RIC         1  2                                        C Record Identification Code

VERSION     3  1  $VERSION                              C Version Number

                               4,189                    1 Version 1
                                   0                    2 Version 2
                                   0                    3 Version 3
                                   0                    4 Version 4

BASEID      4  8  $BSIDFMT                              C Unique SP Identification Number

                               4,189             LOW-HIGH BASEID Count

M0010_CM  171 12                                        C M0010 CMS Certification Number (CCN)

M0014_BR  183  2                                        C M0014 Branch State Code

M0016_BR  185 10                                        C M0016 Branch ID

M0018_NN  195 10                                        C M0018 NPI Physician ID

M0018_NU  205  1                                        C M0018 NPI Physician ID Unknown

M0030_ST  226  8                                        C M0030 Start of Care Date

M0032_RO  234  8                                        C M0032 Resumption of Care Date

M0032_RN  242  1                                        C M0032 Resumption of Care Date NA

M0069_GN  336  1  $SEXFMT                               C M0069 Patient Sex

                               1,491                    1 Male
                               2,698                    2 Female

M0080_AS  337  2  $DISCIOA                              C M0080 Disc of Person Completing Assess

                               3,530                   01 RN
                                 591                   02 PT
                                  15                   03 SLP/ST
                                  53                   04 OT

M0090_AS  339  8                                        C M0090 Date Assessment Completed

M0100_RS  347  2  $ACOMPOA                              C M0100 Reason for Assessment

                               1,439                   01 S/R; Start; further visits planned
                                   0                   02 S/R; Start; no further visits planned
                                 241                   03 S/R; Resumption of care
                                 861                   04 Follow-up; Recertification
                                  17                   05 Follow-up; Other
                                 409                   06 Transfer to inpat fac; Patient not disch
                                  55                   07 Transfer to inpat fac; Patient disch
                                   4                   08 Disch from agency; Death at home
                               1,163                   09 Disch from agency; Disch from agency
                                   0                   10 Disch from agency; No visits completed

M0102_PD  349  8                                        C M0102 Phys Ordered SOC or ROC Date

M0102_PN  357  1                                        C M0102 Phys Ordered SOC or ROC Date NA

M0104_RF  358  8                                        C M0104 Date Of Referral

M0110_EP  366  2  $EPSDFMT                              C M0110 Episode Timing

                               1,631                      Missing
                                 190                   NA No case mix group defined
                                  85                   UK Unknown
                               1,704                   01 Early
                                 579                   02 Later

M0140_AM  368  1  $INDICOA                              C M0140 Race/Eth:Amer Indian/Alaskan Nat

                               2,509                      Missing
                               1,666                    0 Not indicated
                                  14                    1 Indicated

M0140_AS  369  1  $INDICOA                              C M0140 Race/Eth:Asian

                               2,509                      Missing
                               1,645                    0 Not indicated
                                  35                    1 Indicated

M0140_AF  370  1  $INDICOA                              C M0140 Race/Eth:Black or African-American

                               2,509                      Missing
                               1,450                    0 Not indicated
                                 230                    1 Indicated

M0140_HS  371  1  $INDICOA                              C M0140 Race/Eth:Hispanic or Latino

                               2,509                      Missing
                               1,568                    0 Not indicated
                                 112                    1 Indicated

M0140_NT  372  1  $INDICOA                              C M0140 Race/Eth:Nat Hawaii/Oth Pacific Is

                               2,509                      Missing
                               1,677                    0 Not indicated
                                   3                    1 Indicated

M0140_WH  373  1  $INDICOA                              C M0140 Race/Eth:White

                               2,509                      Missing
                                 392                    0 Not indicated
                               1,288                    1 Indicated

M0150_DF  374  1  $INDICOA                              C M0150 Medicaid Fee For Service Payment

                               3,852                    0 Not indicated
                                 337                    1 Indicated

M0150_DH  375  1  $INDICOA                              C M0150 Medicaid HMO/Managed Care Payment

                               4,153                    0 Not indicated
                                  36                    1 Indicated

M0150_RF  376  1  $INDICOA                              C M0150 Medicare Fee For Service Payment

                                 956                    0 Not indicated
                               3,233                    1 Indicated

M0150_RH  377  1  $INDICOA                              C M0150 Medicare HMO/Managed Care Payment

                               3,453                    0 Not indicated
                                 736                    1 Indicated

M0150_NO  378  1  $INDICOA                              C M0150 No Payment

                               4,189                    0 Not indicated
                                   0                    1 Indicated

M0150_OG  379  1  $INDICOA                              C M0150 Other Government Payment

                               4,184                    0 Not indicated
                                   5                    1 Indicated

M0150_OP  380  1  $INDICOA                              C M0150 Other Payment Source

                               4,164                    0 Not indicated
                                  25                    1 Indicated

M0150_PH  381  1  $INDICOA                              C M0150 Private HMO/Managed Care Payment

                               4,177                    0 Not indicated
                                  12                    1 Indicated

M0150_PI  382  1  $INDICOA                              C M0150 Private Insurance Payment

                               4,065                    0 Not indicated
                                 124                    1 Indicated

M0150_SE  383  1  $INDICOA                              C M0150 Self-Pay Payment

                               4,162                    0 Not indicated
                                  27                    1 Indicated

M0150_TI  384  1  $INDICOA                              C M0150 Title Programs Payment

                               4,188                    0 Not indicated
                                   1                    1 Indicated

M0150_UN  385  1  $INDICOA                              C M0150 Unknown Payment Source

                               2,509                      Missing
                               1,680                    0 Not indicated
                                   0                    1 Indicated

M0150_WC  386  1  $INDICOA                              C M0150 Workers Compensation Payment

                               4,187                    0 Not indicated
                                   2                    1 Indicated

M0903_LA  387  8                                        C M0903 Date of Last Home Visit

M0906_DS  395  8                                        C M0906 Discharge/Transfer/Death Date

M1000_IP  403  1  $INDICOA                              C M1000 Inp Discharg;Short Stay Acut Hosp

                               2,509                      Missing
                                 936                    0 Not indicated
                                 744                    1 Indicated

M1000_IR  404  1  $INDICOA                              C M1000 Inp Discharg;IRF

                               2,509                      Missing
                               1,565                    0 Not indicated
                                 115                    1 Indicated

M1000_NF  405  1  $INDICOA                              C M1000 Inp Discharg;Nursing Facility

                               2,509                      Missing
                               1,667                    0 Not indicated
                                  13                    1 Indicated

M1000_LT  406  1  $INDICOA                              C M1000 Discharged Past 14 Days;LTCH

                               2,509                      Missing
                               1,658                    0 Not indicated
                                  22                    1 Indicated

M1000_OT  407  1  $INDICOA                              C M1000 Inp Discharg;Other

                               2,509                      Missing
                               1,678                    0 Not indicated
                                   2                    1 Indicated

M1000_PS  408  1  $INDICOA                              C M1000 Inp Discharg;Psych Hospital Or Uni

                               2,509                      Missing
                               1,677                    0 Not indicated
                                   3                    1 Indicated

M1000_SN  409  1  $INDICOA                              C M1000 Inp Discharg;SNF/TCU Facility

                               2,509                      Missing
                               1,427                    0 Not indicated
                                 253                    1 Indicated

M1000_NO  410  1  $INDICOA                              C M1000 No Inp Discharge

                               2,509                      Missing
                               1,102                    0 Not indicated
                                 578                    1 Indicated

M1005_IU  411  1                                        C M1005 Inpat Discharge Date Unknown

