High Risk Factor - None Of The Above

                               3,627                      Missing
                                 589                    0 Not indicated
                               1,224                    1 Indicated

M1036D    442  1  $INDICOA                              C High Risk Factor - Obesity

                               3,627                      Missing
                               1,474                    0 Not indicated
                                 339                    1 Indicated

M1036E    443  1  $INDICOA                              C High Risk Factor - Smoking

                               3,627                      Missing
                               1,588                    0 Not indicated
                                 225                    1 Indicated

M1036F    444  1  $INDICOA                              C High Risk Factor - UK

                               3,627                      Missing
                               1,781                    0 Not indicated
                                  32                    1 Indicated

M1040     445  2  $YESNAOA                              C Influenza Vaccine Received In Agency

                               3,448                      Missing
                                 340                   NA Inapplicable
                               1,539                   00 No
                                 113                   01 Yes

M1045     447  2  $INFLUOA                              C Influenza Vaccine - Reason Not Received

                               3,901                      Missing
                                 991                   01 Rec from other health care provider
                                  10                   02 Rec from agency previously
                                 124                   03 Offered and declined
                                  13                   04 Medical contraindication(s)
                                   6                   05 Does not meet age/condition guidelines
                                   9                   06 Inability to obtain due to shortage
                                 386                   07 None of the above

M1050     449  1  $YESNOOA                              C Pneum Vaccine (PPV) Received In Agency

                               3,448                      Missing
                               1,922                    0 No
                                  70                    1 Yes

M1055     450  2  $PPVNOOA                              C Pneum Vaccine (PPV) Reason Not Received

                               3,518                      Missing
                               1,167                   01 Rec PPV in past
                                 130                   02 Offered and declined
                                   4                   03 Medical contraindication(s)
                                  44                   04 Does not meet age/condition guidelines
                                 577                   05 None of the above

M1100     452  2                                        C Patient Living Situation

M1200     454  2  $VISIOOA                              C Vision

                               2,004                      Missing
                               2,312                   00 Normal vision
                               1,032                   01 Partially impaired
                                  92                   02 Severely impaired

M1210     456  2  $HEARCOA                              C Ability To Hear

                               3,627                      Missing
                                   0                   UK Unable to assess hearing
                               1,122                   00 Adequate
                                 656                   01 Mildly to moderately impaired
                                  35                   02 Severely impaired

M1220     458  2  $VERBAOA                              C Understanding Of Verbal Content

                               3,627                      Missing
                                   6                   UK Unable to assess hearing
                               1,058                   00 Understands
                                 608                   01 Usually understands
                                 135                   02 Sometimes understands
                                   6                   03 Never understands

M1230     460  2  $SPEECOA                              C Speech And Oral Expression

                               2,262                      Missing
                               2,063                   00 No observable impairement
                                 820                   01 Minimal difficulty
                                 202                   02 Moderate difficulty
                                  61                   03 Severe difficulty
                                  18                   04 Unable to express basic needs
                                  14                   05 Nonresponsive or unable to speak

M1240     462  2  $PAINAOA                              C Formal Pain Assessment

                               3,627                      Missing
                                  64                   00 No standardized assessment
                               1,371                   01 Yes, severe pain not indicated
                                 378                   02 Yes, severe pain indicated

M1242     464  2  $FREQCOA                              C Freq Of Pain Interfering With Activity

                                 640                      Missing
                               1,563                   00 No pain
                                 510                   01 Pain does not interfere
                                 584                   02 Less often than daily
                               1,827                   03 Daily, but not constantly
                                 316                   04 All of the time

M1300     466  2  $ULASSOA                              C Pressure Ulcer Assessment

                               3,627                      Missing
                                  67                   00 No assessment conducted
                                 251                   01 Yes, based on eval of clinical factors
                               1,495                   02 Yes, using a standardized tool

M1302     468  1  $YESNOOA                              C Risk Of Developing Pressure Ulcer

                               3,694                      Missing
                               1,202                    0 No
                                 544                    1 Yes

M1306     469  1  $YESNOOA                              C Unhealed Pressure Ulcer at Least Stg II

                                 640                      Missing
                               4,549                    0 No
                                 251                    1 Yes

M1307A    470  8                                        N Oldest Stg II Onset Date

M1307B    478  2                                        C Oldest Stg II Pressure Ulcer, Discharge

M1308A    480  2                                        C Num Of Pressure Ulcer -Stg II

M1308B    482  2                                        C Num Of Pressure Ulcer -Stg II, SOC ROC

M1308C    484  2                                        C Num Of Pressure Ulcer -Stg III

M1308D    486  2                                        C Num Of Pressure Ulcer -Stg III, SOC ROC

M1308E    488  2                                        C Num Of Pressure Ulcer -Stg IV

M1308F    490  2                                        C Num Of Pressure Ulcer -Stg IV, SOC ROC

