Variable Format    Q#/Freq            Description/Label
 
BASEID   $BSIDFMT                      Unique SP Identification Number          
                          7,188        LOW-HIGH          BASEID Count                            
 
SURVEYYR SVYRFMT                       Survey Year                              
                          7,188                    2016  2016                                    
 
VERSION  VERSFMT                       Version Number                           
                          7,188                       1  Version 1                               
 
TRGT_DT  MMDDYYn8                      Target Date                              
                          7,188        MMDDYYYY          Date as MMDDYYYY                        
 
SUB_DT   MMDDYYn8                      Submission Date                          
                          7,188        MMDDYYYY          Date as MMDDYYYY                        
 
CRCTN_N                                Crctn Num                                
                          3,205                       .  Inapplicable/Missing                    
                          3,983        LOW-HIGH          Range of Values                         
 
MCSC                                   Crctn Stat                               
                          7,188                          Range of Values                         
 
SPEC_VCD                               Data Submission Spec Vers                
                          7,188        Range of values   Range of Values                         
 
ITM_SVC                                Item Set Vers                            
                          7,188        Range of values   Range of Values                         
 
PRCSD_TS MMDDYYn8                      Processed Timestamp                      
                          7,188        MMDDYYYY          Date as MMDDYYYY                        
 
Age                                    Res Age                                  
                          7,188        Range of values   Range of Values                         
 
RSDT_MCI                               Res Match Criteria ID                    
                          7,188        LOW-HIGH          Range of Values                         
 
CURCD                                  CBSA Urban/Rural                         
                          7,188        Range of values   Range of Values                         
 
A0050    $M3RCTYP                      Type of Record                           
                          6,920        1                 Add a new record                        
                            268        2                 Modify existing record                  
 
A0200    $M3PROV                       Type of Provider                         
                          7,188        1                 Nursing home (SNF/NF)                   
 
A0310A   $M3OBRA                       Federal OBRA Rsn for Asmt                
                            777        01                Admission                               
                          1,931        02                Quarterly                               
                            474        03                Annual                                  
                            213        04                Significant change in status            
                              2        05                Sig correction - prior comp             
                          3,791        99                Not OBRA required                       
 
A0310B   $MCASS                        PPS Asmt                                 
                            796        01                Sched. 5-day assessment                 
                            536        02                Sched 14-day assessment                 
                            243        03                Sched 30-day assessment                 
                             79        04                Sched 60-day assessment                 
                             27        05                Sched 90-day assessment                 
                            158        07                Unsched assessment                      
                          5,349        99                None of the above                       
 
A0310C   $M3PPSOT                      PPS Oth Mcare Req Asmt (OMRA)            
                          6,932        0                 No                                      
                             24        1                 Start of therapy                        
                             36        2                 End of therapy                          
                            196        4                 Change of therapy                       
 
A0310E   $M3YESNO                      First Asmt Since Most Rec Admsn          
                          6,050        0                 No                                      
                          1,138        1                 Yes                                     
 
A0310F   $M3REPO                       Entry/Dis                                
                          1,307        01                Entry                                   
                            696        10                Discharge, return not anticipated       
                            421        11                Discharge, return anticipated           
                            170        12                Death in facility                       
                          4,594        99                None of the above                       
 
A0310G   $M3DIS                        Planned Dis                              
                          6,071                          Missing                                 
                            657        1                 Planned                                 
                            460        2                 Unplanned                               
 
A0410    $M3SUBRQ                      Submission Req                           
                          7,188        3                 Federal required                        
 
A0800    $SEXFMT                       Sex                                   
                          2,227        1                 Male                                    
                          4,961        2                 Female                                  
 
A0900    MMDDYYn8                      Birth Date                               
                          7,188        MMDDYYYY          Date as MMDDYYYY                        
 
A1000A   $M3INDIC                      R/E: American Indian or Alaskan Native   
                              7        -                 Not assessed/no information             
                          7,131        0                 Not indicated                           
                             50        1                 Indicated                               
 
A1000B   $M3INDIC                      R/E: Asian                               
                              7        -                 Not assessed/no information             
                          7,083        0                 Not indicated                           
                             98        1                 Indicated                               
 
A1000C   $M3INDIC                      R/E: African American                    
                              7        -                 Not assessed/no information             
                          6,551        0                 Not indicated                           
                            630        1                 Indicated                               
 
A1000D   $M3INDIC                      R/E: Hispanic                            
                              7        -                 Not assessed/no information             
                          6,744        0                 Not indicated                           
                            437        1                 Indicated                               
 
A1000E   $M3INDIC                      R/E: Native Hawaiian/Pacific Islander    
                              7        -                 Not assessed/no information             
                          7,162        0                 Not indicated                           
                             19        1                 Indicated                               
 
A1000F   $M3INDIC                      R/E: White                               
                              7        -                 Not assessed/no information             
                          1,398        0                 Not indicated                           
                          5,783        1                 Indicated                               
 
A1100A   $M3YNDET                      Res Need Interpreter                     
                          1,481                          Missing                                 
                             10        -                 Not assessed/no information             
                          5,527        0                 No                                      
                            161        1                 Yes                                     
                              9        9                 Unable to determine                     
 
A1200    $M3MARTL                      Marital Stat                             
                            199        -                 Not assessed/no information             
                            867        1                 Never married                           
                          1,642        2                 Married                                 
                          3,681        3                 Widowed                                 
                            101        4                 Separated                               
                            698        5                 Divorced                                
 
A1300A                                 Medical Record Num                       
                          7,188                          Range of Values                         
 
A1300D                                 Lifetime Occupation(s) Text              
                          7,188                          Range of Values                         
 
A1500    $M3SMI                        (PASRR)                                  
                          5,722                          Missing                                 
                              1        -                 Not assessed/no information             
                          1,356        0                 No                                      
                             66        1                 Yes                                     
                             43        9                 Not a Medicaid-certified unit           
 
A1510A   $M3INDIC                      Serious Mntl Illness                     
                          7,121                          Missing                                 
                              1        -                 Not assessed/no information             
                             15        0                 Not indicated                           
                             51        1                 Indicated                               
 
A1510B   $M3INDIC                      Intellectual Disability                  
                          7,121                          Missing                                 
                              1        -                 Not assessed/no information             
                             53        0                 Not indicated                           
                             13        1                 Indicated                               
 
A1510C   $M3INDIC                      Oth Related Conds                        
                          7,121                          Missing                                 
                              1        -                 Not assessed/no information             
                             60        0                 Not indicated                           
                              6        1                 Indicated                               
 
A1550A   $M3INDIC                      ID/DD Stat: Down Syndrome                
                          6,411                          Missing                                 
                              1        -                 Not assessed/no information             
                            775        0                 Not indicated                           
                              1        1                 Indicated                               
 
A1550B   $M3INDIC                      ID/DD Stat: Autism                       
                          6,411                          Missing                                 
                              1        -                 Not assessed/no information             
                            776        0                 Not indicated                           
 
A1550C   $M3INDIC                      ID/DD Stat: Epilepsy                     
                          6,411                          Missing                                 
                              1        -                 Not assessed/no information             
                            775        0                 Not indicated                           
                              1        1                 Indicated                               
 
A1550D   $M3INDIC                      ID/DD Stat: Oth Org ID/DD Cond           
                          6,411                          Missing                                 
                              1        -                 Not assessed/no information             
                            774        0                 Not indicated                           
                              2        1                 Indicated                               
 
A1550E   $M3INDIC                      ID/DD Stat: ID/DD W No Org Cond          
                          6,411                          Missing                                 
                              1        -                 Not assessed/no information             
                            774        0                 Not indicated                           
                              2        1                 Indicated                               
 
A1550Z   $M3INDIC                      ID/DD Stat: None of the Above            
                          6,411                          Missing                                 
                              1        -                 Not assessed/no information             
                              6        0                 Not indicated                           
                            770        1                 Indicated                               
 
A1600    MMDDYYn8                      Entry Date                               
                          7,188        MMDDYYYY          Date as MMDDYYYY                        
 
A1700    $M3TYP                        Type of Entry                            
                          4,949        1                 Admission                               
                          2,239        2                 Reentry                                 
 
A1800    $M3ADFRM                      Entered From                             
                            587        01                Community                               
                            343        02                Another nursing home or swing bed       
                          6,094        03                Acute hospital                          
                             57        04                Psychiatric hospital                    
                             32        05                Inpatient rehabilitation facility       
                             22        07                Hospice                                 
                             11        09                09                                      
                             42        99                Other                                   
 
A2000    MMDDYYn8                      Dis Date                                 
                          5,901                       .  Inapplicable                            
                          1,287        MMDDYYYY          Date as MMDDYYYY                        
 
A2100    $M3ADFRM                      Dis Stat                                 
                          5,901                          Missing                                 
                            604        01                Community                               
                             56        02                Another nursing home or swing bed       
                            438        03                Acute hospital                          
                              4        04                Psychiatric hospital                    
                              1        05                Inpatient rehabilitation facility       
                              1        06                ID/DD facility                          
                              3        07                Hospice                                 
                            170        08                Long Term Care Hospital                 
                              1        09                09                                      
                              9        99                Other                                   
 
A2300    MMDDYYn8                      Asmt Ref Date                            
                          1,477                       .  Inapplicable                            
                          5,711        MMDDYYYY          Date as MMDDYYYY                        
 
A2400A   $M3YESNO                      Had a Mcare Stay Since Most Rec Admsn    
                          3,186        0                 No                                      
                          4,002        1                 Yes                                     
 
A2400B   MMDDYYn8                      Start Date of Most Rec Mcare Stay        
                          3,186                       .  Inapplicable                            
                          4,002        MMDDYYYY          Date as MMDDYYYY                        
 
A2400C   MMDDYYn8                      End Date of Most Rec Mcare Stay          
                          5,766                       .  Inapplicable                            
                          1,422        MMDDYYYY          Date as MMDDYYYY                        
 
B0100    $M3YESNO                      Comatose                                 
                          1,515                          Missing                                 
                             11        -                 Not assessed/no information             
                          5,653        0                 No                                      
                              9        1                 Yes                                     
 
B0200    $M3HEAR                       Hearing                                  
                          2,704                          Missing                                 
                             31        -                 Not assessed/no information             
                          3,093        0                 Adequate                                
                            865        1                 Minimal difficulty                      
                            425        2                 Moderate difficulty                     
                             70        3                 Highly impaired                         
 
B0300    $M3YESNO                      Hearing Aide                             
                          2,704                          Missing                                 
                             10        -                 Not assessed/no information             
                          4,093        0                 No                                      
                            381        1                 Yes                                     
 
B0600    $M3CLEAR                      Speech Clarity                           
                          2,704                          Missing                                 
                             10        -                 Not assessed/no information             
                          3,868        0                 Clear speech                            
                            483        1                 Unclear speech                          
                            123        2                 No speech                               
 
B0700    $M3UNDER                      Makes Self Understood                    
                          2,553                          Missing                                 
                             13        -                 Not assessed/no information             
                          2,949        0                 Understood                              
                            907        1                 Usually understood                      
                            453        2                 Sometimes understood                    
                            313        3                 Rarely/Never understood                 
 
B0800    $M3UNDRR                      Ability to Understand Oth                
                          2,704                          Missing                                 
                             13        -                 Not assessed/no information             
                          2,659        0                 Understands                             
                          1,016        1                 Usually understands                     
                            563        2                 Sometimes understands                   
                            233        3                 Rarely/Never understands                
 