M1005_ID  412  8                                        C M1005 Most Recent Inpat Discharge Date

M1010_I1  420  8                                        C M1010 Inpat Diagnosis 1 ICD-9 CD

M1010_I2  428  8                                        C M1010 Inpat Diagnosis 2 ICD-9 CD

M1010_I3  436  8                                        C M1010 Inpat Diagnosis 3 ICD-9 CD

M1010_I4  444  8                                        C M1010 Inpat Diagnosis 4 ICD-9 CD

M1010_I5  452  8                                        C M1010 Inpat Diagnosis 5 ICD-9 CD

M1010_I6  460  8                                        C M1010 Inpat Diagnosis 6 ICD-9 CD

M1012_IN  468  1                                        C M1012 Inpat Procedure ICD-9 NA

M1012_IU  469  1                                        C M1012 Inpat Procedure ICD-9 Unknown

M1012_I1  470  8                                        C M1012 Inpat Procedure 1 ICD-9

M1012_I2  478  8                                        C M1012 Inpat Procedure 2 ICD-9

M1012_I3  486  8                                        C M1012 Inpat Procedure 3 ICD-9

M1012_I4  494  8                                        C M1012 Inpat Procedure 4 ICD-9

M1016_M1  502  8                                        C M1016 Reg Change;Diagnosis 1 ICD-9

M1016_M2  510  8                                        C M1016 Reg Change;Diagnosis 2 ICD-9

M1016_M3  518  8                                        C M1016 Reg Change;Diagnosis 3 ICD-9

M1016_M4  526  8                                        C M1016 Reg Change;Diagnosis 4 ICD-9

M1016_M5  534  8                                        C M1016 Reg Change;Diagnosis 5 ICD-9

M1016_M6  542  8                                        C M1016 Reg Change;Diagnosis 6 ICD-9

M1016_MN  550  1                                        C M1016 Reg Change;Not Applic ICD-9 Code

M1018_IC  551  1  $INDICOA                              C M1018 Pri Cond;Indwelling/SuprapubicCath

                               2,509                      Missing
                               1,650                    0 Not indicated
                                  30                    1 Indicated

M1018_DB  552  1  $INDICOA                              C M1018 Pri Cond;Disruptive Behavior

                               2,509                      Missing
                               1,658                    0 Not indicated
                                  22                    1 Indicated

M1018_ID  553  1  $INDICOA                              C M1018 Pri Cond;Impaired Decision-Making

                               2,509                      Missing
                               1,387                    0 Not indicated
                                 293                    1 Indicated

M1018_IP  554  1  $INDICOA                              C M1018 Pri Cond;Intractable Pain

                               2,509                      Missing
                               1,454                    0 Not indicated
                                 226                    1 Indicated

M1018_ML  555  1  $INDICOA                              C M1018 Pri Cond;Memory Loss

                               2,509                      Missing
                               1,478                    0 Not indicated
                                 202                    1 Indicated

M1018_NA  556  1  $INDICOA                              C M1018 Pri Cond;Not Applicable

                               2,509                      Missing
                               1,559                    0 Not indicated
                                 121                    1 Indicated

M1018_NO  557  1  $INDICOA                              C M1018 Pri Cond;None of the Above

                               2,509                      Missing
                               1,033                    0 Not indicated
                                 647                    1 Indicated

M1018_UN  558  1  $INDICOA                              C M1018 Pri Cond;Unknown

                               2,509                      Missing
                               1,657                    0 Not indicated
                                  23                    1 Indicated

M1018_UI  559  1  $INDICOA                              C M1018 Pri Cond;Urinary Incontinence

                               2,509                      Missing
                               1,061                    0 Not indicated
                                 619                    1 Indicated

M1020_PD  560  8                                        C M1020 Pri Diagnosis ICD-9 Code

M1020_PS  568  2  $SEVEROA                              C M1020 Pri Severity Rating ICD-9 Code

                               2,186                      Missing
                                   0                   00 Asymptomatic, not treatement needed
                                  60                   01 Symptoms contr with current therapy
                                 839                   02 Symptoms contr with difficulty
                                 926                   03 Symptoms poorly contr, freq dose adjust
                                 178                   04 Symptoms poorly contr, hist rehospitali

M1022_D1  570  8                                        C M1022 Oth Diag Code 1 ICD-9

M1022_1S  578  2  $SEVEROA                              C M1022 Oth Diag Code 1 Severity ICD-9

                               1,842                      Missing
                                   1                   00 Asymptomatic, not treatement needed
                                 145                   01 Symptoms contr with current therapy
                               1,182                   02 Symptoms contr with difficulty
                                 897                   03 Symptoms poorly contr, freq dose adjust
                                 122                   04 Symptoms poorly contr, hist rehospitali

M1022_D2  580  8                                        C M1022 Oth Diag Code 2 ICD-9

M1022_2S  588  2  $SEVEROA                              C M1022 Oth Diag Code 2 Severity ICD-9

                               1,802                      Missing
                                   1                   00 Asymptomatic, not treatement needed
                                 303                   01 Symptoms contr with current therapy
                               1,322                   02 Symptoms contr with difficulty
                                 671                   03 Symptoms poorly contr, freq dose adjust
                                  90                   04 Symptoms poorly contr, hist rehospitali

M1022_D3  590  8                                        C M1022 Oth Diag Code 3 ICD-9

M1022_3S  598  2  $SEVEROA                              C M1022 Oth Diag Code 3 Severity ICD-9

                               1,915                      Missing
                                   3                   00 Asymptomatic, not treatement needed
                                 377                   01 Symptoms contr with current therapy
                               1,314                   02 Symptoms contr with difficulty
                                 511                   03 Symptoms poorly contr, freq dose adjust
                                  69                   04 Symptoms poorly contr, hist rehospitali

M1022_D4  600  8                                        C M1022 Oth Diag Code 4 ICD-9

M1022_4S  608  2  $SEVEROA                              C M1022 Oth Diag Code 4 Severity ICD-9

                               2,194                      Missing
                                   5                   00 Asymptomatic, not treatement needed
                                 360                   01 Symptoms contr with current therapy
                               1,228                   02 Symptoms contr with difficulty
                                 367                   03 Symptoms poorly contr, freq dose adjust
                                  35                   04 Symptoms poorly contr, hist rehospitali

M1022_D5  610  8                                        C M1022 Oth Diag Code 5 ICD-9

M1022_5S  618  2  $SEVEROA                              C M1022 Oth Diag Code 5 Severity ICD-9

                               2,581                      Missing
                                   7                   00 Asymptomatic, not treatement needed
                                 375                   01 Symptoms contr with current therapy
                                 927                   02 Symptoms contr with difficulty
                                 262                   03 Symptoms poorly contr, freq dose adjust
                                  37                   04 Symptoms poorly contr, hist rehospitali

M1024_PC  620  8                                        C M1024 ICD-9 Case Mix Diag:Primary,Col 3

M1024_PM  628  8                                        C M1024 ICD-9 Case Mix Diag:Primary,Col 4

M1024_D1  636  8                                        C M1024 Oth Payment Primary Diag 1 Code

M1024_1M  644  8                                        C M1024 Oth Payment Diag 1 Multiple ICD-9

M1024_D2  652  8                                        C M1024 Oth Payment Primary Diag 2 Code

M1024_2M  660  8                                        C M1024 Oth Payment Diag 2 Multiple ICD-9

M1024_D3  668  8                                        C M1024 Oth Payment Primary Diag 3 Code