M1308G    492  2                                        C Num UnStg Pressure Ulcer, NR, Dsg

M1308H    494  2                                        C Num UnStg Pressure Ulcer, NR, SOC ROC

M1308I    496  2                                        C Num UnStg Press Ulcer Slough, SOC ROC

M1308J    498  2                                        C Num UnStg Press Ulcer Slough Eschar

M1308K    500  2                                        C Num UnStg Press Ulcer D\Tissue

M1308L    502  2                                        C Num UnStg Press Ulcer D\Tissue, SOC ROC

M1310     504  4                                        C Largest Pressure Ulcer Length

M1312     508  4                                        C Largest Pressure Ulcer Width

M1314     512  4                                        C Largest Pressure Ulcer Depth

M1320     516  2  $ULSTAPO                              C Status Of Most Problematic Press Ulcer

                               5,302                      Missing
                                   2                   NA No observable pressure ulcer
                                   6                   00 Newly epithelialized
                                   1                   01 Fully granulating
                                  16                   02 Early/Partial granulation
                                 113                   03 Not healing

M1322     518  2  $ULNUMOA                              C Current Number Of Stage I Press Ulcer

                                 639                      Missing
                               4,687                   00 None
                                  72                   01 One
                                  26                   02 Two
                                   3                   03 Three
                                  13                   04 Four or more

M1324     520  2  $ULSTGOA                              C Stage Of Most Problematic Press Ulcer

                                 639                      Missing
                               4,494                   NA No observable pressure ulcer
                                  79                   01 Stage one
                                 114                   02 Stage two
                                  83                   03 Stage three
                                  31                   04 Stage four

M1330     522  2  $STASUOA                              C Stasis Ulcer Present

                                 640                      Missing
                               4,727                   00 No
                                   7                   01 Yes, BOTH observable and unobservable
                                  60                   02 Yes, Observable only
                                   6                   03 Yes, Unobservable only

M1332     524  2  $ULNUMOA                              C Current Num Of (Observable) Stasis Ulcer

                               5,373                      Missing
                                   0                   00 None
                                  45                   01 One
                                  11                   02 Two
                                   2                   03 Three
                                   9                   04 Four or more

M1334     526  2  $ULSTAQO                              C Status Of Most Problematic Stasis Ulcer

                               5,373                      Missing
                                   5                   00 Newly epithelialized
                                   3                   01 Fully granulating
                                  24                   02 Early/Partial granulation
                                  35                   03 Not healing

M1340     528  2  $SURGWOA                              C Does This Patient Have A Surgica Wound

                                 640                      Missing
                               4,106                   00 No
                                 647                   01 Yes, observable
                                  47                   02 Yes, not observable

M1342     530  2  $ULSTAQO                              C Status Of Most Problematic Surgica Wound

                               4,793                      Missing
                                 189                   00 Newly epithelialized
                                 153                   01 Fully granulating
                                 206                   02 Early/Partial granulation
                                  99                   03 Not healing

M1350     532  1  $YESNOOA                              C Skin Lesion Or Open Wound

                                 640                      Missing
                               4,168                    0 No
                                 632                    1 Yes

M1400     533  2  $SBREAOA                              C When Is Patient Dyspneic

                                 639                      Missing
                               1,629                   00 Never
                               1,181                   01 When walking more than 20 feet
                               1,292                   02 With moderate exertion
                                 585                   03 With minimal exertion
                                 114                   04 At rest (day or night)

M1410A    535  1  $INDICOA                              C Resprtry Treat At Home - Airway Press

                               2,262                      Missing
                               3,130                    0 Not indicated
                                  48                    1 Indicated

M1410B    536  1  $INDICOA                              C Resprtry Treat At Home - None

                               2,262                      Missing
                                 508                    0 Not indicated
                               2,670                    1 Indicated

M1410C    537  1  $INDICOA                              C Resprtry Treat At Home - Oxygen

                               2,262                      Missing
                               2,704                    0 Not indicated
                                 474                    1 Indicated

M1410D    538  1  $INDICOA                              C Resprtry Treat At Home - Ventilator

                               2,262                      Missing
                               3,177                    0 Not indicated
                                   1                    1 Indicated

M1500     539  2  $SYMHFOA                              C Symptoms In Heart Failure Patients

                               3,448                      Missing
                                 856                   00 No
                                 176                   01 Yes
                                  17                   02 Not assessed
                                 943                      NA

M1510A    541  1  $INDICOA                              C Heart Fail, Change In Care Plan

                               5,264                      Missing
                                 166                    0 Not indicated
                                  10                    1 Indicated

M1510B    542  1  $INDICOA                              C Heart Fail, Clinical Intervention

                               5,264                      Missing
                                  79                    0 Not indicated
                                  97                    1 Indicated

M1510C    543  1  $INDICOA                              C Heart Fail, ER Treatment Advised