B1000    $M3ADQT                       Vision                                   
                          2,704                          Missing                                 
                             46        -                 Not assessed/no information             
                          3,099        0                 Adequate                                
                            775        1                 Impaired                                
                            261        2                 Moderately impaired                     
                            214        3                 Highly impaired                         
                             89        4                 Severely impaired                       
 
B1200    $M3YESNO                      Corr Lenses                              
                          2,704                          Missing                                 
                             21        -                 Not assessed/no information             
                          2,037        0                 No                                      
                          2,426        1                 Yes                                     
 
C0100    $M3YESNO                      Brief Int for Mntl Stat Be Cond          
                          1,924                          Missing                                 
                            144        -                 Not assessed/no information             
                            568        0                 No                                      
                          4,552        1                 Yes                                     
 
C0200    $M3REP3W                      BIMS: Num of Words Rep After First Att   
                          2,492                          Missing                                 
                            183        -                 Not assessed/no information             
                            243        0                 None                                    
                             85        1                 One                                     
                            220        2                 Two                                     
                          3,965        3                 Three                                   
 
C0300A   $M31ORNT                      BIMS: Temp Ortn - Able to Rep Corr Yr    
                          2,492                          Missing                                 
                            195        -                 Not assessed/no information             
                          1,545        0                 Missed by >5 years or no answer         
                            161        1                 Missed by 2-5 years                     
                            151        2                 Missed by 1 year                        
                          2,644        3                 Correct                                 
 
C0300B   $M31ORNT                      BIMS: Temp Ortn - Able to Rep Corr Mon   
                          2,492                          Missing                                 
                            195        -                 Not assessed/no information             
                          1,322        0                 Missed by >5 years or no answer         
                            329        1                 Missed by 2-5 years                     
                          2,850        2                 Missed by 1 year                        
 
C0300C   $M31ORNT                      BIMS: Temp Ortn - Able to Rep Corr Day   
                          2,492                          Missing                                 
                            212        -                 Not assessed/no information             
                          2,052        0                 Missed by >5 years or no answer         
                          2,432        1                 Missed by 2-5 years                     
 
C0400A   $M3CUE                        BIMS: Rcl - Able to Rcl Sock             
                          2,492                          Missing                                 
                            264        -                 Not assessed/no information             
                          1,346        0                 No - could not recall                   
                            809        1                 Yes, after cueing                       
                          2,277        2                 Yes, no cue required                    
 
C0400B   $M3CUE                        BIMS: Rcl - Able to Rcl Blue             
                          2,492                          Missing                                 
                            270        -                 Not assessed/no information             
                            984        0                 No - could not recall                   
                            968        1                 Yes, after cueing                       
                          2,474        2                 Yes, no cue required                    
 
C0400C   $M3CUE                        BIMS: Rcl - Able to Rcl Bed              
                          2,492                          Missing                                 
                            270        -                 Not assessed/no information             
                          1,476        0                 No - could not recall                   
                            946        1                 Yes, after cueing                       
                          2,004        2                 Yes, no cue required                    
 
C0500                                  Brief Int for Mntl Stat (BIMS) Score Num 
                          7,188                          Range of Values                         
 
C0600    $M3YESNO                      Staff to Cond Brief Int for Mntl Stat    
                          2,492                          Missing                                 
                             63        -                 Not assessed/no information             
                          4,324        0                 No                                      
                            309        1                 Yes                                     
 
C0700    $M3MEMRY                      SA of Mntl Stat - Short Term Memory      
                          5,848                          Missing                                 
                            137        -                 Not assessed/no information             
                            237        0                 Memory OK                               
                            966        1                 Memory problem                          
 
C0800    $M3MEMRY                      SA of Mntl Stat - Long Term Memory       
                          6,370                          Missing                                 
                             61        -                 Not assessed/no information             
                             79        0                 Memory OK                               
                            678        1                 Memory problem                          
 
C0900A   $M3INDIC                      SA of Mntl Stat - Rcls Cur Season        
                          6,370                          Missing                                 
                             43        -                 Not assessed/no information             
                            693        0                 Not indicated                           
                             82        1                 Indicated                               
 
C0900B   $M3INDIC                      SA of Mntl Stat - Rcls Loc of Room       
                          6,370                          Missing                                 
                             43        -                 Not assessed/no information             
                            601        0                 Not indicated                           
                            174        1                 Indicated                               
 
C0900C   $M3INDIC                      SA of Mntl Stat - Rcls Staff Name        
                          6,370                          Missing                                 
                             43        -                 Not assessed/no information             
                            562        0                 Not indicated                           
                            213        1                 Indicated                               
 
C0900D   $M3INDIC                      SA of Mntl Stat - Rcls Nrs Home          
                          6,370                          Missing                                 
                             43        -                 Not assessed/no information             
                            617        0                 Not indicated                           
                            158        1                 Indicated                               
 
C0900Z   $M3INDIC                      SA of Mntl Stat - Rcls None of Above     
                          6,370                          Missing                                 
                             43        -                 Not assessed/no information             
                            295        0                 Not indicated                           
                            480        1                 Indicated                               
 
C1000    $M3DECIS                      Cog Skills for Decision Making           
                          5,848                          Missing                                 
                            114        -                 Not assessed/no information             
                            150        0                 Independent                             
                            163        1                 Modified independence                   
                            332        2                 Moderately impaired                     
                            581        3                 Severely impaired                       
 
C1300A   $M3BHFLU                      S/SDlrm - Inattention                    
                          3,033                          Missing                                 
                             65        -                 Not assessed/no information             
                          3,523        0                 Behavior not present                    
                            185        1                 Behavior always present, no fluctuate   
                            382        2                 Behavior present, fluctuates            
 
C1300B   $M3BHFLU                      S/SDlrm - Disorganized Thinking          
                          3,033                          Missing                                 
                             73        -                 Not assessed/no information             
                          3,513        0                 Behavior not present                    
                            166        1                 Behavior always present, no fluctuate   
                            403        2                 Behavior present, fluctuates            
 
C1300C   $M3BHFLU                      S/SDlrm - Alt Level of Consciousness     
                          3,033                          Missing                                 
                             65        -                 Not assessed/no information             
                          3,957        0                 Behavior not present                    
                             38        1                 Behavior always present, no fluctuate   
                             95        2                 Behavior present, fluctuates            
 
C1300D   $M3BHFLU                      S/SDlrm - Psychomotor Retardation        
                          3,033                          Missing                                 
                             66        -                 Not assessed/no information             
                          3,996        0                 Behavior not present                    
                             31        1                 Behavior always present, no fluctuate   
                             62        2                 Behavior present, fluctuates            
 
C1600    $M3YESNO                      Acute Onset Mntl Stat Change             
                          3,033                          Missing                                 
                            119        -                 Not assessed/no information             
                          3,969        0                 No                                      
                             67        1                 Yes                                     
 
D0100    $M3YESNO                      Res Mood Int Be Cond                     
                          1,924                          Missing                                 
                            151        -                 Not assessed/no information             
                            601        0                 No                                      
                          4,512        1                 Yes                                     
 
D0200A1  $M3YNNOR                      Res Mood Int - Interest Loss             
                          2,525                          Missing                                 
                            190        -                 Not assessed/no information             
                          3,848        0                 No                                      
                            451        1                 Yes                                     
                            174        9                 No Response                             
 
D0200A2  $M3DEPRB                      Res Mood Int - Interest Loss Freq        
                          2,699                          Missing                                 
                            191        -                 Not assessed/no information             
                          3,865        0                 Never or 1 day                          
                            201        1                 2 - 6 days                              
                            110        2                 7 - 11 days                             
                            122        3                 12-14 days                              
 
D0200B1  $M3YNNOR                      Res Mood Int - Feel Down                 
                          2,525                          Missing                                 
                            191        -                 Not assessed/no information             
                          3,172        0                 No                                      
                          1,130        1                 Yes                                     
                            170        9                 No Response                             
 
D0200B2  $M3DEPRB                      Res Mood Int - Feel Down Freq            
                          2,695                          Missing                                 
                            195        -                 Not assessed/no information             
                          3,225        0                 Never or 1 day                          
                            611        1                 2 - 6 days                              
                            252        2                 7 - 11 days                             
                            210        3                 12-14 days                              
 
D0200C1  $M3YNNOR                      Res Mood Int - Trouble Sleep             
                          2,525                          Missing                                 
                            191        -                 Not assessed/no information             
                          3,434        0                 No                                      
                            867        1                 Yes                                     
                            171        9                 No Response                             
 
D0200C2  $M3DEPRB                      Res Mood Int - Trouble Sleep Freq        
                          2,696                          Missing                                 
                            193        -                 Not assessed/no information             
                          3,468        0                 Never or 1 day                          
                            432        1                 2 - 6 days                              
                            194        2                 7 - 11 days                             
                            205        3                 12-14 days                              
 
D0200D1  $M3YNNOR                      Res Mood Int - Little Energy             
                          2,525                          Missing                                 
                            208        -                 Not assessed/no information             
                          2,867        0                 No                                      
                          1,433        1                 Yes                                     
                            155        9                 No Response                             
 
D0200D2  $M3DEPRB                      Res Mood Int - Little Energy Freq        
                          2,680                          Missing                                 
                            215        -                 Not assessed/no information             
                          2,895        0                 Never or 1 day                          
                            681        1                 2 - 6 days                              
                            340        2                 7 - 11 days                             
                            377        3                 12-14 days                              
 
D0200E1  $M3YNNOR                      Res Mood Int - Poor Appetite             
                          2,525                          Missing                                 
                            217        -                 Not assessed/no information             
                          3,598        0                 No                                      
                            699        1                 Yes                                     
                            149        9                 No Response                             
 
D0200E2  $M3DEPRB                      Res Mood Int - Poor Appetite Freq        
                          2,674                          Missing                                 
                            217        -                 Not assessed/no information             
                          3,618        0                 Never or 1 day                          
                            371        1                 2 - 6 days                              
                            154        2                 7 - 11 days                             
                            154        3                 12-14 days                              
 
D0200F1  $M3YNNOR                      Res Mood Int - Self Dprcn                
                          2,525                          Missing                                 
                            222        -                 Not assessed/no information             
                          3,997        0                 No                                      
                            280        1                 Yes                                     
                            164        9                 No Response                             
 
D0200F2  $M3DEPRB                      Res Mood Int - Self Dprcn Freq           
                          2,689                          Missing                                 
                            222        -                 Not assessed/no information             
                          4,004        0                 Never or 1 day                          
                            153        1                 2 - 6 days                              
                             48        2                 7 - 11 days                             
                             72        3                 12-14 days                              
 
D0200G1  $M3YNNOR                      Res Mood Int - Lack of Conc              
                          2,525                          Missing                                 
                            223        -                 Not assessed/no information             
                          3,750        0                 No                                      
                            529        1                 Yes                                     
                            161        9                 No Response                             
 
D0200G2  $M3DEPRB                      Res Mood Int - Lack of Conc Freq         
                          2,686                          Missing                                 
                            229        -                 Not assessed/no information             
                          3,774        0                 Never or 1 day                          
                            249        1                 2 - 6 days                              
                            122        2                 7 - 11 days                             
                            128        3                 12-14 days                              
 