M1024_3M  676  8                                        C M1024 Oth Payment Diag 3 Multiple ICD-9

M1024_D4  684  8                                        C M1024 Oth Payment Primary Diag 4 Code

M1024_4M  692  8                                        C M1024 Oth Payment Diag 4 Multiple ICD-9

M1024_D5  700  8                                        C M1024 Oth Payment Primary Diag 5 Code

M1024_5M  708  8                                        C M1024 Oth Payment Diag 5 Multiple ICD-9

M1030_HE  716  1  $INDICOA                              C M1030 Home Thera; Enteral Nutrition

                               1,631                      Missing
                               2,531                    0 Not indicated
                                  27                    1 Indicated

M1030_HI  717  1  $INDICOA                              C M1030 Home Thera; Intravenous/Infusion T

                               1,631                      Missing
                               2,500                    0 Not indicated
                                  58                    1 Indicated

M1030_HN  718  1  $INDICOA                              C M1030 Home Thera; None of the Above

                               1,631                      Missing
                                  83                    0 Not indicated
                               2,475                    1 Indicated

M1030_HP  719  1  $INDICOA                              C M1030 Home Thera; Parenteral Nutrition

                               1,631                      Missing
                               2,558                    0 Not indicated
                                   0                    1 Indicated

M1032_RD  720  1  $INDICOA                              C M1032 Risk Hosp;Mental/Emotional/Behavio

                               2,509                      Missing
                               1,462                    0 Not indicated
                                 218                    1 Indicated

M1032_RR  721  1  $INDICOA                              C M1032 Risk Hosp;Frailty Indicators

                               2,509                      Missing
                               1,089                    0 Not indicated
                                 591                    1 Indicated

M1032_RA  722  1  $INDICOA                              C M1032 Risk Hosp;History of Falls

                               2,509                      Missing
                               1,101                    0 Not indicated
                                 579                    1 Indicated

M1032_RM  723  1  $INDICOA                              C M1032 Risk Hosp;Mult Hospitalizations

                               2,509                      Missing
                               1,075                    0 Not indicated
                                 605                    1 Indicated

M1032_RN  724  1  $INDICOA                              C M1032 Risk Hosp;None of the Above

                               2,509                      Missing
                               1,632                    0 Not indicated
                                  48                    1 Indicated

M1032_R_  725  1  $INDICOA                              C M1032 Risk Hosp;5 or More Meds

                               2,509                      Missing
                                 189                    0 Not indicated
                               1,491                    1 Indicated

M1032_HO  726  1  $INDICOA                              C M1032 Risk Hosp;Other

                               2,509                      Missing
                               1,509                    0 Not indicated
                                 171                    1 Indicated

M1034_OV  727  2  $STATUOA                              C M1034 Overall Status

                               2,509                      Missing
                                   7                   UK Unknown
                                 177                   00 SP is stable with no heightened risk
                                 881                   01 SP is temporarily facing high health ris
                                 527                   02 SP is likely to remain in fragile health
                                  88                   03 SP has serious progressive conditions

M1036_RA  729  1  $INDICOA                              C M1036 Risk Factor - Alcohol Dependency

                               2,509                      Missing
                               1,619                    0 Not indicated
                                  61                    1 Indicated

M1036_RD  730  1  $INDICOA                              C M1036 Risk Factor - Drug Dependency

                               2,509                      Missing
                               1,659                    0 Not indicated
                                  21                    1 Indicated

M1036_RN  731  1  $INDICOA                              C M1036 Risk Factor - None of the Above

                               2,509                      Missing
                                 664                    0 Not indicated
                               1,016                    1 Indicated

M1036_RO  732  1  $INDICOA                              C M1036 Risk Factor - Obesity

                               2,509                      Missing
                               1,316                    0 Not indicated
                                 364                    1 Indicated

M1036_RS  733  1  $INDICOA                              C M1036 Risk Factor - Smoking

                               2,509                      Missing
                               1,386                    0 Not indicated
                                 294                    1 Indicated

M1036_RU  734  1  $INDICOA                              C M1036 Risk Factor - Unknown

                               2,509                      Missing
                               1,640                    0 Not indicated
                                  40                    1 Indicated

M1040_IN  735  2  $YESNAOA                              C M1040 Influ Vacc;Received from Agency

                               2,562                      Missing
                                 407                   NA Inapplicable
                               1,173                   00 No
                                  47                   01 Yes

M1045_RS  737  2  $INFLUOA                              C M1045 Influ Vacc;Reason Not Received

                               3,016                      Missing
                                 882                   01 Rec from other health care provider
                                   7                   02 Rec from agency previously
                                  96                   03 Offered and declined
                                   5                   04 Medical contraindication(s)
                                   3                   05 Does not meet age/condition guidelines
                                   0                   06 Inability to obtain due to shortage
                                 180                   07 None of the above

M1050_PP  739  1  $YESNOOA                              C M1050 Pneumo Vacc;Received In Agency

                               2,562                      Missing
                               1,592                    0 No
                                  35                    1 Yes

M1055_RS  740  2  $PPVNOOA                              C M1055 Pneumol Vacc;Reason Not Received

                               2,597                      Missing
                               1,153                   01 Rec PPV in past
                                 103                   02 Offered and declined
                                   2                   03 Medical contraindication(s)
                                  41                   04 Does not meet age/condition guidelines
                                 293                   05 None of the above

M1100_PT  742  2                                        C M1100 Patient Living Arrangement

M1200_VS  744  2  $VISIOOA                              C M1200 Vision

                               1,631                      Missing
                               1,743                   00 Normal vision
                                 777                   01 Partially impaired
                                  38                   02 Severely impaired

M1210_HE  746  2  $HEARCOA                              C M1210 Hearing

                               2,509                      Missing
                                   4                   UK Unable to assess hearing
                                 940                   00 Adequate
                                 715                   01 Mildly to moderately impaired
                                  21                   02 Severely impaired

M1220_UN  748  2  $VERBAOA                              C M1220 Understand Verbal Content

                               2,509                      Missing
                                   6                   UK Unable to assess hearing
                                 911                   00 Understands
                                 614                   01 Usually understands
                                 143                   02 Sometimes understands
                                   6                   03 Never understands

M1230_VR  750  2  $SPEECOA                              C M1230 Verbal Expression

                               1,346                      Missing
                               1,759                   00 No observable impairement
                                 799                   01 Minimal difficulty
                                 186                   02 Moderate difficulty
                                  74                   03 Severe difficulty
                                  15                   04 Unable to express basic needs
                                  10                   05 Nonresponsive or unable to speak

M1240_PA  752  2  $PAINAOA                              C M1240 Formal Pain Assess

                               2,509                      Missing
                                  26                   00 No standardized assessment
                               1,246                   01 Yes, severe pain not indicated
                                 408                   02 Yes, severe pain indicated

M1242_PA  754  2  $FREQCOA                              C M1242 Freq Of Pain Interfere W Activity

                                 468                      Missing
                               1,077                   00 No pain
                                 434                   01 Pain does not interfere
                                 458                   02 Less often than daily
                               1,371                   03 Daily, but not constantly
                                 381                   04 All of the time

M1300_PR  756  2  $ULASSOA                              C M1300 Pressure Ulcer Assess

                               2,509                      Missing
                                  26                   00 No assessment conducted
                                 130                   01 Yes, based on eval of clinical factors
                               1,524                   02 Yes, using a standardized tool

M1302_PR  758  1  $YESNOOA                              C M1302 Risk Of Devel Press Ulcers

                               2,535                      Missing
                               1,020                    0 No
                                 634                    1 Yes