                               5,264                      Missing
                                 132                    0 Not indicated
                                  44                    1 Indicated

M1510D    544  1  $INDICOA                              C Heart Fail, No Action Taken

                               5,264                      Missing
                                 167                    0 Not indicated
                                   9                    1 Indicated

M1510E    545  1  $INDICOA                              C Heart Fail, Physician Contacted

                               5,264                      Missing
                                  97                    0 Not indicated
                                  79                    1 Indicated

M1510F    546  1  $INDICOA                              C Heart Fail, Physician-Ordered Treatment

                               5,264                      Missing
                                 143                    0 Not indicated
                                  33                    1 Indicated

M1600     547  2  $UTINFOA                              C Patient Treated For UTI Last 14 Days

                               2,262                      Missing
                                  19                   NA Patient on prophylactic treatment
                                   5                   UK Unknown
                               2,926                   00 No
                                 228                   01 Yes

M1610     549  2  $UIUCPOA                              C Urinary Incontinence Or Catheter Presenc

                                 639                      Missing
                               2,152                   00 No incontinence or catheter
                               2,389                   01 Patient is incintinent
                                 260                   02 Patient requires a urinary catheter

M1615     551  2  $URINCOO                              C When Does Urinary Incontinence Occur

                               4,030                      Missing
                                 197                   00 Timed-voiding deters incontinence
                                 350                   01 Occasional stress incontinence
                                  65                   02 During the night only
                                  30                   03 During the day only
                                 768                   04 During the day and night

M1620     553  2  $BWINCOA                              C Bowel Incontinence Frequency

                                 639                      Missing
                                 112                   NA Patient has ostomy for bowel elimination
                                   0                   UK Unknown
                               3,877                   00 Very rarely or never has bowel incont
                                 253                   01 Less than once weekly
                                 278                   02 One to three times weekly
                                  85                   03 Four to six times weekly
                                 152                   04 On a daily basis
                                  44                   05 More often than once daily

M1630     555  2  $BWOSTOA                              C Ostomy For Bowel Elimination

                               2,004                      Missing
                               3,344                   00 Does not have an ostomy
                                  74                   01 Ostomy was not related to inpatient stay
                                  18                   02 Ostomy was related to inpatient stay

M1700     557  2  $COGFUOA                              C Cognitive Functioning

                               2,262                      Missing
                               1,868                   00 Alert/Oriented
                                 917                   01 Req prompting
                                 281                   02 Req assist and some direction
                                  98                   03 Req conciderable assist in routine situa
                                  14                   04 Totally dependent due to disturbances

M1710     559  2  $WCONFOA                              C When Confused

                               2,262                      Missing
                                   9                   NA Patient nonresponsive
                               1,658                   00 Never
                               1,074                   01 In new or complex situations
                                  55                   02 On awakening or at night only
                                 310                   03 During the day or evening
                                  72                   04 Constantly

M1720     561  2  $WANXIOA                              C When Anxious

                               2,262                      Missing
                                   8                   NA Patient nonresponsive
                               1,890                   00 None of the time
                                 780                   01 Less often than daily
                                 462                   02 Daily, but not constantly
                                  38                   03 All of the time

M1730A    563  2  $DEPRAOA                              C Depression Screening

                               3,627                      Missing
                                   0                   NA Patient nonresponsive
                                 121                   00 No
                               1,626                   01 Yes, PHQ-2 scale
                                  10                   02 Yes, other, further evaluation
                                  56                   03 Yes, other, no further evaluation

M1730B    565  2  $DEPRBOA                              C Feeling Down, Depressed, Or Hopeless

                               3,814                      Missing
                                  17                   NA Patient nonresponsive
                               1,225                   00 Not at all (0-1)
                                 292                   01 Several days (2-6)
                                  54                   02 More than half of the days (7-11)
                                  38                   03 Nearly every day (12-14)

M1730C    567  2  $DEPRBOA                              C Low Interest Or Pleasure In Doing Things

                               3,814                      Missing
                                  16                   NA Patient nonresponsive
                               1,245                   00 Not at all (0-1)
                                 269                   01 Several days (2-6)
                                  51                   02 More than half of the days (7-11)
                                  45                   03 Nearly every day (12-14)

M1740A    569  1  $INDICOA                              C Cog/Behavr/Psych Symp -Delusional

                               2,262                      Missing
                               3,137                    0 Not indicated
                                  41                    1 Indicated

M1740B    570  1  $INDICOA                              C Cog/Behavr/Psych Symp -Impaired Decision

                               2,262                      Missing
                               2,625                    0 Not indicated
                                 553                    1 Indicated

M1740C    571  1  $INDICOA                              C Cog/Behavr/Psych Symp -Memory Deficit

                               2,262                      Missing
                               2,633                    0 Not indicated
                                 545                    1 Indicated

M1740D    572  1  $INDICOA                              C Cog/Behavr/Psych Symp -None Of The Above