D0200H1  $M3YNNOR                      Res Mood Int - Movement Diff             
                          2,525                          Missing                                 
                            224        -                 Not assessed/no information             
                          3,914        0                 No                                      
                            364        1                 Yes                                     
                            161        9                 No Response                             
 
D0200H2  $M3DEPRB                      Res Mood Int - Movement Diff Freq        
                          2,686                          Missing                                 
                            226        -                 Not assessed/no information             
                          3,925        0                 Never or 1 day                          
                            173        1                 2 - 6 days                              
                             78        2                 7 - 11 days                             
                            100        3                 12-14 days                              
 
D0200I1  $M3YNNOR                      Res Mood Int - Neg Stmnt                 
                          2,525                          Missing                                 
                            222        -                 Not assessed/no information             
                          4,233        0                 No                                      
                             56        1                 Yes                                     
                            152        9                 No Response                             
 
D0200I2  $M3DEPRB                      Res Mood Int - Neg Stmnt Freq            
                          2,677                          Missing                                 
                            222        -                 Not assessed/no information             
                          4,241        0                 Never or 1 day                          
                             26        1                 2 - 6 days                              
                             12        2                 7 - 11 days                             
                             10        3                 12-14 days                              
 
D0300                                  Res Mood Int - Tot Svrty Mood Score      
                          7,188                          Range of Values                         
 
D0350    $M3YESNO                      Res Mood Int - Neg Stmnts Notify Staff   
                          7,132                          Missing                                 
                              3        0                 No                                      
                             53        1                 Yes                                     
 
D0500A1  $M3YESNO                      SA of Res Mood - Interest Loss           
                          6,201                          Missing                                 
                             80        -                 Not assessed/no information             
                            757        0                 No                                      
                            150        1                 Yes                                     
 
D0500A2  $M3DEPRB                      SA of Res Mood - Interest Loss Freq      
                          6,201                          Missing                                 
                             81        -                 Not assessed/no information             
                            756        0                 Never or 1 day                          
                             39        1                 2 - 6 days                              
                             45        2                 7 - 11 days                             
                             66        3                 12-14 days                              
 
D0500B1  $M3YESNO                      SA of Res Mood - Feel Down               
                          6,201                          Missing                                 
                             77        -                 Not assessed/no information             
                            759        0                 No                                      
                            151        1                 Yes                                     
 
D0500B2  $M3DEPRB                      SA of Res Mood - Feel Down Freq          
                          6,201                          Missing                                 
                             77        -                 Not assessed/no information             
                            759        0                 Never or 1 day                          
                             66        1                 2 - 6 days                              
                             36        2                 7 - 11 days                             
                             49        3                 12-14 days                              
 
D0500C1  $M3YESNO                      SA of Res Mood - Trouble Sleep           
                          6,201                          Missing                                 
                             74        -                 Not assessed/no information             
                            738        0                 No                                      
                            175        1                 Yes                                     
 
D0500C2  $M3DEPRB                      SA of Res Mood - Trouble Sleep Freq      
                          6,201                          Missing                                 
                             74        -                 Not assessed/no information             
                            739        0                 Never or 1 day                          
                             59        1                 2 - 6 days                              
                             57        2                 7 - 11 days                             
                             58        3                 12-14 days                              
 
D0500D1  $M3YESNO                      SA of Res Mood - Little Energy           
                          6,201                          Missing                                 
                             79        -                 Not assessed/no information             
                            636        0                 No                                      
                            272        1                 Yes                                     
 
D0500D2  $M3DEPRB                      SA of Res Mood - Little Energy Freq      
                          6,201                          Missing                                 
                             79        -                 Not assessed/no information             
                            638        0                 Never or 1 day                          
                             91        1                 2 - 6 days                              
                             87        2                 7 - 11 days                             
                             92        3                 12-14 days                              
 
D0500E1  $M3YESNO                      SA of Res Mood - Poor Appetite           
                          6,201                          Missing                                 
                             75        -                 Not assessed/no information             
                            701        0                 No                                      
                            211        1                 Yes                                     
 
D0500E2  $M3DEPRB                      SA of Res Mood - Poor Appetite Freq      
                          6,201                          Missing                                 
                             75        -                 Not assessed/no information             
                            708        0                 Never or 1 day                          
                             97        1                 2 - 6 days                              
                             53        2                 7 - 11 days                             
                             54        3                 12-14 days                              
 
D0500F1  $M3YESNO                      SA of Res Mood - Self Dprcn              
                          6,201                          Missing                                 
                             85        -                 Not assessed/no information             
                            893        0                 No                                      
                              9        1                 Yes                                     
 
D0500F2  $M3DEPRB                      SA of Res Mood - Self Dprcn Freq         
                          6,201                          Missing                                 
                             85        -                 Not assessed/no information             
                            894        0                 Never or 1 day                          
                              2        1                 2 - 6 days                              
                              4        2                 7 - 11 days                             
                              2        3                 12-14 days                              
 
D0500G1  $M3YESNO                      SA of Res Mood - Conc                    
                          6,201                          Missing                                 
                             84        -                 Not assessed/no information             
                            631        0                 No                                      
                            272        1                 Yes                                     
 
D0500G2  $M3DEPRB                      SA of Res Mood - Conc Freq               
                          6,201                          Missing                                 
                             84        -                 Not assessed/no information             
                            634        0                 Never or 1 day                          
                             40        1                 2 - 6 days                              
                             41        2                 7 - 11 days                             
                            188        3                 12-14 days                              
 
D0500H1  $M3YESNO                      SA of Res Mood - Movement Diff           
                          6,201                          Missing                                 
                             76        -                 Not assessed/no information             
                            829        0                 No                                      
                             82        1                 Yes                                     
 
D0500H2  $M3DEPRB                      SA of Res Mood - Movement Diff Freq      
                          6,201                          Missing                                 
                             76        -                 Not assessed/no information             
                            831        0                 Never or 1 day                          
                             31        1                 2 - 6 days                              
                             17        2                 7 - 11 days                             
                             32        3                 12-14 days                              
 
D0500I1  $M3YESNO                      SA of Res Mood - Neg Stmnt               
                          6,201                          Missing                                 
                             78        -                 Not assessed/no information             
                            904        0                 No                                      
                              5        1                 Yes                                     
 
D0500I2  $M3DEPRB                      SA of Res Mood - Neg Stmnt Freq          
                          6,201                          Missing                                 
                             78        -                 Not assessed/no information             
                            904        0                 Never or 1 day                          
                              3        1                 2 - 6 days                              
                              1        2                 7 - 11 days                             
                              1        3                 12-14 days                              
 
D0500J1  $M3YESNO                      SA of Res Mood - Short Temper            
                          6,201                          Missing                                 
                             74        -                 Not assessed/no information             
                            760        0                 No                                      
                            153        1                 Yes                                     
 
D0500J2  $M3DEPRB                      SA of Res Mood - Short Temper Freq       
                          6,201                          Missing                                 
                             74        -                 Not assessed/no information             
                            764        0                 Never or 1 day                          
                             80        1                 2 - 6 days                              
                             33        2                 7 - 11 days                             
                             36        3                 12-14 days                              
 
D0600                                  SA Tot Svrty Mood Score                  
                          7,188                          Range of Values                         
 
D0650    $M3YESNO                      SA of Res Mood - Neg Stmnt Notify        
                          7,183                          Missing                                 
                              2        0                 No                                      
                              3        1                 Yes                                     
 
E0100A   $M3INDIC                      Bhvr: Hallucinations                     
                          1,524                          Missing                                 
                             33        -                 Not assessed/no information             
                          5,554        0                 Not indicated                           
                             77        1                 Indicated                               
 
E0100B   $M3INDIC                      Bhvr: Delusion                           
                          1,524                          Missing                                 
                             31        -                 Not assessed/no information             
                          5,422        0                 Not indicated                           
                            211        1                 Indicated                               
 
E0100Z   $M3INDIC                      Bhvr: No Psychosis                       
                          1,524                          Missing                                 
                             33        -                 Not assessed/no information             
                            247        0                 Not indicated                           
                          5,384        1                 Indicated                               
 
E0200A   $M3BEHAV                      Bhvr: Phys Bhvral                        
                          1,524                          Missing                                 
                             37        -                 Not assessed/no information             
                          5,450        0                 Behavior not exhibited                  
                            143        1                 1 to 3 days                             
                             24        2                 4 to 6 days                             
                             10        3                 Behavior exhibited daily                
 
E0200B   $M3BEHAV                      Bhvr: Verbal Bhvral                      
                          1,524                          Missing                                 
                             37        -                 Not assessed/no information             
                          5,330        0                 Behavior not exhibited                  
                            220        1                 1 to 3 days                             
                             55        2                 4 to 6 days                             
                             22        3                 Behavior exhibited daily                
 
E0200C   $M3BEHAV                      Bhvr: Oth Bhvral                         
                          1,524                          Missing                                 
                             37        -                 Not assessed/no information             
                          5,400        0                 Behavior not exhibited                  
                            150        1                 1 to 3 days                             
                             39        2                 4 to 6 days                             
                             38        3                 Behavior exhibited daily                
 
E0300    $M3YESNO                      Overall Pres of Bhvral Sympt             
                          5,621                          Missing                                 
                              4        -                 Not assessed/no information             
                          1,412        0                 No                                      
                            151        1                 Yes                                     
 
E0500A   $M3YESNO                      Bhvr Imp on Res: Risk to Inj Self        
                          7,033                          Missing                                 
                              5        -                 Not assessed/no information             
                            124        0                 No                                      
                             26        1                 Yes                                     
 
E0500B   $M3YESNO                      Bhvr Imp on Res: Int W Care              
                          7,033                          Missing                                 
                              5        -                 Not assessed/no information             
                            100        0                 No                                      
                             50        1                 Yes                                     
 
E0500C   $M3YESNO                      Bhvr Imp on Res: Int W Part              
                          7,033                          Missing                                 
                              5        -                 Not assessed/no information             
                            120        0                 No                                      
                             30        1                 Yes                                     
 
E0600A   $M3YESNO                      Bhvr Imp on Oth: Risk to Inj Oth         
                          7,033                          Missing                                 
                              5        -                 Not assessed/no information             
                            130        0                 No                                      
                             20        1                 Yes                                     
 
E0600B   $M3YESNO                      Bhvr Imp on Oth: Intrude On Priv of Oth  
                          7,033                          Missing                                 
                              5        -                 Not assessed/no information             
                            122        0                 No                                      
                             28        1                 Yes                                     
 
E0600C   $M3YESNO                      Bhvr Imp on Oth: Dis Care or Living Env  
                          7,033                          Missing                                 
                              5        -                 Not assessed/no information             
                            106        0                 No                                      
                             44        1                 Yes                                     
 
E0800    $M3BEHAV                      Rejection of Care: Pres and Freq         
                          1,524                          Missing                                 
                             37        -                 Not assessed/no information             
                          5,196        0                 Behavior not exhibited                  
                            338        1                 1 to 3 days                             
                             70        2                 4 to 6 days                             
                             23        3                 Behavior exhibited daily                
 
E0900    $M3BEHAV                      Wandering: Pres and Freq                 
                          1,524                          Missing                                 
                             37        -                 Not assessed/no information             
                          5,407        0                 Behavior not exhibited                  
                            111        1                 1 to 3 days                             
                             36        2                 4 to 6 days                             
                             73        3                 Behavior exhibited daily                
 