M1306_PR  759  1  $YESNOOA                              C M1306 Unheal Press Ulcers; St II+

                                 468                      Missing
                               3,549                    0 No
                                 172                    1 Yes

M1307_PD  760  8                                        C M1307 Oldest St II Press Ulcer Onset Dat

M1307_PS  768  2                                        C M1307 Oldest St II Press Ulcer Since SOC

M1308_2N  770  2                                        C M1308 # Curr Press Ulcers, St II

M1308_2A  772  2                                        C M1308 # St II Press Ulcers at SOC/ROC

M1308_3N  774  2                                        C M1308 # Curr Press Ulcers, St III

M1308_3A  776  2                                        C M1308 # St III Press Ulcers at SOC/ROC

M1308_4N  778  2                                        C M1308 # Current Press Ulcers, St IV

M1308_4A  780  2                                        C M1308 # Stage IV Press Ulcers at SOC/ROC

M1308_UN  782  2                                        C M1308 # Unstag PresUlc;NonRemovDsg

M1308_UD  784  2                                        C M1308 # Unstag PresUlc;NonRemovDsg@SOC/R

M1308_UE  786  2                                        C M1308 # Unstag PresUlc;Eschar@SOC/ROC

M1308_ES  788  2                                        C M1308 # Unstag PresUlc;Eschar

M1308_DE  790  2                                        C M1308 # Unstag PresUlc;DeepTissue

M1308_U_  792  2                                        C M1308 # Unstag PresUlc;DeepTissue@SOC/RO

M1310_ST  794  4                                        C M1310 Largest Press Ulcer Length

M1312_ST  798  4                                        C M1312 Largest Press Ulcer Width

M1314_ST  802  4                                        C M1314 Largest Press Ulcer Depth

M1320_PR  806  2  $ULSTAPO                              C M1320 Status, Most Problemat Press Ulcer

                               4,079                      Missing
                                   2                   NA No observable pressure ulcer
                                   2                   00 Newly epithelialized
                                   2                   01 Fully granulating
                                   5                   02 Early/Partial granulation
                                  99                   03 Not healing

M1322_ST  808  2  $ULNUMOA                              C M1322 Curr # Of Stage I Press Ulcers

                                 468                      Missing
                               3,652                   00 None
                                  57                   01 One
                                  12                   02 Two
                                   0                   03 Three
                                   0                   04 Four or more

M1324_PR  810  2  $ULSTGOA                              C M1324 Stage, Most Problemat Press Ulcer

                                 468                      Missing
                               3,524                   NA No observable pressure ulcer
                                  45                   01 Stage one
                                 116                   02 Stage two
                                  23                   03 Stage three
                                  13                   04 Stage four

M1330_ST  812  2  $STASUOA                              C M1330 Stasis Ulcer Present

                                 468                      Missing
                               3,664                   00 No
                                   3                   01 Yes, BOTH observable and unobservable
                                  49                   02 Yes, Observable only
                                   5                   03 Yes, Unobservable only

M1332_ST  814  2  $ULNUMOA                              C M1332 Curr # Of Stasis Ulcer

                               4,137                      Missing
                                   0                   00 None
                                  28                   01 One
                                  16                   02 Two
                                   3                   03 Three
                                   5                   04 Four or more

M1334_ST  816  2  $ULSTAQO                              C M1334 Status, Most Problemat Stasis Ulce

                               4,137                      Missing
                                   3                   00 Newly epithelialized
                                   2                   01 Fully granulating
                                  15                   02 Early/Partial granulation
                                  32                   03 Not healing

M1340_SR  818  2  $SURGWOA                              C M1340 Surgical Wound Present

                                 468                      Missing
                               3,170                   00 No
                                 507                   01 Yes, observable
                                  44                   02 Yes, not observable

M1342_SR  820  2  $ULSTAQO                              C M1342 Status, Most Problemat Surg Wound

                               3,682                      Missing
                                 231                   00 Newly epithelialized
                                  35                   01 Fully granulating
                                  68                   02 Early/Partial granulation
                                 173                   03 Not healing

M1350_OP  822  1  $YESNOOA                              C M1350 Skin Lesion Or Open Wound

                                 468                      Missing
                               3,118                    0 No
                                 603                    1 Yes

M1400_SO  823  2  $SBREAOA                              C M1400 When Is Patient Dyspneic or SOB

                                 468                      Missing
                               1,299                   00 Never
                                 914                   01 When walking more than 20 feet
                                 960                   02 With moderate exertion
                                 425                   03 With minimal exertion
                                 123                   04 At rest (day or night)

M1410_CP  825  1  $INDICOA                              C M1410 Resp Treat @ Home;CPAP/BPAP

                               1,346                      Missing
                               2,777                    0 Not indicated
                                  66                    1 Indicated

M1410_RS  826  1  $INDICOA                              C M1410 Resp Treat @ Home;None of the Abov

                               1,346                      Missing
                                 481                    0 Not indicated
                               2,362                    1 Indicated

M1410_OX  827  1  $INDICOA                              C M1410 Resp Treat @ Home;Oxygen

                               1,346                      Missing
                               2,409                    0 Not indicated
                                 434                    1 Indicated

M1410_VN  828  1  $INDICOA                              C M1410 Resp Treat @ Home;Ventilator

                               1,346                      Missing
                               2,842                    0 Not indicated
                                   1                    1 Indicated

M1500_HR  829  2  $SYMHFOA                              C M1500 Heart Fail Present

                               2,562                      Missing
                                 494                   00 No
                                 132                   01 Yes
                                   6                   02 Not assessed
                                 995                      NA

M1510_CA  831  1  $INDICOA                              C M1510 Heart Fail FollUp;Chg In Care Plan

                               4,059                      Missing
                                 120                    0 Not indicated
                                  10                    1 Indicated

M1510_CL  832  1  $INDICOA                              C M1510 Heart Fail FollUp;Pt Educ/Clinic I

                               4,059                      Missing
                                  43                    0 Not indicated
                                  87                    1 Indicated

M1510_ER  833  1  $INDICOA                              C M1510 Heart Fail FollUp;Emerg Trea Advis

                               4,057                      Missing
                                  93                    0 Not indicated
                                  39                    1 Indicated

M1510_NO  834  1  $INDICOA                              C M1510 Heart Fail FollUp;No Action Taken

                               4,058                      Missing
                                 131                    0 Not indicated
                                   0                    1 Indicated

M1510_CN  835  1  $INDICOA                              C M1510 Heart Fail FollUp;Phys Contacted

                               4,058                      Missing
                                  76                    0 Not indicated
                                  55                    1 Indicated

M1510_TR  836  1  $INDICOA                              C M1510 Heart Fail FollUp;Phys Ordered Tre

                               4,059                      Missing
                                  88                    0 Not indicated
                                  42                    1 Indicated

M1600_UT  837  2  $UTINFOA                              C M1600 UTI Treatment

                               1,346                      Missing
                                  16                   NA Patient on prophylactic treatment
                                  15                   UK Unknown
                               2,599                   00 No
                                 213                   01 Yes

M1610_UR  839  2  $UIUCPOA                              C M1610 Urinar Incont Or Catheter Presence

                                 468                      Missing
                               1,714                   00 No incontinence or catheter
                               1,842                   01 Patient is incintinent
                                 165                   02 Patient requires a urinary catheter

M1615_UR  841  2  $URINCOO                              C M1615 Urinar Incont Timing