                               2,262                      Missing
                                 860                    0 Not indicated
                               2,318                    1 Indicated

M1740E    573  1  $INDICOA                              C Cog/Behavr/Psych Symp -Aggression

                               2,262                      Missing
                               3,160                    0 Not indicated
                                  18                    1 Indicated

M1740F    574  1  $INDICOA                              C Cog/Behavr/Psych Symp -Socially Inapp

                               2,262                      Missing
                               3,159                    0 Not indicated
                                  19                    1 Indicated

M1740G    575  1  $INDICOA                              C Cog/Behavr/Psych Symp  Verbal Disruption

                               2,262                      Missing
                               3,134                    0 Not indicated
                                  44                    1 Indicated

M1745     576  2  $FREQBOA                              C Freq Of Disruptive Behavior Symptoms

                               2,262                      Missing
                               2,726                   00 Never
                                  55                   01 Less than once a month
                                  10                   02 One a month
                                  70                   03 Several times each month
                                  98                   04 Several times a week
                                 219                   05 At least daily

M1750     578  1  $YESNOOA                              C Receives Psych Nursing Services

                               3,627                      Missing
                               1,786                    0 No
                                  27                    1 Yes

M1800     579  2  $GROOMOA                              C Current Grooming

                               2,262                      Missing
                               1,508                   00 Able to groom self unaided
                                 940                   01 Utensils must be placed within reach
                                 540                   02 Someone must assis patient to groom self
                                 190                   03 Depends entirely upon another person

M1810     581  2  $DRESSOA                              C Current Dress Upper

                                 639                      Missing
                               1,881                   00 No assist needed
                               1,485                   01 No assist needed if clothing laid out
                               1,074                   02 Assist from another person
                                 361                   03 Depends entirely upon another person

M1820     583  2  $DRESSOA                              C Current Dress Lower

                                 639                      Missing
                               1,582                   00 No assist needed
                                 972                   01 No assist needed if clothing laid out
                               1,707                   02 Assist from another person
                                 540                   03 Depends entirely upon another person

M1830     585  2  $BATHCOA                              C Current Bathing

                                 640                      Missing
                                 526                   00 Bathes self independently
                                 863                   01 Bathes self with use of devices
                               1,225                   02 Bathes with intermittent assist
                               1,215                   03 Bathes with complete assist/supervision
                                 266                   04 Unable, bed/sink/chair, independent
                                 346                   05 Unable, bed/sing/chair, assisted
                                 359                   06 Unable, totally bathed by another person

M1840     587  2  $TOILEOA                              C Toilet Transferring

                                 640                      Missing
                               2,752                   00 Toilet, to and from independently
                               1,394                   01 Toilet, when reminded/assist/supervised
                                 256                   02 Unable toil, able to bedside commode
                                  42                   03 Unable toil/bedside commode, able bedpan
                                 356                   04 Depends entirely upon another person

M1845     589  2  $TOILHOA                              C Current Toileting Hygiene

                               2,263                      Missing
                               1,716                   00 Hygiene management independently
                                 768                   01 Hygiene management if supplies laid out
                                 471                   02 Hygiene management assisted
                                 222                   03 Depends entirely upon another person

M1850     591  2  $TRANSOA                              C Transferring

                                 640                      Missing
                               1,331                   00 Able to independently transfer
                               2,662                   01 Transfers with minimal assist or device
                                 462                   02 Unable transfer self, able to pivot
                                 196                   03 Unable transfer self, unable to pivot
                                  34                   04 Bedfast, unable trans, able to positio
                                 115                   05 Bedfast, unable trans, unable to positio

M1860     593  2  $AMBUCOA                              C Ambulation/Locomotion

                                 640                      Missing
                                 666                   00 Able to independently walk/stairs
                               1,087                   01 Able to walk w/ 1 handed device
                               1,805                   02 Able to walk w/ 2 handed device
                                 669                   03 Able to walk w/ constant assist/supervis
                                 258                   04 Chairfast, able to wheel self independ
                                 258                   05 Chairfast, unable to wheel self independ
                                  57                   06 Bedfast, unable to ambulate/or chair

M1870     595  2  $FEEDIOA                              C Current Feeding

                               2,262                      Missing
                               2,016                   00 Able independently feed self
                               1,014                   01 Able feed self with intermittent assist
                                 121                   02 Unable feed self, complete assist/superv
                                  12                   03 Able take nutri oral, rec tube feedi
                                   9                   04 Unable take nutri oral, rec tube feedi
                                   6                   05 Unable take nutri oral or tube feedi

M1880     597  2  $MEALSOA                              C Current Preparing Light Meals

                               2,262                      Missing
                               1,222                   00 Able to independently prepare all meals
                                 988                   01 Unable to prepare meals on regular basis
                                 968                   02 Unable to prepare any meals