E1000A   $M3YESNO                      Wander Risk Imp                          
                          7,110                          Missing                                 
                              6        -                 Not assessed/no information             
                             60        0                 No                                      
                             12        1                 Yes                                     
 
E1000B   $M3YESNO                      Wandering Intrudes on Priv of Oth        
                          7,110                          Missing                                 
                              6        -                 Not assessed/no information             
                             52        0                 No                                      
                             20        1                 Yes                                     
 
E1100    $M3CHNG                       Change in Bhvr or Oth Sympt              
                          5,621                          Missing                                 
                             11        -                 Not assessed/no information             
                            893        0                 Same                                    
                             21        1                 Improved                                
                             33        2                 Worse                                   
                            609        3                 N/A                                     
 
F0300    $M3YESNO                      Should Dly and Act Pref Int Be Cond      
                          5,621                          Missing                                 
                             30        -                 Not assessed/no information             
                            154        0                 No                                      
                          1,383        1                 Yes                                     
 
F0400A   $M3IMPRT                      Int for Dly Pref: Chooses Clothes        
                          5,775                          Missing                                 
                             30        -                 Not assessed/no information             
                            750        1                 Very important                          
                            371        2                 Somewhat important                      
                            204        3                 Not very important                      
                             35        4                 Not important at all                    
                              6        5                 Important, but cannot do or no choice   
                             17        9                 No response or non-responsive           
 
F0400B   $M3IMPRT                      Int for Dly Pref: Care Personal Items    
                          5,775                          Missing                                 
                             30        -                 Not assessed/no information             
                            887        1                 Very important                          
                            331        2                 Somewhat important                      
                            108        3                 Not very important                      
                             21        4                 Not important at all                    
                             19        5                 Important, but cannot do or no choice   
                             17        9                 No response or non-responsive           
 
F0400C   $M3IMPRT                      Int for Dly Pref: Bathing Option         
                          5,775                          Missing                                 
                             31        -                 Not assessed/no information             
                            852        1                 Very important                          
                            348        2                 Somewhat important                      
                            124        3                 Not very important                      
                             29        4                 Not important at all                    
                              9        5                 Important, but cannot do or no choice   
                             20        9                 No response or non-responsive           
 
F0400D   $M3IMPRT                      Int for Dly Pref: Snack Between Meals    
                          5,775                          Missing                                 
                             32        -                 Not assessed/no information             
                            539        1                 Very important                          
                            487        2                 Somewhat important                      
                            258        3                 Not very important                      
                             69        4                 Not important at all                    
                             12        5                 Important, but cannot do or no choice   
                             16        9                 No response or non-responsive           
 
F0400E   $M3IMPRT                      Int for Dly Pref: Choose Bed Time        
                          5,775                          Missing                                 
                             32        -                 Not assessed/no information             
                            935        1                 Very important                          
                            288        2                 Somewhat important                      
                            117        3                 Not very important                      
                             23        4                 Not important at all                    
                              1        5                 Important, but cannot do or no choice   
                             17        9                 No response or non-responsive           
 
F0400F   $M3IMPRT                      Int for Dly Pref: Fam Involvement        
                          5,775                          Missing                                 
                             32        -                 Not assessed/no information             
                          1,119        1                 Very important                          
                            150        2                 Somewhat important                      
                             61        3                 Not very important                      
                             29        4                 Not important at all                    
                              5        5                 Important, but cannot do or no choice   
                             17        9                 No response or non-responsive           
 
F0400G   $M3IMPRT                      Int for Dly Pref: Priv Phone Time        
                          5,775                          Missing                                 
                             34        -                 Not assessed/no information             
                            488        1                 Very important                          
                            313        2                 Somewhat important                      
                            387        3                 Not very important                      
                            156        4                 Not important at all                    
                             16        5                 Important, but cannot do or no choice   
                             19        9                 No response or non-responsive           
 
F0400H   $M3IMPRT                      Int for Dly Pref: Lock Item              
                          5,775                          Missing                                 
                             33        -                 Not assessed/no information             
                            466        1                 Very important                          
                            291        2                 Somewhat important                      
                            379        3                 Not very important                      
                            220        4                 Not important at all                    
                              5        5                 Important, but cannot do or no choice   
                             19        9                 No response or non-responsive           
 
F0500A   $M3IMPRT                      Int for Act Pref: Reading Mat Available  
                          5,775                          Missing                                 
                             33        -                 Not assessed/no information             
                            569        1                 Very important                          
                            365        2                 Somewhat important                      
                            292        3                 Not very important                      
                            100        4                 Not important at all                    
                             33        5                 Important, but cannot do or no choice   
                             21        9                 No response or non-responsive           
 
F0500B   $M3IMPRT                      Int for Act Pref: Music                  
                          5,775                          Missing                                 
                             33        -                 Not assessed/no information             
                            695        1                 Very important                          
                            456        2                 Somewhat important                      
                            179        3                 Not very important                      
                             30        4                 Not important at all                    
                              4        5                 Important, but cannot do or no choice   
                             16        9                 No response or non-responsive           
 
F0500C   $M3IMPRT                      Int for Act Pref: Animal Pres            
                          6,331                          Missing                                 
                             23        -                 Not assessed/no information             
                            284        1                 Very important                          
                            202        2                 Somewhat important                      
                            189        3                 Not very important                      
                             77        4                 Not important at all                    
                              4        5                 Important, but cannot do or no choice   
                             10        9                 No response or non-responsive           
                             66        E                 E                                       
                              2        S                 S                                       
 
F0500D   $M3IMPRT                      Int for Act Pref: News                   
                          5,775                          Missing                                 
                             34        -                 Not assessed/no information             
                            707        1                 Very important                          
                            408        2                 Somewhat important                      
                            188        3                 Not very important                      
                             52        4                 Not important at all                    
                              4        5                 Important, but cannot do or no choice   
                             20        9                 No response or non-responsive           
 
F0500E   $M3IMPRT                      Int for Act Pref: Group Act              
                          5,775                          Missing                                 
                             33        -                 Not assessed/no information             
                            478        1                 Very important                          
                            508        2                 Somewhat important                      
                            282        3                 Not very important                      
                             84        4                 Not important at all                    
                              8        5                 Important, but cannot do or no choice   
                             20        9                 No response or non-responsive           
 
F0500F   $M3IMPRT                      Int for Act Pref: Favorite Act           
                          5,775                          Missing                                 
                             33        -                 Not assessed/no information             
                            819        1                 Very important                          
                            430        2                 Somewhat important                      
                             58        3                 Not very important                      
                             29        4                 Not important at all                    
                             25        5                 Important, but cannot do or no choice   
                             19        9                 No response or non-responsive           
 
F0500G   $M3IMPRT                      Int for Act Pref: Time Outdoors          
                          5,775                          Missing                                 
                             32        -                 Not assessed/no information             
                            804        1                 Very important                          
                            389        2                 Somewhat important                      
                            129        3                 Not very important                      
                             30        4                 Not important at all                    
                              9        5                 Important, but cannot do or no choice   
                             20        9                 No response or non-responsive           
 
F0500H   $M3IMPRT                      Int for Act Pref: Religion               
                          5,775                          Missing                                 
                             34        -                 Not assessed/no information             
                            723        1                 Very important                          
                            359        2                 Somewhat important                      
                            200        3                 Not very important                      
                             69        4                 Not important at all                    
                              7        5                 Important, but cannot do or no choice   
                             21        9                 No response or non-responsive           
 
F0600    $M3PRIRS                      Dly and Act Pref Primary Respondent      
                          5,775                          Missing                                 
                             31        -                 Not assessed/no information             
                          1,240        1                 Resident                                
                            119        2                 Family or significant other             
                             23        9                 Interview could not be completed        
 
F0700    $M3YESNO                      Cond SA of Dly and Act Pref              
                          5,775                          Missing                                 
                             18        -                 Not assessed/no information             
                          1,359        0                 No                                      
                             36        1                 Yes                                     
 
F0800A   $M3INDIC                      SA: Chooses Clothes                      
                          6,980                          Missing                                 
                             24        -                 Not assessed/no information             
                            137        0                 Not indicated                           
                             47        1                 Indicated                               
 
F0800B   $M3INDIC                      SA: Care Personal Item                   
                          6,980                          Missing                                 
                             24        -                 Not assessed/no information             
                            147        0                 Not indicated                           
                             37        1                 Indicated                               
 
F0800C   $M3INDIC                      SA: Tub Bath                             
                          6,980                          Missing                                 
                             29        -                 Not assessed/no information             
                            167        0                 Not indicated                           
                             12        1                 Indicated                               
 
F0800D   $M3INDIC                      SA: Shower                               
                          6,980                          Missing                                 
                             22        -                 Not assessed/no information             
                             67        0                 Not indicated                           
                            119        1                 Indicated                               
 
F0800E   $M3INDIC                      SA: Bed Bath                             
                          6,980                          Missing                                 
                             27        -                 Not assessed/no information             
                            129        0                 Not indicated                           
                             52        1                 Indicated                               
 
F0800F   $M3INDIC                      SA: Sponge Bath                          
                          6,980                          Missing                                 
                             27        -                 Not assessed/no information             
                            142        0                 Not indicated                           
                             39        1                 Indicated                               
 
F0800G   $M3INDIC                      SA: Snacks Between                       
                          6,980                          Missing                                 
                             21        -                 Not assessed/no information             
                             79        0                 Not indicated                           
                            108        1                 Indicated                               
 
F0800H   $M3INDIC                      SA: Bed Time                             
                          6,980                          Missing                                 
                             27        -                 Not assessed/no information             
                            151        0                 Not indicated                           
                             30        1                 Indicated                               
 
F0800I   $M3INDIC                      SA: Fam Involvement                      
                          6,980                          Missing                                 
                             24        -                 Not assessed/no information             
                             46        0                 Not indicated                           
                            138        1                 Indicated                               
 
F0800J   $M3INDIC                      SA: Priv Phone                           
                          6,980                          Missing                                 
                             26        -                 Not assessed/no information             
                            176        0                 Not indicated                           
                              6        1                 Indicated                               
 
F0800K   $M3INDIC                      SA: Lock Item                            
                          6,980                          Missing                                 
                             26        -                 Not assessed/no information             
                            170        0                 Not indicated                           
                             12        1                 Indicated                               
 
F0800L   $M3INDIC                      SA: Reading Mat Available                
                          6,980                          Missing                                 
                             25        -                 Not assessed/no information             
                            135        0                 Not indicated                           
                             48        1                 Indicated                               
 
F0800M   $M3INDIC                      SA: Music                                
                          6,980                          Missing                                 
                             19        -                 Not assessed/no information             
                             43        0                 Not indicated                           
                            146        1                 Indicated                               
 
F0800N   $M3INDIC                      SA: Animal Pres                          
                          6,980                          Missing                                 
                             19        -                 Not assessed/no information             
                            118        0                 Not indicated                           
                             71        1                 Indicated                               
 
F0800O   $M3INDIC                      SA: News                                 
                          6,980                          Missing                                 
                             25        -                 Not assessed/no information             
                            158        0                 Not indicated                           
                             25        1                 Indicated                               
 