                               2,831                      Missing
                                 144                   00 Timed-voiding deters incontinence
                                 478                   01 Occasional stress incontinence
                                  49                   02 During the night only
                                  14                   03 During the day only
                                 673                   04 During the day and night

M1620_BW  843  2  $BWINCOA                              C M1620 Bowel Incontinence Frequency

                                 468                      Missing
                                  42                   NA Patient has ostomy for bowel elimination
                                   4                   UK Unknown
                               3,067                   00 Very rarely or never has bowel incont
                                 202                   01 Less than once weekly
                                 188                   02 One to three times weekly
                                  78                   03 Four to six times weekly
                                 118                   04 On a daily basis
                                  22                   05 More often than once daily

M1630_OS  845  2  $BWOSTOA                              C M1630 Ostomy For Bowel Elimination

                               1,631                      Missing
                               2,526                   00 Does not have an ostomy
                                  21                   01 Ostomy was not related to inpatient stay
                                  11                   02 Ostomy was related to inpatient stay

M1700_CG  847  2  $COGFUOA                              C M1700 Cognitive Functioning

                               1,346                      Missing
                               1,577                   00 Alert/Oriented
                                 859                   01 Req prompting
                                 299                   02 Req assist and some direction
                                  86                   03 Req conciderable assist in routine situa
                                  22                   04 Totally dependent due to disturbances

M1710_CN  849  2  $WCONFOA                              C M1710 When Confused Frequency

                               1,346                      Missing
                                  11                   NA Patient nonresponsive
                               1,370                   00 Never
                               1,075                   01 In new or complex situations
                                  44                   02 On awakening or at night only
                                 253                   03 During the day or evening
                                  90                   04 Constantly

M1720_AN  851  2  $WANXIOA                              C M1720 When Anxious Frequency

                               1,346                      Missing
                                   8                   NA Patient nonresponsive
                               1,636                   00 None of the time
                                 738                   01 Less often than daily
                                 439                   02 Daily, but not constantly
                                  22                   03 All of the time

M1730_DS  853  2  $DEPRAOA                              C M1730 Depression Screening

                               2,509                      Missing
                                   0                   NA Patient nonresponsive
                                  64                   00 No
                               1,564                   01 Yes, PHQ-2 scale
                                   5                   02 Yes, other, further evaluation
                                  47                   03 Yes, other, no further evaluation

M1730_PD  855  2  $DEPRAOA                              C M1730 PHQ2 Down/Depressed/Hopeless

                               2,625                      Missing
                                  22                   NA Patient nonresponsive
                               1,196                   00 No
                                 275                   01 Yes, PHQ-2 scale
                                  47                   02 Yes, other, further evaluation
                                  24                   03 Yes, other, no further evaluation

M1730_PI  857  2  $DEPRAOA                              C M1730 PHQ2 Little Interest/Pleasure

                               2,625                      Missing
                                  20                   NA Patient nonresponsive
                               1,209                   00 No
                                 270                   01 Yes, PHQ-2 scale
                                  38                   02 Yes, other, further evaluation
                                  27                   03 Yes, other, no further evaluation

M1740_DL  859  1  $INDICOA                              C M1740 Cog/Behav/Psych; Delusional

                               1,346                      Missing
                               2,810                    0 Not indicated
                                  33                    1 Indicated

M1740_IM  860  1  $INDICOA                              C M1740 Cog/Behav/Psych;Impaired Decision_

                               1,346                      Missing
                               2,349                    0 Not indicated
                                 494                    1 Indicated

M1740_ME  861  1  $INDICOA                              C M1740 Cog/Behav/Psych;Memory Deficit

                               1,346                      Missing
                               2,395                    0 Not indicated
                                 448                    1 Indicated

M1740_CG  862  1  $INDICOA                              C M1740 Cog/Behav/Psych;None of the Above

                               1,346                      Missing
                                 737                    0 Not indicated
                               2,106                    1 Indicated

M1740_PH  863  1  $INDICOA                              C M1740 Cog/Behav/Psych;Physical Aggressio

                               1,346                      Missing
                               2,828                    0 Not indicated
                                  15                    1 Indicated

M1740_DS  864  1  $INDICOA                              C M1740 Cog/Behav/Psych;Disruptive/Inappro

                               1,346                      Missing
                               2,826                    0 Not indicated
                                  17                    1 Indicated

M1740_VR  865  1  $INDICOA                              C M1740 Cog/Behav/Psych;Verbal Disruption

                               1,346                      Missing
                               2,804                    0 Not indicated
                                  39                    1 Indicated

M1745_DS  866  2  $FREQBOA                              C M1745 Freq Of Disruptive Behav Symptoms

                               1,346                      Missing
                               2,427                   00 Never
                                  47                   01 Less than once a month
                                  17                   02 One a month
                                  58                   03 Several times each month
                                  91                   04 Several times a week
                                 203                   05 At least daily

M1750_PH  868  1  $YESNOOA                              C M1750 Receives Psych Nursing Services

                               2,509                      Missing
                               1,664                    0 No
                                  16                    1 Yes

M1800_GR  869  2  $GROOMOA                              C M1800 Current Grooming

                               1,346                      Missing
                               1,022                   00 Able to groom self unaided
                               1,008                   01 Utensils must be placed within reach
                                 623                   02 Someone must assis patient to groom self
                                 190                   03 Depends entirely upon another person

M1810_DR  871  2  $DRESSOA                              C M1810 Current Dress Upper Body

                                 468                      Missing
                               1,081                   00 No assist needed
                               1,351                   01 No assist needed if clothing laid out
                               1,006                   02 Assist from another person
                                 283                   03 Depends entirely upon another person

M1820_DR  873  2  $DRESSOA                              C M1820 Current Dress Lower Body

                                 468                      Missing
                                 916                   00 No assist needed
                                 860                   01 No assist needed if clothing laid out
                               1,467                   02 Assist from another person
                                 478                   03 Depends entirely upon another person

M1830_BA  875  2  $BATHCOA                              C M1830 Ability To Wash Body

                                 468                      Missing
                                 318                   00 Bathes self independently
                                 579                   01 Bathes self with use of devices
                                 843                   02 Bathes with intermittent assist
                               1,235                   03 Bathes with complete assist/supervision
                                 207                   04 Unable, bed/sink/chair, independent
                                 301                   05 Unable, bed/sing/chair, assisted
                                 238                   06 Unable, totally bathed by another person

M1840_TO  877  2  $TOILEOA                              C M1840 Current Toilet Transferring

                                 468                      Missing
                               1,710                   00 Toilet, to and from independently
                               1,534                   01 Toilet, when reminded/assist/supervised
                                 210                   02 Unable toil, able to bedside commode
                                  38                   03 Unable toil/bedside commode, able bedpan
                                 229                   04 Depends entirely upon another person

M1845_TO  879  2  $TOILHOA                              C M1845 Current Toileting Hygiene

                               1,346                      Missing
                               1,173                   00 Hygiene management independently
                                 905                   01 Hygiene management if supplies laid out
                                 542                   02 Hygiene management assisted
                                 223                   03 Depends entirely upon another person

M1850_TR  881  2  $TRANSOA                              C M1850 Current Transferring

                                 468                      Missing
                                 839                   00 Able to independently transfer
                               2,164                   01 Transfers with minimal assist or device
                                 483                   02 Unable transfer self, able to pivot
                                 151                   03 Unable transfer self, unable to pivot
                                  12                   04 Bedfast, unable trans, able to positio
                                  72                   05 Bedfast, unable trans, unable to positio

M1860_AM  883  2  $AMBUCOA                              C M1860 Current Ambulation/Locomotion