M1890     599  2  $TELEPOA                              C Current Phone Use

                               2,262                      Missing
                                  48                   NA Patient does not have a telephone
                               2,239                   00 Able independently dial/answer calls
                                 231                   01 Able use a specif adapted phone and call
                                 229                   02 Able answer calls, diff placing calls
                                 207                   03 Able answer calls only some of the time
                                  96                   04 Unable answer phone at all, can listen
                                 128                   05 Totaly unable to use the telephone

M1900A    601  2  $PRADLOA                              C Prior Functioning ADL/IADL - Ambulation

                               3,627                      Missing
                                 763                   00 Independent
                                 844                   01 Needed some help
                                 206                   02 Dependent

M1900B    603  2  $PRADLOA                              C Prior Functioning ADL/IADL - Household

                               3,627                      Missing
                                 321                   00 Independent
                                 835                   01 Needed some help
                                 657                   02 Dependent

M1900C    605  2  $PRADLOA                              C Prior Functioning ADL/IADL - Self Care

                               3,627                      Missing
                                 675                   00 Independent
                                 944                   01 Needed some help
                                 194                   02 Dependent

M1900D    607  2  $PRADLOA                              C Prior Functioning ADL/IADL - Transfer

                               3,627                      Missing
                                 898                   00 Independent
                                 755                   01 Needed some help
                                 160                   02 Dependent

M1910     609  2  $FALLMOA                              C Multi-Factor Fall Risk Assessment

                               3,627                      Missing
                                 108                   00 No multi-factor fall risk assessment
                                 289                   01 Yes, does not indicated a risk for fall
                               1,416                   02 Yes, indicates a risk for falls fall

M2000     611  2  $DRUGROA                              C Drug Regimen Review

                               3,627                      Missing
                                   3                   NA Patient is not taking any medications
                                  10                   00 Not assessed
                               1,490                   01 No problems found during review
                                 310                   02 Problems found during review

M2002     613  1  $YESNOOA                              C Medication Follow-Up

                               5,130                      Missing
                                  87                    0 No
                                 223                    1 Yes

M2004     614  2  $YESNAOA                              C Medication Intervention

                               3,448                      Missing
                               1,207                   NA Inapplicable
                                 464                   00 No
                                 321                   01 Yes

M2010     616  2  $YESNAOA                              C Patient/Caregiver High Risk Drug Educ

                               3,630                      Missing
                                 451                   NA Inapplicable
                                 128                   00 No
                               1,231                   01 Yes

M2015     618  2  $YESNAOA                              C Patient/Caregiver Drug Educ Intervention

                               3,448                      Missing
                                  13                   NA Inapplicable
                                 301                   00 No
                               1,678                   01 Yes

M2020     620  2  $MGMRXOA                              C Current Management Of Oral

                               2,266                      Missing
                                  10                   NA No med of this type prescribed
                               1,236                   00 Able to independently take correct med
                                 899                   01 Able to take med corect times w/ prepare
                                 368                   02 Able to take med corect times w/ assist
                                 661                   03 Unable to take med unless administered

M2030     622  2  $MGMRXOA                              C Current Management Of Injectable

                                 643                      Missing
                               3,582                   NA No med of this type prescribed
                                 347                   00 Able to independently take correct med
                                 209                   01 Able to take med corect times w/ prepare
                                  53                   02 Able to take med corect times w/ assist
                                 606                   03 Unable to take med unless administered

M2040A    624  2  $PRADLOA                              C Prior Medication Management - Injectable

                               3,627                      Missing
                                 161                   00 Independent
                                 135                   01 Needed some help
                                 165                   02 Dependent
                               1,352                   02 NA

M2040B    626  2  $PRADLOA                              C Prior Medication Management - Oral

                               3,627                      Missing
                                 715                   00 Independent
                                 681                   01 Needed some help
                                 388                   02 Dependent
                                  29                   02 NA

M2100A    628  2  $ASSISOA                              C Care Management - ADL Assistance

                               2,263                      Missing
                                 902                   00 No assistance needed
                               1,895                   01 Currently provide assistance
                                 205                   02 Need training to provide assistance
                                  58                   03 Not likely to provide assistance
                                  27                   04 Unclear if caregiver will provide assist
                                  90                   05 Assistance needed, no caregiver

M2100B    630  2  $ASSISOA                              C Care Management - Advocacy

                               2,263                      Missing
                                 477                   00 No assistance needed
                               2,578                   01 Currently provide assistance
                                  51                   02 Need training to provide assistance
                                  10                   03 Not likely to provide assistance
                                  17                   04 Unclear if caregiver will provide assist
                                  44                   05 Assistance needed, no caregiver

M2100C    632  2  $ASSISOA                              C Care Management - IADL Assistance

                               2,263                      Missing
                                 346                   00 No assistance needed
                               2,637                   01 Currently provide assistance
                                  82                   02 Need training to provide assistance
                                  18                   03 Not likely to provide assistance
                                  18                   04 Unclear if caregiver will provide assist
                                  76                   05 Assistance needed, no caregiver