F0800P   $M3INDIC                      SA: Group Act                            
                          6,980                          Missing                                 
                             19        -                 Not assessed/no information             
                             86        0                 Not indicated                           
                            103        1                 Indicated                               
 
F0800Q   $M3INDIC                      SA: Favorite Act                         
                          6,980                          Missing                                 
                             24        -                 Not assessed/no information             
                             82        0                 Not indicated                           
                            102        1                 Indicated                               
 
F0800R   $M3INDIC                      SA: Time Away Nrs Home                   
                          6,980                          Missing                                 
                             28        -                 Not assessed/no information             
                            160        0                 Not indicated                           
                             20        1                 Indicated                               
 
F0800S   $M3INDIC                      SA: Time Outdoors                        
                          6,980                          Missing                                 
                             20        -                 Not assessed/no information             
                            104        0                 Not indicated                           
                             84        1                 Indicated                               
 
F0800T   $M3INDIC                      SA: Part in Rel Act                      
                          6,980                          Missing                                 
                             24        -                 Not assessed/no information             
                             98        0                 Not indicated                           
                             86        1                 Indicated                               
 
F0800Z   $M3INDIC                      SA: None of Above Act                    
                          6,980                          Missing                                 
                             19        -                 Not assessed/no information             
                            183        0                 Not indicated                           
                              6        1                 Indicated                               
 
G0110A1  $M3ADLCT                      ADL Ass: Bed Mob Self Perf               
                          1,511                          Missing                                 
                              3        -                 Not assessed/no information             
                            302        0                 Independent                             
                            484        1                 Supervision                             
                            786        2                 Limited assistance                      
                          3,730        3                 Extensive assistance                    
                            365        4                 Total dependence                        
                              7        7                 Activity occurred only once or twice    
 
G0110A2  $M3ADLSP                      ADL Ass: Bed Mob Supp Prov               
                          2,541                          Missing                                 
                              1        -                 -                                       
                            201        0                 No setup or physical help from staff    
                            229        1                 Setup help only                         
                          2,205        2                 One person physical assist              
                          2,011        3                 Two+ persons physical assist            
 
G0110B1  $M3ADLCT                      ADL Ass: Trans Self Perf                 
                          1,511                          Missing                                 
                              3        -                 Not assessed/no information             
                            233        0                 Independent                             
                            533        1                 Supervision                             
                            846        2                 Limited assistance                      
                          3,273        3                 Extensive assistance                    
                            644        4                 Total dependence                        
                             79        7                 Activity occurred only once or twice    
                             66        8                 Activity did not occur                  
 
G0110B2  $M3ADLSP                      ADL Ass: Trans Self Supp Prov            
                          2,541                          Missing                                 
                              1        -                 -                                       
                            164        0                 No setup or physical help from staff    
                            240        1                 Setup help only                         
                          2,027        2                 One person physical assist              
                          2,156        3                 Two+ persons physical assist            
                             59        8                 ADL activity did not occur              
 
G0110C1  $M3ADLCT                      ADL Ass: Wlk In Room Self Perf           
                          1,665                          Missing                                 
                             12        -                 Not assessed/no information             
                            282        0                 Independent                             
                            689        1                 Supervision                             
                            872        2                 Limited assistance                      
                            909        3                 Extensive assistance                    
                             15        4                 Total dependence                        
                            285        7                 Activity occurred only once or twice    
                          2,459        8                 Activity did not occur                  
 
G0110C2  $M3ADLSP                      ADL Ass: Wlk In Room Supp Prov           
                          2,696                          Missing                                 
                              3        -                 -                                       
                            218        0                 No setup or physical help from staff    
                            337        1                 Setup help only                         
                          1,574        2                 One person physical assist              
                            209        3                 Two+ persons physical assist            
                          2,151        8                 ADL activity did not occur              
 
G0110D1  $M3ADLCT                      ADL Ass: Wlk In Corr Self Perf           
                          1,665                          Missing                                 
                             12        -                 Not assessed/no information             
                            204        0                 Independent                             
                            682        1                 Supervision                             
                            830        2                 Limited assistance                      
                            761        3                 Extensive assistance                    
                             17        4                 Total dependence                        
                            369        7                 Activity occurred only once or twice    
                          2,648        8                 Activity did not occur                  
 
G0110D2  $M3ADLSP                      ADL Ass: Wlk In Corr Self Supp Prov      
                          2,696                          Missing                                 
                              3        -                 -                                       
                            198        0                 No setup or physical help from staff    
                            300        1                 Setup help only                         
                          1,513        2                 One person physical assist              
                            185        3                 Two+ persons physical assist            
                          2,293        8                 ADL activity did not occur              
 
G0110E1  $M3ADLCT                      ADL Ass: Loc On Self Perf                
                          1,665                          Missing                                 
                             12        -                 Not assessed/no information             
                            387        0                 Independent                             
                            959        1                 Supervision                             
                            887        2                 Limited assistance                      
                          2,169        3                 Extensive assistance                    
                            798        4                 Total dependence                        
                            138        7                 Activity occurred only once or twice    
                            173        8                 Activity did not occur                  
 
G0110E2  $M3ADLSP                      ADL Ass: Loc On Supp Prov                
                          2,696                          Missing                                 
                              4        -                 -                                       
                            271        0                 No setup or physical help from staff    
                            493        1                 Setup help only                         
                          3,445        2                 One person physical assist              
                            134        3                 Two+ persons physical assist            
                            145        8                 ADL activity did not occur              
 
G0110F1  $M3ADLCT                      ADL Ass: Loc Off Self Perf               
                          1,665                          Missing                                 
                             13        -                 Not assessed/no information             
                            328        0                 Independent                             
                            841        1                 Supervision                             
                            725        2                 Limited assistance                      
                          1,845        3                 Extensive assistance                    
                            960        4                 Total dependence                        
                            380        7                 Activity occurred only once or twice    
                            431        8                 Activity did not occur                  
 
G0110F2  $M3ADLSP                      ADL Ass: Loc Off Supp Prov               
                          2,696                          Missing                                 
                              4        -                 -                                       
                            239        0                 No setup or physical help from staff    
                            444        1                 Setup help only                         
                          3,346        2                 One person physical assist              
                             98        3                 Two+ persons physical assist            
                            361        8                 ADL activity did not occur              
 
G0110G1  $M3ADLCT                      ADL Ass: Dress Self Perf                 
                          1,665                          Missing                                 
                             10        -                 Not assessed/no information             
                            141        0                 Independent                             
                            381        1                 Supervision                             
                            761        2                 Limited assistance                      
                          3,716        3                 Extensive assistance                    
                            490        4                 Total dependence                        
                             19        7                 Activity occurred only once or twice    
                              5        8                 Activity did not occur                  
 
G0110G2  $M3ADLSP                      ADL Ass: Dress Supp Prov                 
                          2,696                          Missing                                 
                              3        -                 -                                       
                             62        0                 No setup or physical help from staff    
                            181        1                 Setup help only                         
                          3,554        2                 One person physical assist              
                            688        3                 Two+ persons physical assist            
                              4        8                 ADL activity did not occur              
 
G0110H1  $M3ADLCT                      ADL Ass: Eating Self Perf                
                          1,511                          Missing                                 
                              3        -                 Not assessed/no information             
                          1,401        0                 Independent                             
                          2,424        1                 Supervision                             
                            677        2                 Limited assistance                      
                            851        3                 Extensive assistance                    
                            306        4                 Total dependence                        
                             12        7                 Activity occurred only once or twice    
                              3        8                 Activity did not occur                  
 
G0110H2  $M3ADLSP                      ADL Ass: Eating Supp Prov                
                          2,541                          Missing                                 
                              1        -                 -                                       
                            122        0                 No setup or physical help from staff    
                          2,387        1                 Setup help only                         
                          2,116        2                 One person physical assist              
                             19        3                 Two+ persons physical assist            
                              2        8                 ADL activity did not occur              
 
G0110I1  $M3ADLCT                      ADL Ass: Toileting Self Perf             
                          1,511                          Missing                                 
                              3        -                 Not assessed/no information             
                            200        0                 Independent                             
                            427        1                 Supervision                             
                            663        2                 Limited assistance                      
                          3,705        3                 Extensive assistance                    
                            665        4                 Total dependence                        
                             10        7                 Activity occurred only once or twice    
                              4        8                 Activity did not occur                  
 
G0110I2  $M3ADLSP                      ADL Ass: Toileting Supp Prov             
                          2,541                          Missing                                 
                              1        -                 -                                       
                            110        0                 No setup or physical help from staff    
                            210        1                 Setup help only                         
                          2,637        2                 One person physical assist              
                          1,685        3                 Two+ persons physical assist            
                              4        8                 ADL activity did not occur              
 
G0110J1  $M3ADLCT                      ADL Ass: Personal Hygiene Self Perf      
                          1,665                          Missing                                 
                             10        -                 Not assessed/no information             
                            223        0                 Independent                             
                            607        1                 Supervision                             
                            876        2                 Limited assistance                      
                          3,277        3                 Extensive assistance                    
                            514        4                 Total dependence                        
                             13        7                 Activity occurred only once or twice    
                              3        8                 Activity did not occur                  
 
G0110J2  $M3ADLSP                      ADL Ass: Personal Hygiene Supp Prov      
                          2,696                          Missing                                 
                              3        -                 -                                       
                             73        0                 No setup or physical help from staff    
                            332        1                 Setup help only                         
                          3,662        2                 One person physical assist              
                            419        3                 Two+ persons physical assist            
                              3        8                 ADL activity did not occur              
 
G0120A   $M3ADLCT                      ADL Ass: Bathing Self Perf               
                          1,665                          Missing                                 
                             19        -                 Not assessed/no information             
                             73        0                 Independent                             
                            165        1                 Supervision                             
                            281        2                 Limited assistance                      
                          2,801        3                 Extensive assistance                    
                          1,930        4                 Total dependence                        
                            254        8                 Activity did not occur                  
 
G0120B   $M3ADLSP                      ADL Ass: Bathing Supp Prov               
                          2,696                          Missing                                 
                             13        -                 -                                       
                             23        0                 No setup or physical help from staff    
                            119        1                 Setup help only                         
                          3,360        2                 One person physical assist              
                            785        3                 Two+ persons physical assist            
                            192        8                 ADL activity did not occur              
 
G0300A   $M3BAL                        Blnce Dur Seated to Standing Pos         
                          2,696                          Missing                                 
                             11        -                 Not assessed/no information             
                            233        0                 Steady at all times                     
                            730        1                 Not steady, but able to stabilize w/o as
                          2,712        2                 Not steady, only able to stabilize w/ as
                            806        8                 Activity did not occur                  
 
G0300B   $M3BAL                        Blnce Dur Wlking                         
                          2,696                          Missing                                 
                             12        -                 Not assessed/no information             
                            235        0                 Steady at all times                     
                            764        1                 Not steady, but able to stabilize w/o as
                          1,571        2                 Not steady, only able to stabilize w/ as
                          1,910        8                 Activity did not occur                  
 
G0300C   $M3BAL                        Blnce When Turning Around                
                          2,696                          Missing                                 
                             28        -                 Not assessed/no information             
                            220        0                 Steady at all times                     
                            720        1                 Not steady, but able to stabilize w/o as
                          1,399        2                 Not steady, only able to stabilize w/ as
                          2,125        8                 Activity did not occur                  
 