                                 468                      Missing
                                 382                   00 Able to independently walk/stairs
                                 673                   01 Able to walk w/ 1 handed device
                               1,379                   02 Able to walk w/ 2 handed device
                                 941                   03 Able to walk w/ constant assist/supervis
                                 172                   04 Chairfast, able to wheel self independ
                                 135                   05 Chairfast, unable to wheel self independ
                                  39                   06 Bedfast, unable to ambulate/or chair

M1870_EA  885  2  $FEEDIOA                              C M1870 Current Feeding or Eating

                               1,346                      Missing
                               1,556                   00 Able independently feed self
                               1,150                   01 Able feed self with intermittent assist
                                 100                   02 Unable feed self, complete assist/superv
                                   9                   03 Able take nutri oral, rec tube feedi
                                  19                   04 Unable take nutri oral, rec tube feedi
                                   9                   05 Unable take nutri oral or tube feedi

M1880_PR  887  2  $MEALSOA                              C M1880 Current Plan/Prepare Light Meal

                               1,346                      Missing
                                 928                   00 Able to independently prepare all meals
                               1,028                   01 Unable to prepare meals on regular basis
                                 887                   02 Unable to prepare any meals

M1890_TE  889  2  $TELEPOA                              C M1890 Current Telephone Use

                               1,346                      Missing
                                  59                   NA Patient does not have a telephone
                               1,908                   00 Able independently dial/answer calls
                                 241                   01 Able use a specif adapted phone and call
                                 251                   02 Able answer calls, diff placing calls
                                 179                   03 Able answer calls only some of the time
                                  91                   04 Unable answer phone at all, can listen
                                 114                   05 Totaly unable to use the telephone

M1900_PA  891  2  $PRADLOA                              C M1900 Pri Funct ADL/IADL; Ambulation

                               2,509                      Missing
                                 681                   00 Independent
                                 855                   01 Needed some help
                                 144                   02 Dependent

M1900_PH  893  2  $PRADLOA                              C M1900 Pri Funct ADL/IADL; Household Task

                               2,509                      Missing
                                 303                   00 Independent
                                 767                   01 Needed some help
                                 610                   02 Dependent

M1900_PS  895  2  $PRADLOA                              C M1900 Pri Funct ADL/IADL; Self Care

                               2,509                      Missing
                                 611                   00 Independent
                                 903                   01 Needed some help
                                 166                   02 Dependent

M1900_PT  897  2  $PRADLOA                              C M1900 Pri Funct ADL/IADL; Transfer

                               2,509                      Missing
                                 778                   00 Independent
                                 779                   01 Needed some help
                                 123                   02 Dependent

M1910_FA  899  2  $FALLMOA                              C M1910 Multi-Factor Fall Risk Assessment

                               2,509                      Missing
                                  50                   00 No multi-factor fall risk assessment
                                 149                   01 Yes, does not indicated a risk for fall
                               1,481                   02 Yes, indicates a risk for falls fall

M2000_DR  901  2  $DRUGROA                              C M2000 Drug Regimen Review

                               2,509                      Missing
                                   2                   NA Patient is not taking any medications
                                  10                   00 Not assessed
                               1,319                   01 No problems found during review
                                 349                   02 Problems found during review

M2002_MD  903  1  $YESNOOA                              C M2002 Medication Follow-Up

                               3,840                      Missing
                                  68                    0 No
                                 281                    1 Yes

M2004_MD  904  2  $YESNAOA                              C M2004 Medication Intervention

                               2,562                      Missing
                               1,158                   NA Inapplicable
                                 193                   00 No
                                 276                   01 Yes

M2010_DR  906  2  $YESNAOA                              C M2010 Patient/Caregiv High Risk Drug Edu

                               2,511                      Missing
                                 367                   NA Inapplicable
                                  42                   00 No
                               1,269                   01 Yes

M2015_DR  908  2  $YESNAOA                              C M2015 Patient/Caregiv Drug Educ Interven

                               2,562                      Missing
                                  17                   NA Inapplicable
                                 146                   00 No
                               1,464                   01 Yes

M2020_OR  910  2  $MGMRXOA                              C M2020 Curr Manag Of Oral Medications

                               1,348                      Missing
                                  13                   NA No med of this type prescribed
                                 893                   00 Able to independently take correct med
                                 864                   01 Able to take med corect times w/ prepare
                                 393                   02 Able to take med corect times w/ assist
                                 678                   03 Unable to take med unless administered

M2030_IN  912  2  $MGMRXOA                              C M2030 Curr Manag Of Injectable Medicatio

                                 470                      Missing
                               2,900                   NA No med of this type prescribed
                                 233                   00 Able to independently take correct med
                                 166                   01 Able to take med corect times w/ prepare
                                  57                   02 Able to take med corect times w/ assist
                                 363                   03 Unable to take med unless administered

M2040_PR  914  2  $PRADLOA                              C M2040 Prior Medication Manag; Injectable

                               2,509                      Missing
                                  95                   00 Independent
                                 126                   01 Needed some help
                                 132                   02 Dependent
                               1,327                   02 NA

M2100_AD  918  2  $ASSISOA                              C M2100 Care Manag;ADL Assistance

                               1,346                      Missing
                                   0                   NA Missing
                                 671                   00 No assistance needed
                               1,619                   01 Currently provide assistance
                                 358                   02 Need training to provide assistance
                                  60                   03 Not likely to provide assistance
                                  43                   04 Unclear if caregiver will provide assist
                                  92                   05 Assistance needed, no caregiver

M2100_AV  920  2  $ASSISOA                              C M2100 Care Manag;Advocacy or Facilitatio

                               1,346                      Missing
                                   0                   NA Missing
                                 331                   00 No assistance needed
                               2,337                   01 Currently provide assistance
                                  92                   02 Need training to provide assistance
                                  14                   03 Not likely to provide assistance
                                  34                   04 Unclear if caregiver will provide assist
                                  35                   05 Assistance needed, no caregiver

M2100_IA  922  2  $ASSISOA                              C M2100 Care Manag;IADL Assistance

                               1,346                      Missing
                                   0                   NA Missing
                                 327                   00 No assistance needed
                               2,212                   01 Currently provide assistance
                                 168                   02 Need training to provide assistance
                                  28                   03 Not likely to provide assistance
                                  34                   04 Unclear if caregiver will provide assist
                                  74                   05 Assistance needed, no caregiver

M2100_EQ  924  2  $ASSISOA                              C M2100 Care Manag;Management of Equip

                               1,346                      Missing
                                   0                   NA Missing
                               2,073                   00 No assistance needed
                                 591                   01 Currently provide assistance
                                 141                   02 Need training to provide assistance
                                  12                   03 Not likely to provide assistance
                                  11                   04 Unclear if caregiver will provide assist
                                  15                   05 Assistance needed, no caregiver

M2100_PR  926  2  $ASSISOA                              C M2100 Care Manag;Medical Procedure/Treat

                               1,346                      Missing
                                   0                   NA Missing
                               2,004                   00 No assistance needed
                                 474                   01 Currently provide assistance
                                 213                   02 Need training to provide assistance
                                  62                   03 Not likely to provide assistance
                                  21                   04 Unclear if caregiver will provide assist
                                  69                   05 Assistance needed, no caregiver

M2100_MD  928  2  $ASSISOA                              C M2100 Care Manag;Medication Administrati