M2100D    634  2  $ASSISOA                              C Care Management - Equipment

                               2,263                      Missing
                               2,533                   00 No assistance needed
                                 542                   01 Currently provide assistance
                                  61                   02 Need training to provide assistance
                                  14                   03 Not likely to provide assistance
                                   9                   04 Unclear if caregiver will provide assist
                                  18                   05 Assistance needed, no caregiver

M2100E    636  2  $ASSISOA                              C Care Management - Medical Procedures

                               2,263                      Missing
                               2,302                   00 No assistance needed
                                 589                   01 Currently provide assistance
                                 153                   02 Need training to provide assistance
                                  65                   03 Not likely to provide assistance
                                  11                   04 Unclear if caregiver will provide assist
                                  57                   05 Assistance needed, no caregiver

M2100F    638  2  $ASSISOA                              C Care Management - Medication Admin

                               2,263                      Missing
                               1,205                   00 No assistance needed
                               1,694                   01 Currently provide assistance
                                 151                   02 Need training to provide assistance
                                  36                   03 Not likely to provide assistance
                                  19                   04 Unclear if caregiver will provide assist
                                  72                   05 Assistance needed, no caregiver

M2100G    640  2  $ASSISOA                              C Care Management - Supervision And Safety

                               2,263                      Missing
                               1,481                   00 No assistance needed
                               1,527                   01 Currently provide assistance
                                  83                   02 Need training to provide assistance
                                  26                   03 Not likely to provide assistance
                                  17                   04 Unclear if caregiver will provide assist
                                  43                   05 Assistance needed, no caregiver

M2110     642  2  $FREQAOA                              C Freq Of ADL/IADL Assist From Caregiver

                               2,263                      Missing
                                   5                   UK Unknown
                               2,290                   01 Daily
                                 308                   02 Three or more times per week
                                 257                   03 One to two times per week
                                  98                   04 Received, but less often than weekly
                                 219                   05 No assistance received

M2200A    644  1                                        C Therapy Need - NA

M2200B    645  3                                        C Therapy Need - Number Of Visits

M2250A    648  2  $YESNAOA                              C Plan Care Synopsis - At Risk For Falls

                               3,627                      Missing
                                 163                   NA Inapplicable
                                  61                   00 No
                               1,589                   01 Yes

M2250B    650  2  $YESNAOA                              C Plan Care Synopsis - Depression

                               3,627                      Missing
                               1,239                   NA Inapplicable
                                  95                   00 No
                                 479                   01 Yes

M2250C    652  2  $YESNAOA                              C Plan Care Synopsis - Diabetic Foot Care

                               3,627                      Missing
                               1,111                   NA Inapplicable
                                  70                   00 No
                                 632                   01 Yes

M2250D    654  2  $YESNAOA                              C Plan Care Synopsis - Pain Intervention

                               3,627                      Missing
                                 453                   NA Inapplicable
                                  58                   00 No
                               1,302                   01 Yes

M2250E    656  2  $YESNAOA                              C Plan Care Synopsis - Patient Specific

                               3,627                      Missing
                                 838                   NA Inapplicable
                                 103                   00 No
                                 872                   01 Yes

M2250F    658  2  $YESNAOA                              C Plan Care Synopsis - Pr Ulcer Treatment

                               3,627                      Missing
                               1,641                   NA Inapplicable
                                  53                   00 No
                                 119                   01 Yes

M2250G    660  2  $YESNAOA                              C Plan Care Synopsis - Pr Ulcer Prevention

                               3,627                      Missing
                               1,131                   NA Inapplicable
                                  69                   00 No
                                 613                   01 Yes

M2300     662  2  $EMERCOA                              C Emergent Care Since Last OASIS

                               3,448                      Missing
                                  22                   UK Unknown
                               1,520                   00 No
                                  61                   01 Yes, without hospital admission
                                 389                   02 Yes, with hospital admission

M2310A    664  1  $INDICOA                              C Emergent Care - Acute Mental/Behavioral

                               4,990                      Missing
                                 437                    0 Not indicated
                                  13                    1 Indicated

M2310B    665  1  $INDICOA                              C Emergent Care - Cardiac Dysrhythmia

                               4,990                      Missing
                                 439                    0 Not indicated
                                  11                    1 Indicated

M2310C    666  1  $INDICOA                              C Emergent Care - Dehydration

                               4,990                      Missing
                                 427                    0 Not indicated
                                  23                    1 Indicated

M2310D    667  1  $INDICOA                              C Emergent Care - DVT, Pulmonary Embolus

                               4,990                      Missing
                                 447                    0 Not indicated
                                   3                    1 Indicated

M2310E    668  1  $INDICOA                              C Emergent Care - GI Issues

                               4,990                      Missing
                                 444                    0 Not indicated
                                   6                    1 Indicated