G0300D   $M3BAL                        Blnce Moving On and Off Toilet           
                          2,696                          Missing                                 
                             16        -                 Not assessed/no information             
                            219        0                 Steady at all times                     
                            668        1                 Not steady, but able to stabilize w/o as
                          2,634        2                 Not steady, only able to stabilize w/ as
                            955        8                 Activity did not occur                  
 
G0300E   $M3BAL                        Blnce W Surface to Surface Trans         
                          2,696                          Missing                                 
                             11        -                 Not assessed/no information             
                            224        0                 Steady at all times                     
                            706        1                 Not steady, but able to stabilize w/o as
                          3,388        2                 Not steady, only able to stabilize w/ as
                            163        8                 Activity did not occur                  
 
G0400A   $M3RANGE                      Func Lim in ROM: Upper Ext Mtn           
                          2,696                          Missing                                 
                              8        -                 Not assessed/no information             
                          3,543        0                 No impairment                           
                            562        1                 Impairment on one side                  
                            379        2                 Impairment on both sides                
 
G0400B   $M3RANGE                      Func Lim in ROM: Lower Ext Mtn           
                          2,696                          Missing                                 
                              8        -                 Not assessed/no information             
                          2,959        0                 No impairment                           
                            738        1                 Impairment on one side                  
                            787        2                 Impairment on both sides                
 
G0600A   $M3INDIC                      Mob Devices: Cane                        
                          2,696                          Missing                                 
                              1        -                 Not assessed/no information             
                          4,408        0                 Not indicated                           
                             83        1                 Indicated                               
 
G0600B   $M3INDIC                      Mob Devices: Wlker                       
                          2,696                          Missing                                 
                              1        -                 Not assessed/no information             
                          2,399        0                 Not indicated                           
                          2,092        1                 Indicated                               
 
G0600C   $M3INDIC                      Mob Devices: Wheelchair                  
                          2,696                          Missing                                 
                            797        0                 Not indicated                           
                          3,695        1                 Indicated                               
 
G0600D   $M3INDIC                      Mob Devices: Limb Prosthesis             
                          2,696                          Missing                                 
                              2        -                 Not assessed/no information             
                          4,476        0                 Not indicated                           
                             14        1                 Indicated                               
 
G0600Z   $M3INDIC                      Mob Devices: None of Above               
                          2,696                          Missing                                 
                          4,150        0                 Not indicated                           
                            342        1                 Indicated                               
 
G0900A   $M3YNDET                      Func Rehab Pot: Res Increased Ind        
                          6,411                          Missing                                 
                              5        -                 Not assessed/no information             
                             68        0                 No                                      
                            644        1                 Yes                                     
                             60        9                 Unable to determine                     
 
G0900B   $M3YESNO                      Func Rehab Pot: Staff Increased Ind      
                          6,411                          Missing                                 
                             11        -                 Not assessed/no information             
                             77        0                 No                                      
                            689        1                 Yes                                     
 
H0100A   $M3INDIC                      Bldr and Bwl App: Indwelling Cath        
                          1,665                          Missing                                 
                          5,146        0                 Not indicated                           
                            377        1                 Indicated                               
 
H0100B   $M3INDIC                      Bldr and Bwl App: Ext Cath               
                          1,665                          Missing                                 
                          5,522        0                 Not indicated                           
                              1        1                 Indicated                               
 
H0100C   $M3INDIC                      Bldr and Bwl App: Ostomy                 
                          1,665                          Missing                                 
                          5,438        0                 Not indicated                           
                             85        1                 Indicated                               
 
H0100D   $M3INDIC                      Bldr and Bwl App: Imt Cath               
                          1,665                          Missing                                 
                          5,483        0                 Not indicated                           
                             40        1                 Indicated                               
 
H0100Z   $M3INDIC                      Bldr and Bwl App: No Urny App            
                          1,665                          Missing                                 
                            476        0                 Not indicated                           
                          5,047        1                 Indicated                               
 
H0200A   $M3YNDET                      Urny Toil Prog: Trial Toileting Prog     
                          2,541                          Missing                                 
                              4        -                 Not assessed/no information             
                          4,023        0                 No                                      
                            580        1                 Yes                                     
                             40        9                 Unable to determine                     
 
H0200B   $M3TOILT                      Urny Toil Prog: Resp To Toileting Prog   
                          7,006                          Missing                                 
                              8        -                 Not assessed/no information             
                             81        0                 No improvement                          
                             39        1                 Decreased wetness                       
                             12        2                 Completely dry                          
                             42        9                 Unable to determine                     
 
H0200C   $M3YESNO                      Urny Toil Prog: Cur Toileting Prog       
                          6,564                          Missing                                 
                              5        -                 Not assessed/no information             
                            234        0                 No                                      
                            385        1                 Yes                                     
 
H0300    $M3CONT                       Urny Continence                          
                          1,665                          Missing                                 
                              4        -                 Not assessed/no information             
                          1,279        0                 Always continent                        
                          1,149        1                 Occasionally incontinent                
                          1,471        2                 Frequently incontinent                  
                          1,285        3                 Always incontinent                      
                            335        9                 Not rated                               
 
H0400    $M3CONT                       Bwl Continence                           
                          1,665                          Missing                                 
                              8        -                 Not assessed/no information             
                          2,228        0                 Always continent                        
                            700        1                 Occasionally incontinent                
                          1,117        2                 Frequently incontinent                  
                          1,381        3                 Always incontinent                      
                             89        9                 Not rated                               
 
H0500    $M3YESNO                      Bwl Toileting Prog                       
                          2,541                          Missing                                 
                              3        -                 Not assessed/no information             
                          4,473        0                 No                                      
                            171        1                 Yes                                     
 
H0600    $M3YESNO                      Constipation                             
                          5,618                          Missing                                 
                              2        -                 Not assessed/no information             
                          1,485        0                 No                                      
                             83        1                 Yes                                     
 
I0100    $M3INDIC                      Actv Diag: Cancer                        
                          5,618                          Missing                                 
                          1,484        0                 Not indicated                           
                             86        1                 Indicated                               
 
I0200    $M3INDIC                      Actv Diag: Anemia                        
                          2,696                          Missing                                 
                          3,200        0                 Not indicated                           
                          1,292        1                 Indicated                               
 
I0300    $M3INDIC                      Actv Diag: Dysrhythmia                   
                          5,618                          Missing                                 
                          1,201        0                 Not indicated                           
                            369        1                 Indicated                               
 
I0400    $M3INDIC                      Actv Diag: Coronary Artery Dis (CAD)     
                          5,618                          Missing                                 
                          1,193        0                 Not indicated                           
                            377        1                 Indicated                               
 
I0500    $M3INDIC                      Actv Diag: Deep Vein Thrombosis (DVT)    
                          5,618                          Missing                                 
                          1,520        0                 Not indicated                           
                             50        1                 Indicated                               
 
I0600    $M3INDIC                      Actv Diag: Heart Failure (CHF)           
                          2,696                          Missing                                 
                          3,442        0                 Not indicated                           
                          1,050        1                 Indicated                               
 
I0700    $M3INDIC                      Actv Diag: Hypertension                  
                          2,696                          Missing                                 
                            917        0                 Not indicated                           
                          3,575        1                 Indicated                               
 
I0800    $M3INDIC                      Actv Diag: Hypotension                   
                          2,696                          Missing                                 
                          4,386        0                 Not indicated                           
                            106        1                 Indicated                               
 
I0900    $M3INDIC                      Actv Diag: (PVD)                         
                          1,665                          Missing                                 
                          4,874        0                 Not indicated                           
                            649        1                 Indicated                               
 
I1100    $M3INDIC                      Actv Diag: Cirrhosis                     
                          5,618                          Missing                                 
                          1,563        0                 Not indicated                           
                              7        1                 Indicated                               
 
I1200    $M3INDIC                      Actv Diag:  (GERD)                       
                          5,618                          Missing                                 
                          1,017        0                 Not indicated                           
                            553        1                 Indicated                               
 
I1300    $M3INDIC                      Actv Diag: Ulcrative Colitis             
                          5,618                          Missing                                 
                          1,555        0                 Not indicated                           
                             15        1                 Indicated                               
 
I1400    $M3INDIC                      Actv Diag: (BPH)                         
                          5,618                          Missing                                 
                          1,416        0                 Not indicated                           
                            154        1                 Indicated                               
 
I1500    $M3INDIC                      Actv Diag: (ESRD)                        
                          5,618                          Missing                                 
                          1,338        0                 Not indicated                           
                            232        1                 Indicated                               
 
I1550    $M3INDIC                      Actv Diag: Neurogenic Bldr               
                          1,665                          Missing                                 
                          5,377        0                 Not indicated                           
                            146        1                 Indicated                               
 
I1650    $M3INDIC                      Actv Diag: Obstructive Uropathy          
                          1,665                          Missing                                 
                          5,477        0                 Not indicated                           
                             46        1                 Indicated                               
 
I1700    $M3INDIC                      Actv Diag: (MDRO)                        
                          2,696                          Missing                                 
                          4,450        0                 Not indicated                           
                             42        1                 Indicated                               
 
I2000    $M3INDIC                      Actv Diag: Pneumonia                     
                          2,545                          Missing                                 
                          4,380        0                 Not indicated                           
                            263        1                 Indicated                               
 
I2100    $M3INDIC                      Actv Diag: Septicemia                    
                          2,545                          Missing                                 
                          4,539        0                 Not indicated                           
                            104        1                 Indicated                               
 
I2200    $M3INDIC                      Actv Diag: Tuberculosis                  
                          2,696                          Missing                                 
                          4,490        0                 Not indicated                           
                              2        1                 Indicated                               
 
I2300    $M3INDIC                      Actv Diag: Urny Tract Infn (UTI)         
                          1,665                          Missing                                 
                              1        -                 Not assessed/no information             
                          5,035        0                 Not indicated                           
                            487        1                 Indicated                               
 
I2400    $M3INDIC                      Actv Diag: Viral Hepatitis               
                          2,696                          Missing                                 
                          4,465        0                 Not indicated                           
                             27        1                 Indicated                               
 
I2500    $M3INDIC                      Wound Infn                               
                          2,696                          Missing                                 
                          4,474        0                 Not indicated                           
                             18        1                 Indicated                               
 
I2900    $M3INDIC                      Actv Diag: Diabetes Mellitus (DM)        
                          1,515                          Missing                                 
                              1        -                 Not assessed/no information             
                          3,770        0                 Not indicated                           
                          1,902        1                 Indicated                               
 
I3100    $M3INDIC                      Actv Diag: Hyponatremia                  
                          2,696                          Missing                                 
                          4,408        0                 Not indicated                           
                             84        1                 Indicated                               
 
I3200    $M3INDIC                      Actv Diag: Hyperkalemia                  
                          2,696                          Missing                                 
                          4,432        0                 Not indicated                           
                             60        1                 Indicated                               
 
I3300    $M3INDIC                      Actv Diag: Hyperlipidemia                
                          2,696                          Missing                                 
                              1        -                 Not assessed/no information             
                          2,496        0                 Not indicated                           
                          1,995        1                 Indicated                               
 
I3400    $M3INDIC                      Actv Diag: Thyroid                       
                          5,618                          Missing                                 
                          1,168        0                 Not indicated                           
                            402        1                 Indicated                               
 