                               1,346                      Missing
                                   0                   NA Missing
                                 863                   00 No assistance needed
                               1,502                   01 Currently provide assistance
                                 378                   02 Need training to provide assistance
                                  29                   03 Not likely to provide assistance
                                  29                   04 Unclear if caregiver will provide assist
                                  42                   05 Assistance needed, no caregiver

M2100_SF  930  2  $ASSISOA                              C M2100 Care Manag;Supervision/Safety

                               1,346                      Missing
                                   0                   NA Missing
                               1,187                   00 No assistance needed
                               1,391                   01 Currently provide assistance
                                 197                   02 Need training to provide assistance
                                  12                   03 Not likely to provide assistance
                                  33                   04 Unclear if caregiver will provide assist
                                  23                   05 Assistance needed, no caregiver

M2110_AD  932  2  $FREQAOA                              C M2110 Freq Of ADL/IADL Assist From Careg

                               1,346                      Missing
                                   4                   UK Unknown
                               2,094                   01 Daily
                                 273                   02 Three or more times per week
                                 218                   03 One to two times per week
                                  95                   04 Received, but less often than weekly
                                 159                   05 No assistance received

M2200_NA  934  1                                        C M2200 Therapy Need; Not Applicable

M2200_VI  935  3                                        C M2200 Therapy Need; Number Of Visits

M2250_FA  938  2  $ASSISOA                              C M2250 POC Synop; Fall Prevention

                               2,576                      Missing
                                   0                   NA Missing
                                  23                   00 No assistance needed
                               1,590                   01 Currently provide assistance
                                   0                   02 Need training to provide assistance
                                   0                   03 Not likely to provide assistance
                                   0                   04 Unclear if caregiver will provide assist
                                   0                   05 Assistance needed, no caregiver

M2250_DT  940  2  $ASSISOA                              C M2250 POC Synop; Depression Intervention

                               3,701                      Missing
                                   0                   NA Missing
                                  27                   00 No assistance needed
                                 461                   01 Currently provide assistance
                                   0                   02 Need training to provide assistance
                                   0                   03 Not likely to provide assistance
                                   0                   04 Unclear if caregiver will provide assist
                                   0                   05 Assistance needed, no caregiver

M2250_DB  942  2  $YESNAOA                              C M2250 POC Synop; Diabetic Foot Care

                               2,509                      Missing
                               1,044                   NA Inapplicable
                                  31                   00 No
                                 605                   01 Yes

M2250_PI  944  2  $YESNAOA                              C M2250 POC Synop; Pain Intervention

                               2,509                      Missing
                                 308                   NA Inapplicable
                                  25                   00 No
                               1,347                   01 Yes

M2250_PN  946  2  $YESNAOA                              C M2250 POC Synop; Parameter Phys Notif

                               2,509                      Missing
                                 861                   NA Inapplicable
                                  53                   00 No
                                 766                   01 Yes

M2250_PU  948  2  $YESNAOA                              C M2250 POC Synop; Press Ulcer Moist Treat

                               2,509                      Missing
                               1,575                   NA Inapplicable
                                  14                   00 No
                                  91                   01 Yes

M2250_PR  950  2  $YESNAOA                              C M2250 POC Synop; Press Ulcer Prevention

                               2,509                      Missing
                                 920                   NA Inapplicable
                                  21                   00 No
                                 739                   01 Yes

M2300_EM  952  2  $EMERCOA                              C M2300 EmergCare Since Last OASIS

                               2,562                      Missing
                                  31                   UK Unknown
                               1,241                   00 No
                                  70                   01 Yes, without hospital admission
                                 285                   02 Yes, with hospital admission

M2310_MN  954  1  $INDICOA                              C M2310 EmergCare;Acute Mental/Behavioral

                               3,834                      Missing
                                 349                    0 Not indicated
                                   6                    1 Indicated

M2310_CR  955  1  $INDICOA                              C M2310 EmergCare;Cardiac Dysrhythmia

                               3,834                      Missing
                                 336                    0 Not indicated
                                  19                    1 Indicated

M2310_DE  956  1  $INDICOA                              C M2310 EmergCare;Dehydration/Malnutrition

                               3,834                      Missing
                                 333                    0 Not indicated
                                  22                    1 Indicated

M2310_PL  957  1  $INDICOA                              C M2310 EmergCare;DVT, Pulmonary Embolus

                               3,834                      Missing
                                 350                    0 Not indicated
                                   5                    1 Indicated

M2310_GI  958  1  $INDICOA                              C M2310 EmergCare;GI Issues

                               3,834                      Missing
                                 348                    0 Not indicated
                                   7                    1 Indicated

M2310_HR  959  1  $INDICOA                              C M2310 EmergCare;Heart Failure

                               3,834                      Missing
                                 328                    0 Not indicated
                                  27                    1 Indicated

M2310_DB  960  1  $INDICOA                              C M2310 EmergCare;Hypo/Hyperglycemia/Diabe

                               3,834                      Missing
                                 347                    0 Not indicated
                                   8                    1 Indicated

M2310_MD  961  1  $INDICOA                              C M2310 EmergCare;Improper Medication Admi

                               3,834                      Missing
                                 353                    0 Not indicated
                                   2                    1 Indicated

M2310_FA  962  1  $INDICOA                              C M2310 EmergCare;Injury From Fall

                               3,834                      Missing
                                 316                    0 Not indicated
                                  39                    1 Indicated

M2310_IV  963  1  $INDICOA                              C M2310 EmergCare;IV Catheter Infection

                               3,834                      Missing
                                 355                    0 Not indicated
                                   0                    1 Indicated

M2310_CH  964  1  $INDICOA                              C M2310 EmergCare;Myocardial Infarc/Chest

                               3,834                      Missing
                                 344                    0 Not indicated
                                  11                    1 Indicated

M2310_OH  965  1  $INDICOA                              C M2310 EmergCare;Other Heart Disease

                               3,834                      Missing
                                 345                    0 Not indicated
                                  10                    1 Indicated

M2310_OR  966  1  $INDICOA                              C M2310 EmergCare;Other Respir Problem

                               3,834                      Missing
                                 319                    0 Not indicated
                                  36                    1 Indicated

M2310_OT  967  1  $INDICOA                              C M2310 EmergCare;Other

                               3,834                      Missing
                                 241                    0 Not indicated
                                 114                    1 Indicated

M2310_UN  968  1  $INDICOA                              C M2310 EmergCare;Unknown

                               3,834                      Missing
                                 342                    0 Not indicated
                                  13                    1 Indicated

M2310_RS  969  1  $INDICOA                              C M2310 EmergCare;Respir Infection

                               3,834                      Missing
                                 319                    0 Not indicated
                                  36                    1 Indicated

M2310_ST  970  1  $INDICOA                              C M2310 EmergCare;Stroke (CVA) or TIA

                               3,834                      Missing
                                 352                    0 Not indicated
                                   3                    1 Indicated

M2310_PA  971  1  $INDICOA                              C M2310 EmergCare;Uncontrolled Pain

                               3,834                      Missing
                                 338                    0 Not indicated
                                  17                    1 Indicated

M2310_UT  972  1  $INDICOA                              C M2310 EmergCare;Urinary Tract Infection

                               3,834                      Missing
                                 328                    0 Not indicated
                                  27                    1 Indicated

M2310_WN  973  1  $INDICOA                              C M2310 EmergCare;Wound Infection/Deterior

                               3,834                      Missing
                                 348                    0 Not indicated
                                   7                    1 Indicated

M2400_DP  974  2  $YESNAOA                              C M2400 Synopsis; Depression Prevention

                               2,562                      Missing
                               1,147                   NA Inapplicable
                                  25                   00 No
                                 455                   01 Yes