M2310F    669  1  $INDICOA                              C Emergent Care - Heart Failure

                               4,990                      Missing
                                 426                    0 Not indicated
                                  24                    1 Indicated

M2310G    670  1  $INDICOA                              C Emergent Care - Hypo/Hyperglycemia

                               4,990                      Missing
                                 433                    0 Not indicated
                                  17                    1 Indicated

M2310H    671  1  $INDICOA                              C Emergent Care - Improp Medication Admin

                               4,990                      Missing
                                 445                    0 Not indicated
                                   5                    1 Indicated

M2310I    672  1  $INDICOA                              C Emergent Care - Injury Caused By Fall

                               4,990                      Missing
                                 411                    0 Not indicated
                                  39                    1 Indicated

M2310J    673  1  $INDICOA                              C Emergent Care - IV Catheter Infection

                               4,990                      Missing
                                 447                    0 Not indicated
                                   3                    1 Indicated

M2310K    674  1  $INDICOA                              C Emergent Care - Myocardial Infarction

                               4,990                      Missing
                                 427                    0 Not indicated
                                  23                    1 Indicated

M2310L    675  1  $INDICOA                              C Emergent Care - Other Heart Disease

                               4,990                      Missing
                                 446                    0 Not indicated
                                   4                    1 Indicated

M2310M    676  1  $INDICOA                              C Emergent Care - Other Respiratory

                               4,990                      Missing
                                 401                    0 Not indicated
                                  49                    1 Indicated

M2310N    677  1  $INDICOA                              C Emergent Care - Other Than Above

                               4,990                      Missing
                                 293                    0 Not indicated
                                 157                    1 Indicated

M2310O    678  1  $INDICOA                              C Emergent Care - Reason Unknown

                               4,990                      Missing
                                 415                    0 Not indicated
                                  35                    1 Indicated

M2310P    679  1  $INDICOA                              C Emergent Care - Respiratory Infection

                               4,990                      Missing
                                 411                    0 Not indicated
                                  39                    1 Indicated

M2310Q    680  1  $INDICOA                              C Emergent Care - Stroke (CVA) Or TIA

                               4,990                      Missing
                                 436                    0 Not indicated
                                  14                    1 Indicated

M2310R    681  1  $INDICOA                              C Emergent Care - Uncontrolled Pain

                               4,990                      Missing
                                 428                    0 Not indicated
                                  22                    1 Indicated

M2310S    682  1  $INDICOA                              C Emergent Care - Urinary Tract Infection

                               4,990                      Missing
                                 439                    0 Not indicated
                                  11                    1 Indicated

M2310T    683  1  $INDICOA                              C Emergent Care - Wound Infection Or Deter

                               4,990                      Missing
                                 437                    0 Not indicated
                                  13                    1 Indicated

M2400A    684  2  $YESNAOA                              C Intervention - Depression Intervent

                               3,448                      Missing
                               1,427                   NA Inapplicable
                                 119                   00 No
                                 446                   01 Yes

M2400B    686  2  $YESNAOA                              C Intervention - Diabetic Foot Care

                               3,448                      Missing
                               1,284                   NA Inapplicable
                                  87                   00 No
                                 621                   01 Yes

M2400C    688  2  $YESNAOA                              C Intervention - Falls Prevention

                               3,448                      Missing
                                 196                   NA Inapplicable
                                  64                   00 No
                               1,732                   01 Yes

M2400D    690  2  $YESNAOA                              C Intervention - Treat Of Pressure Ulcer

                               3,448                      Missing
                               1,800                   NA Inapplicable
                                  59                   00 No
                                 133                   01 Yes

M2400E    692  2  $YESNAOA                              C Intervention - Monitor And Mitigate Pain

                               3,448                      Missing
                                 558                   NA Inapplicable
                                  69                   00 No
                               1,365                   01 Yes

M2400F    694  2  $YESNAOA                              C Intervention - Prevent Pressure Ulcers

                               3,448                      Missing
                               1,354                   NA Inapplicable
                                  65                   00 No
                                 573                   01 Yes

M2410     696  2  $INFACOA                              C Inpatient Facility Admitted

                               3,447                      Missing
                               1,365                   NA No inpatient facility admission
                                 593                   01 Hospital
                                  11                   02 Rehabilitation facility
                                  23                   03 Nursing home
                                   1                   04 Hospice

M2420     698  2  $DISPOCA                              C Discharge Disposition

                               4,076                      Missing
                                   7                   UK Unknown, other
                               1,015                   01 Patient remained in commun, no assistive
                                 306                   02 Patient remained in commun, assistive
                                  19                   03 Patient transferred to a noninsti hospic
                                  17                   04 Unknown, location not served by agency

M2430A    700  1  $INDICOA                              C Hospital - Acute Mental/Behavioral