I3700    $M3INDIC                      Actv Diag: Arthritis                     
                          5,618                          Missing                                 
                          1,078        0                 Not indicated                           
                            492        1                 Indicated                               
 
I3800    $M3INDIC                      Actv Diag: Osteoporosis                  
                          5,618                          Missing                                 
                          1,347        0                 Not indicated                           
                            223        1                 Indicated                               
 
I3900    $M3INDIC                      Actv Diag: Hip Fracture                  
                          2,696                          Missing                                 
                          4,259        0                 Not indicated                           
                            233        1                 Indicated                               
 
I4000    $M3INDIC                      Actv Diag: Oth Fracture                  
                          2,696                          Missing                                 
                          4,234        0                 Not indicated                           
                            258        1                 Indicated                               
 
I4200    $M3INDIC                      Actv Diag: Alzheimers Disease            
                          2,696                          Missing                                 
                          3,860        0                 Not indicated                           
                            632        1                 Indicated                               
 
I4300    $M3INDIC                      Actv Diag: Aphasia                       
                          2,696                          Missing                                 
                          4,333        0                 Not indicated                           
                            159        1                 Indicated                               
 
I4400    $M3INDIC                      Actv Diag: Cerebral Palsy                
                          2,545                          Missing                                 
                          4,626        0                 Not indicated                           
                             17        1                 Indicated                               
 
I4500    $M3INDIC                      Actv Diag: (CVA or TIA or Stroke)        
                          2,696                          Missing                                 
                          4,030        0                 Not indicated                           
                            462        1                 Indicated                               
 
I4800    $M3INDIC                      Actv Diag: Dementia                      
                          2,696                          Missing                                 
                              1        -                 Not assessed/no information             
                          2,592        0                 Not indicated                           
                          1,899        1                 Indicated                               
 
I4900    $M3INDIC                      Actv Diag: Hemiplegia                    
                          2,545                          Missing                                 
                          4,323        0                 Not indicated                           
                            320        1                 Indicated                               
 
I5000    $M3INDIC                      Actv Diag: Paraplegia                    
                          2,696                          Missing                                 
                          4,479        0                 Not indicated                           
                             13        1                 Indicated                               
 
I5100    $M3INDIC                      Actv Diag: Quadriplegia                  
                          2,545                          Missing                                 
                          4,626        0                 Not indicated                           
                             17        1                 Indicated                               
 
I5200    $M3INDIC                      Actv Diag: Multiple Sclerosis            
                          2,545                          Missing                                 
                          4,610        0                 Not indicated                           
                             33        1                 Indicated                               
 
I5250    $M3INDIC                      Actv Diag: Huntingtons                   
                          1,665                          Missing                                 
                          5,514        0                 Not indicated                           
                              9        1                 Indicated                               
 
I5300    $M3INDIC                      Actv Diag: Parkinsons                    
                          2,545                          Missing                                 
                          4,344        0                 Not indicated                           
                            299        1                 Indicated                               
 
I5350    $M3INDIC                      Tourettes                                
                          1,665                          Missing                                 
                          5,523        0                 Not indicated                           
 
I5400    $M3INDIC                      Actv Diag: Seizure                       
                          2,696                          Missing                                 
                          4,154        0                 Not indicated                           
                            338        1                 Indicated                               
 
I5500    $M3INDIC                      Actv Diag: Traumatic Brain Inj (TBI)     
                          2,696                          Missing                                 
                          4,468        0                 Not indicated                           
                             24        1                 Indicated                               
 
I5600    $M3INDIC                      Actv Diag: Malnutrition                  
                          1,665                          Missing                                 
                          5,362        0                 Not indicated                           
                            161        1                 Indicated                               
 
I5700    $M3INDIC                      Actv Diag: Anxiety Disorder              
                          1,665                          Missing                                 
                              1        -                 Not assessed/no information             
                          4,089        0                 Not indicated                           
                          1,433        1                 Indicated                               
 
I5800    $M3INDIC                      Actv Diag: Depression                    
                          2,696                          Missing                                 
                          2,343        0                 Not indicated                           
                          2,149        1                 Indicated                               
 
I5900    $M3INDIC                      Actv Diag: Manic Depression              
                          1,665                          Missing                                 
                          5,367        0                 Not indicated                           
                            156        1                 Indicated                               
 
I5950    $M3INDIC                      Actv Diag: Psychotic                     
                          1,665                          Missing                                 
                          5,171        0                 Not indicated                           
                            352        1                 Indicated                               
 
I6000    $M3INDIC                      Actv Diag: Schizophrenia                 
                          1,665                          Missing                                 
                          5,303        0                 Not indicated                           
                            220        1                 Indicated                               
 
I6100    $M3INDIC                      Actv Diag:  (PTSD)                       
                          1,665                          Missing                                 
                              1        -                 Not assessed/no information             
                          5,515        0                 Not indicated                           
                              7        1                 Indicated                               
 
I6200    $M3INDIC                      Actv Diag: Asth, COPD, Chron Lung Dis    
                          2,545                          Missing                                 
                          3,536        0                 Not indicated                           
                          1,107        1                 Indicated                               
 
I6300    $M3INDIC                      Actv Diag: Resp Failure                  
                          2,545                          Missing                                 
                          4,480        0                 Not indicated                           
                            163        1                 Indicated                               
 
I6500    $M3INDIC                      Actv Diag: Cataracts, Glauc or Mac Deg   
                          5,618                          Missing                                 
                          1,296        0                 Not indicated                           
                            274        1                 Indicated                               
 
I7900    $M3INDIC                      Actv Diag: No Actv Disease               
                          5,618                          Missing                                 
                          1,561        0                 Not indicated                           
                              9        1                 Indicated                               
 
I8000A                                 Addl Actv Diag: ICD 1                    
                          7,188                          Range of Values                         
 
I8000B                                 Addl Actv Diag: ICD 2                    
                          7,188                          Range of Values                         
 
I8000C                                 Addl Actv Diag: ICD 3                    
                          7,188                          Range of Values                         
 
I8000D                                 Addl Actv Diag: ICD 4                    
                          7,188                          Range of Values                         
 
I8000E                                 Addl Actv Diag: ICD 5                    
                          7,188                          Range of Values                         
 
I8000F                                 Addl Actv Diag: ICD 6                    
                          7,188                          Range of Values                         
 
I8000G                                 Addl Actv Diag: ICD 7                    
                          7,188                          Range of Values                         
 
I8000H                                 Addl Actv Diag: ICD 8                    
                          7,188                          Range of Values                         
 
I8000I                                 Addl Actv Diag: ICD 9                    
                          7,188                          Range of Values                         
 
I8000J                                  Addl Actv Diag: ICD 10                  
                          7,188                          Range of Values                         
 
J0100A   $M3YESNO                      Pain management: Scheduled Pain Med      
                          1,665                          Missing                                 
                              5        -                 Not assessed/no information             
                          3,258        0                 No                                      
                          2,260        1                 Yes                                     
 
J0100B   $M3YESNO                      Pain management: PRN Pain Med            
                          1,665                          Missing                                 
                              7        -                 Not assessed/no information             
                          3,309        0                 No                                      
                          2,207        1                 Yes                                     
 
J0100C   $M3YESNO                      Pain management: Oth Pain Intervention   
                          1,665                          Missing                                 
                             27        -                 Not assessed/no information             
                          4,263        0                 No                                      
                          1,233        1                 Yes                                     
 
J0200    $M3YESNO                      Should Pain Asmt be Cond                 
                          2,074                          Missing                                 
                            114        -                 Not assessed/no information             
                            443        0                 No                                      
                          4,557        1                 Yes                                     
 
J0300    $M3YNANS                      Pain Asmt Int: Pain Pres                 
                          2,517                          Missing                                 
                            177        -                 Not assessed/no information             
                          2,586        0                 No                                      
                          1,656        1                 Yes                                     
                            252        9                 Unable to answer                        
 
J0400    $M31PAIN                      Pain Asmt Int: Pain Freq                 
                          5,355                          Missing                                 
                            182        -                 Not assessed/no information             
                             91        1                 Almost constantly                       
                            430        2                 Frequently                              
                            946        3                 Occasionally                            
                            155        4                 Rarely                                  
                             29        9                 Unable to answer                        
 
J0500A   $M3YNANS                      Pain Asmt Int: Pain Effect Sleep         
                          5,355                          Missing                                 
                            184        -                 Not assessed/no information             
                          1,309        0                 No                                      
                            314        1                 Yes                                     
                             26        9                 Unable to answer                        
 
J0500B   $M3YNANS                      Pain Asmt Int: Pain Effect Act           
                          5,355                          Missing                                 
                            184        -                 Not assessed/no information             
                          1,229        0                 No                                      
                            389        1                 Yes                                     
                             31        9                 Unable to answer                        
 
J0600A                                 Pain Intensity Numeric Rating Scale Num  
                          7,188                          Range of Values                         
 
J0600B   $M32PAIN                      Pain Intensity Verbal Descr Scale Num    
                          6,464                          Missing                                 
                            216        -                 Not assessed/no information             
                            233        1                 Mild                                    
                            225        2                 Moderate                                
                             28        3                 Severe                                  
                              4        4                 Very severe, horrible                   
                             18        9                 Unable to answer                        
 
J0700    $M3YESNO                      Staff Cond Pain Asmt                     
                          5,645                          Missing                                 
                             90        -                 Not assessed/no information             
                          1,397        0                 No                                      
                             56        1                 Yes                                     
 
J0800A   $M3INDIC                      SA for Pain: Nonverbal Sound             
                          6,400                          Missing                                 
                             42        -                 Not assessed/no information             
                            686        0                 Not indicated                           
                             60        1                 Indicated                               
 
J0800B   $M3INDIC                      SA for Pain: Vocal Complaint             
                          6,400                          Missing                                 
                             41        -                 Not assessed/no information             
                            643        0                 Not indicated                           
                            104        1                 Indicated                               
 
J0800C   $M3INDIC                      SA for Pain: Facial Expression           
                          6,400                          Missing                                 
                             41        -                 Not assessed/no information             
                            674        0                 Not indicated                           
                             73        1                 Indicated                               
 
J0800D   $M3INDIC                      SA for Pain: Protective Movement         
                          6,400                          Missing                                 
                             41        -                 Not assessed/no information             
                            725        0                 Not indicated                           
                             22        1                 Indicated                               
 
J0800Z   $M3INDIC                      SA for Pain: None Above Signs of Pain    
                          6,400                          Missing                                 
                             42        -                 Not assessed/no information             
                            165        0                 Not indicated                           
                            581        1                 Indicated                               
 
J0850    $M3PAINI                      SA for Pain: Nonverbal Sound             
                          6,981                          Missing                                 
                             42        -                 Not assessed/no information             
                             87        1                 Indicators of pain 1-2 days             
                             51        2                 Indicators of pain 3-4 days             
                             27        3                 Indicators of pain daily                
 
J1100A   $M3INDIC                      Shortness of Breath W Exertion           
                          1,665                          Missing                                 
                              5        -                 Not assessed/no information             
                          4,949        0                 Not indicated                           
                            569        1                 Indicated                               
 
J1100B   $M3INDIC                      Shortness of Breath When Sitting         
                          1,665                          Missing                                 
                              5        -                 Not assessed/no information             
                          5,298        0                 Not indicated                           
                            220        1                 Indicated                               
 