M2400_DB  976  2  $YESNAOA                              C M2400 Synopsis; Diabetic Foot Care

                               2,562                      Missing
                               1,064                   NA Inapplicable
                                  36                   00 No
                                 527                   01 Yes

M2400_FA  978  2  $YESNAOA                              C M2400 Synopsis; Falls Prevention

                               2,562                      Missing
                                  60                   NA Inapplicable
                                  18                   00 No
                               1,549                   01 Yes

M2400_PS  980  2  $YESNAOA                              C M2400 Synopsis; Press Ulcer Moist Treatm

                               2,562                      Missing
                               1,507                   NA Inapplicable
                                  17                   00 No
                                 103                   01 Yes

M2400_PI  982  2  $YESNAOA                              C M2400 Synopsis; Pain Intervention

                               2,562                      Missing
                                 297                   NA Inapplicable
                                  21                   00 No
                               1,309                   01 Yes

M2400_PV  984  2  $YESNAOA                              C M2400 Synopsis; Press Ulcer Prevention

                               2,562                      Missing
                                 948                   NA Inapplicable
                                  20                   00 No
                                 659                   01 Yes

M2410_AD  986  2  $INFACOA                              C M2410 Admit Inpatient Facility Type

                               2,562                      Missing
                               1,163                   NA No inpatient facility admission
                                 431                   01 Hospital
                                  11                   02 Rehabilitation facility
                                  21                   03 Nursing home
                                   1                   04 Hospice

M2420_DS  988  2  $DISPOCA                              C M2420 Discharge Location

                               3,026                      Missing
                                   8                   UK Unknown, other
                                 831                   01 Patient remained in commun, no assistive
                                 290                   02 Patient remained in commun, assistive
                                  23                   03 Patient transferred to a noninsti hospic
                                  11                   04 Unknown, location not served by agency

M2430_MN  990  1  $INDICOA                              C M2430 Hosp Reas;Acute Mental/Behavioral

                               3,758                      Missing
                                 424                    0 Not indicated
                                   7                    1 Indicated

M2430_CR  991  1  $INDICOA                              C M2430 Hosp Reas;Cardiac Dysrhythmia

                               3,758                      Missing
                                 410                    0 Not indicated
                                  21                    1 Indicated

M2430_DE  992  1  $INDICOA                              C M2430 Hosp Reas;Dehydration/Malnutrition

                               3,758                      Missing
                                 413                    0 Not indicated
                                  18                    1 Indicated

M2430_PL  993  1  $INDICOA                              C M2430 Hosp Reas;DVT, Pulmonary Embolus

                               3,758                      Missing
                                 425                    0 Not indicated
                                   6                    1 Indicated

M2430_GI  994  1  $INDICOA                              C M2430 Hosp Reas;GI Issues

                               3,758                      Missing
                                 419                    0 Not indicated
                                  12                    1 Indicated

M2430_HR  995  1  $INDICOA                              C M2430 Hosp Reas;Heart Failure

                               3,758                      Missing
                                 399                    0 Not indicated
                                  32                    1 Indicated

M2430_DB  996  1  $INDICOA                              C M2430 Hosp Reas;Hypo/Hyperglycemia/Diabe

                               3,758                      Missing
                                 422                    0 Not indicated
                                   9                    1 Indicated

M2430_MD  997  1  $INDICOA                              C M2430 Hosp Reas;Improper Medication Admi

                               3,758                      Missing
                                 429                    0 Not indicated
                                   2                    1 Indicated

M2430_FA  998  1  $INDICOA                              C M2430 Hosp Reas;Injury Caused by Fall

                               3,758                      Missing
                                 398                    0 Not indicated
                                  33                    1 Indicated

M2430_IV  999  1  $INDICOA                              C M2430 Hosp Reas IV Catheter Infection

                               3,758                      Missing
                                 431                    0 Not indicated
                                   0                    1 Indicated

M2430_CH 1000  1  $INDICOA                              C M2430 Hosp Reas Myocardial Infarc/Chest

                               3,758                      Missing
                                 417                    0 Not indicated
                                  14                    1 Indicated

M2430_OH 1001  1  $INDICOA                              C M2430 Hosp Reas Other Heart Disease

                               3,758                      Missing
                                 424                    0 Not indicated
                                   7                    1 Indicated

M2430_OR 1002  1  $INDICOA                              C M2430 Hosp Reas Other Respiratory Proble

                               3,758                      Missing
                                 392                    0 Not indicated
                                  39                    1 Indicated

M2430_OC 1003  1  $INDICOA                              C M2430 Hosp Reas Other

                               3,758                      Missing
                                 293                    0 Not indicated
                                 138                    1 Indicated

M2430_UN 1004  1  $INDICOA                              C M2430 Hosp Reas Unknown

                               3,758                      Missing
                                 405                    0 Not indicated
                                  26                    1 Indicated

M2430_RS 1005  1  $INDICOA                              C M2430 Hosp Reas Respiratory Infection

                               3,758                      Missing
                                 387                    0 Not indicated
                                  44                    1 Indicated

M2430_SC 1006  1  $INDICOA                              C M2430 Hosp Reas Sched Treatment/Procedur

                               3,758                      Missing
                                 413                    0 Not indicated
                                  18                    1 Indicated

M2430_ST 1007  1  $INDICOA                              C M2430 Hosp Reas Stroke (CVA) Or TIA

                               3,758                      Missing
                                 423                    0 Not indicated
                                   8                    1 Indicated

M2430_PA 1008  1  $INDICOA                              C M2430 Hosp Reas Uncontrolled Pain

                               3,758                      Missing
                                 413                    0 Not indicated
                                  18                    1 Indicated

M2430_UT 1009  1  $INDICOA                              C M2430 Hosp Reas Urinary Tract Infect

                               3,758                      Missing
                                 407                    0 Not indicated
                                  24                    1 Indicated

M2430_WN 1010  1  $INDICOA                              C M2430 Hosp Reas Wound Infection/Deterior

                               3,758                      Missing
                                 417                    0 Not indicated
                                  14                    1 Indicated

M2440_HO 1011  1  $INDICOA                              C M2440 Admit Nurs Home Reas;Hospice

                               4,168                      Missing
                                  21                    0 Not indicated
                                   0                    1 Indicated

M2440_OT 1012  1  $INDICOA                              C M2440 Admit Nurs Home Reas;Other

                               4,168                      Missing
                                  19                    0 Not indicated
                                   2                    1 Indicated

M2440_PR 1013  1  $INDICOA                              C M2440 Admit Nurs Home Reas;Permanent Pla

                               4,168                      Missing
                                  14                    0 Not indicated
                                   7                    1 Indicated

M2440_RE 1014  1  $INDICOA                              C M2440 Admit Nurs Home Reas;Respite Care

                               4,168                      Missing
                                  19                    0 Not indicated
                                   2                    1 Indicated

M2440_TH 1015  1  $INDICOA                              C M2440 Admit Nurs Home Reas;Therapy Servi

                               4,168                      Missing
                                  11                    0 Not indicated
                                  10                    1 Indicated

M2440_UK 1016  1  $INDICOA                              C M2440 Admit Nurs Home Reas;Unknown

                               4,168                      Missing
                                  21                    0 Not indicated
                                   0                    1 Indicated

M2440_US 1017  1  $INDICOA                              C M2440 Admit Nurs Home Reas;Unsafe At Hom

                               4,168                      Missing
                                  19                    0 Not indicated
                                   2                    1 Indicated