                               4,847                      Missing
                                 579                    0 Not indicated
                                  14                    1 Indicated

M2430B    701  1  $INDICOA                              C Hospital - Cardiac Dysrhythmia

                               4,847                      Missing
                                 582                    0 Not indicated
                                  11                    1 Indicated

M2430C    702  1  $INDICOA                              C Hospital - Dehydration

                               4,847                      Missing
                                 568                    0 Not indicated
                                  25                    1 Indicated

M2430D    703  1  $INDICOA                              C Hospital - DVT, Pulmonary Embolus

                               4,847                      Missing
                                 588                    0 Not indicated
                                   5                    1 Indicated

M2430E    704  1  $INDICOA                              C Hospital - GI Issues

                               4,847                      Missing
                                 581                    0 Not indicated
                                  12                    1 Indicated

M2430F    705  1  $INDICOA                              C Hospital - Heart Failure

                               4,847                      Missing
                                 552                    0 Not indicated
                                  41                    1 Indicated

M2430G    706  1  $INDICOA                              C Hospital - Hypo/Hyperglycemic

                               4,847                      Missing
                                 573                    0 Not indicated
                                  20                    1 Indicated

M2430H    707  1  $INDICOA                              C Hospital - Improp Medication Admin

                               4,847                      Missing
                                 590                    0 Not indicated
                                   3                    1 Indicated

M2430I    708  1  $INDICOA                              C Hospital - Injury Caused By Fall

                               4,847                      Missing
                                 553                    0 Not indicated
                                  40                    1 Indicated

M2430J    709  1  $INDICOA                              C Hospital - IV Catheter Infection

                               4,847                      Missing
                                 591                    0 Not indicated
                                   2                    1 Indicated

M2430K    710  1  $INDICOA                              C Hospital - Myocardial Infarction

                               4,847                      Missing
                                 569                    0 Not indicated
                                  24                    1 Indicated

M2430L    711  1  $INDICOA                              C Hospital - Other Heart Disease

                               4,847                      Missing
                                 583                    0 Not indicated
                                  10                    1 Indicated

M2430M    712  1  $INDICOA                              C Hospital - Other Respiratory Problem

                               4,847                      Missing
                                 532                    0 Not indicated
                                  61                    1 Indicated

M2430N    713  1  $INDICOA                              C Hospital - Other Than Above

                               4,847                      Missing
                                 391                    0 Not indicated
                                 202                    1 Indicated

M2430O    714  1  $INDICOA                              C Hospital - Reason Unknown

                               4,847                      Missing
                                 536                    0 Not indicated
                                  57                    1 Indicated

M2430P    715  1  $INDICOA                              C Hospital - Respiratory Infection

                               4,847                      Missing
                                 539                    0 Not indicated
                                  54                    1 Indicated

M2430Q    716  1  $INDICOA                              C Hospital - Scheduled Treat Or Procedure

                               4,847                      Missing
                                 566                    0 Not indicated
                                  27                    1 Indicated

M2430R    717  1  $INDICOA                              C Hospital - Stroke (CVA) Or TIA

                               4,847                      Missing
                                 576                    0 Not indicated
                                  17                    1 Indicated

M2430S    718  1  $INDICOA                              C Hospital - Uncontrolled Pain

                               4,847                      Missing
                                 571                    0 Not indicated
                                  22                    1 Indicated

M2430T    719  1  $INDICOA                              C Hospital - Urinary Tract Infect

                               4,847                      Missing
                                 571                    0 Not indicated
                                  22                    1 Indicated

M2430U    720  1  $INDICOA                              C Hospital - Wound Infection Or Deter

                               4,847                      Missing
                                 572                    0 Not indicated
                                  21                    1 Indicated

M2440A    721  1  $INDICOA                              C Nursing Home - Hospice Care

                               5,417                      Missing
                                  22                    0 Not indicated
                                   1                    1 Indicated

M2440B    722  1  $INDICOA                              C Nursing Home - Other

                               5,417                      Missing
                                  19                    0 Not indicated
                                   4                    1 Indicated

M2440C    723  1  $INDICOA                              C Nursing Home - Permanent Placement

                               5,417                      Missing
                                  13                    0 Not indicated
                                  10                    1 Indicated

M2440D    724  1  $INDICOA                              C Nursing Home - Respite Care

                               5,417                      Missing
                                  20                    0 Not indicated
                                   3                    1 Indicated

M2440E    725  1  $INDICOA                              C Nursing Home - Therapy Services

                               5,417                      Missing
                                  18                    0 Not indicated
                                   5                    1 Indicated

M2440F    726  1  $INDICOA                              C Nursing Home - Unknown

                               5,417                      Missing
                                  21                    0 Not indicated
                                   2                    1 Indicated

M2440G    727  1  $INDICOA                              C Nursing Home - Unsafe At Home

                               5,417                      Missing
                                  18                    0 Not indicated
                                   5                    1 Indicated