J1100C   $M3INDIC                      Shortness of Breath When Lying Flat      
                          1,515                          Missing                                 
                              5        -                 Not assessed/no information             
                          5,249        0                 Not indicated                           
                            419        1                 Indicated                               
 
J1100Z   $M3INDIC                      None of Above Shortness of Breath        
                          1,665                          Missing                                 
                              5        -                 Not assessed/no information             
                            768        0                 Not indicated                           
                          4,750        1                 Indicated                               
 
J1300    $M3YESNO                      Tobacco Use                              
                          5,618                          Missing                                 
                              3        -                 Not assessed/no information             
                          1,532        0                 No                                      
                             35        1                 Yes                                     
 
J1400    $M3YESNO                      Life Prognosis Less Than Six Mons        
                          1,665                          Missing                                 
                              7        -                 Not assessed/no information             
                          5,332        0                 No                                      
                            184        1                 Yes                                     
 
J1550A   $M3INDIC                      Prob Conds: Fever                        
                          1,515                          Missing                                 
                              2        -                 Not assessed/no information             
                          5,590        0                 Not indicated                           
                             81        1                 Indicated                               
 
J1550B   $M3INDIC                      Prob Conds: Vomiting                     
                          1,515                          Missing                                 
                              2        -                 Not assessed/no information             
                          5,607        0                 Not indicated                           
                             64        1                 Indicated                               
 
J1550C   $M3INDIC                      Prob Conds: Dehydration                  
                          1,665                          Missing                                 
                              2        -                 Not assessed/no information             
                          5,509        0                 Not indicated                           
                             12        1                 Indicated                               
 
J1550D   $M3INDIC                      Prob Conds: Internal Bleeding            
                          1,665                          Missing                                 
                              2        -                 Not assessed/no information             
                          5,488        0                 Not indicated                           
                             33        1                 Indicated                               
 
J1550Z   $M3INDIC                      Prob Conds: None of Above                
                          1,665                          Missing                                 
                              2        -                 Not assessed/no information             
                            172        0                 Not indicated                           
                          5,349        1                 Indicated                               
 
J1700A   $M3YNDET                      Fall History on Admsn: Fall 30 Day       
                          6,070                          Missing                                 
                              6        -                 Not assessed/no information             
                            667        0                 No                                      
                            395        1                 Yes                                     
                             50        9                 Unable to determine                     
 
J1700B   $M3YNDET                      Fall History on Admsn: Fall 31-180 Day   
                          6,070                          Missing                                 
                             12        -                 Not assessed/no information             
                            759        0                 No                                      
                            234        1                 Yes                                     
                            113        9                 Unable to determine                     
 
J1700C   $M3YNDET                      Fall History on Admsn: Fall Six Mon      
                          6,070                          Missing                                 
                              5        -                 Not assessed/no information             
                            881        0                 No                                      
                            177        1                 Yes                                     
                             55        9                 Unable to determine                     
 
J1800    $M3YESNO                      Falls Since Admsn or Prior Asmt          
                          1,631                          Missing                                 
                              5        -                 Not assessed/no information             
                          4,764        0                 No                                      
                            788        1                 Yes                                     
 
J1900A   $M3FALLS                      Falls Since Adm/Prior Asmt W No Inj      
                          6,395                          Missing                                 
                              5        -                 Not assessed/no information             
                            179        0                 None                                    
                            428        1                 One                                     
                            181        2                 Two or more                             
 
J1900B   $M3FALLS                      Falls Since Adm/Prior Asmt W Inj Ex Maj  
                          6,395                          Missing                                 
                              5        -                 Not assessed/no information             
                            540        0                 None                                    
                            210        1                 One                                     
                             38        2                 Two or more                             
 
J1900C   $M3FALLS                      Falls Since Adm/Prior Asmt W Maj Inj     
                          6,395                          Missing                                 
                              5        -                 Not assessed/no information             
                            736        0                 None                                    
                             51        1                 One                                     
                              1        2                 Two or more                             
 
K0100A   $M3INDIC                      Swall Disorder: Loss Mouth Eating        
                          2,696                          Missing                                 
                              2        -                 Not assessed/no information             
                          4,476        0                 Not indicated                           
                             14        1                 Indicated                               
 
K0100B   $M3INDIC                      Swall Disorder: Hold Food Mouth          
                          2,696                          Missing                                 
                              2        -                 Not assessed/no information             
                          4,450        0                 Not indicated                           
                             40        1                 Indicated                               
 
K0100C   $M3INDIC                      Swall Disorder: Choke Drinking Meal      
                          2,696                          Missing                                 
                              2        -                 Not assessed/no information             
                          4,417        0                 Not indicated                           
                             73        1                 Indicated                               
 
K0100D   $M3INDIC                      Swall Disorder: Complaint Swall          
                          2,696                          Missing                                 
                              2        -                 Not assessed/no information             
                          4,417        0                 Not indicated                           
                             73        1                 Indicated                               
 
K0100Z   $M3INDIC                      Swall Disorder: None of Above            
                          2,696                          Missing                                 
                              2        -                 Not assessed/no information             
                            159        0                 Not indicated                           
                          4,331        1                 Indicated                               
 
K0200A                                 Height Num                               
                          7,188                          Range of Values                         
 
K0200B                                 Weight Num                               
                          7,188                          Range of Values                         
 
K0300    $M3WGHT                       Weight Loss                              
                          1,515                          Missing                                 
                             39        -                 Not assessed/no information             
                          5,212        0                 No or unknown                           
                             56        1                 Yes, on physician-prescribed regimen    
                            366        2                 Yes, not on physician-prescribed regimen
 
K0310    $M3WGHT                       Weight Gain                              
                          1,515                          Missing                                 
                             38        -                 Not assessed/no information             
                          5,376        0                 No or unknown                           
                             50        1                 Yes, on physician-prescribed regimen    
                            209        2                 Yes, not on physician-prescribed regimen
 
K0510A1  $M3INDIC                      Nutr App: Prior Par/IV Feeding           
                          6,936                          Missing                                 
                              9        -                 Not assessed/no information             
                            236        0                 Not indicated                           
                              7        1                 Indicated                               
 
K0510A2  $M3INDIC                      Nutr App: Post Par/IV Feeding            
                          1,515                          Missing                                 
                              4        -                 Not assessed/no information             
                          5,629        0                 Not indicated                           
                             40        1                 Indicated                               
 
K0510B1  $M3INDIC                      Nutr App: Prior Feeding Tube             
                          6,936                          Missing                                 
                              9        -                 Not assessed/no information             
                            240        0                 Not indicated                           
                              3        1                 Indicated                               
 
K0510B2  $M3INDIC                      Nutr App: Post Feeding Tube              
                          1,515                          Missing                                 
                              4        -                 Not assessed/no information             
                          5,486        0                 Not indicated                           
                            183        1                 Indicated                               
 
K0510C1  $M3INDIC                      Nutr App: Prior Mech Alt Diet            
                          6,965                          Missing                                 
                              8        -                 Not assessed/no information             
                            172        0                 Not indicated                           
                             43        1                 Indicated                               
 
K0510C2  $M3INDIC                      Nutr App: Post Mech Alt Diet             
                          2,066                          Missing                                 
                              6        -                 Not assessed/no information             
                          3,418        0                 Not indicated                           
                          1,698        1                 Indicated                               
 
K0510D1  $M3INDIC                      Nutr App: Prior Ther Diet                
                          6,965                          Missing                                 
                              7        -                 Not assessed/no information             
                            125        0                 Not indicated                           
                             91        1                 Indicated                               
 
K0510D2  $M3INDIC                      Nutr App: Post Ther Diet                 
                          2,066                          Missing                                 
                              4        -                 Not assessed/no information             
                          2,597        0                 Not indicated                           
                          2,521        1                 Indicated                               
 
K0510Z1  $M3INDIC                      Nutr App: Prior None of Above            
                          6,965                          Missing                                 
                              7        -                 Not assessed/no information             
                            118        0                 Not indicated                           
                             98        1                 Indicated                               
 
K0510Z2  $M3INDIC                      Nutr App: Post None of Above             
                          2,066                          Missing                                 
                              3        -                 Not assessed/no information             
                          3,549        0                 Not indicated                           
                          1,570        1                 Indicated                               
 
K0700A   $M3ARTCL                      Pct Cal Intake Through Par/Tube Feeding  
                          7,188                          Missing                                 
 
K0700B   $M3IVFLU                      Avg Fluid Intake by IV Or Tube Feeding   
                          7,188                          Missing                                 
 
L0200A   $M3INDIC                      Dental Stat: Broken Denture              
                          2,696                          Missing                                 
                             22        -                 Not assessed/no information             
                          4,419        0                 Not indicated                           
                             51        1                 Indicated                               
 
L0200B   $M3INDIC                      Dental Stat: No Teeth                    
                          5,618                          Missing                                 
                              1        -                 Not assessed/no information             
                          1,274        0                 Not indicated                           
                            295        1                 Indicated                               
 
L0200C   $M3INDIC                      Dental Stat: Abnormal Mouth Tiss         
                          5,618                          Missing                                 
                              2        -                 Not assessed/no information             
                          1,566        0                 Not indicated                           
                              2        1                 Indicated                               
 
L0200D   $M3INDIC                      Dental Stat: Cavity                      
                          5,618                          Missing                                 
                              2        -                 Not assessed/no information             
                          1,446        0                 Not indicated                           
                            122        1                 Indicated                               
 
L0200E   $M3INDIC                      Dental Stat: Inflamed Gum                
                          5,618                          Missing                                 
                              2        -                 Not assessed/no information             
                          1,564        0                 Not indicated                           
                              4        1                 Indicated                               
 
L0200F   $M3INDIC                      Dental Stat: Mouth or Facial Pain        
                          2,696                          Missing                                 
                             32        -                 Not assessed/no information             
                          4,426        0                 Not indicated                           
                             34        1                 Indicated                               
 
L0200G   $M3INDIC                      Dental Stat: Unable to Examine           
                          5,618                          Missing                                 
                              1        -                 Not assessed/no information             
                          1,552        0                 Not indicated                           
                             17        1                 Indicated                               
 
L0200Z   $M3INDIC                      Dental Stat: None of Above               
                          5,618                          Missing                                 
                              2        -                 Not assessed/no information             
                            445        0                 Not indicated                           
                          1,123        1                 Indicated                               
 
M0100A   $M3INDIC                      Det of Press Ulcr Risk: Ulcr Visible     
                          1,665                          Missing                                 
                              8        -                 Not assessed/no information             
                          4,941        0                 Not indicated                           
                            574        1                 Indicated                               
 
M0100B   $M3INDIC                      Det of Press Ulcr Risk: Frml Asmt/Instr  
                          2,696                          Missing                                 
                            738        0                 Not indicated                           
                          3,754        1                 Indicated                               
 
M0100C   $M3INDIC                      Det of Press Ulcr Risk: Clinical Asmt    
                          2,696                          Missing                                 
                            315        0                 Not indicated                           
                          4,177        1                 Indicated                               
 
M0100Z   $M3INDIC                      Det of Press Ulcr Risk: None of Above    
                          2,696                          Missing                                 
                          4,371        0                 Not indicated                           
                            121        1                 Indicated                               
 
M0150    $M3YESNO                      Press Ulcr Risk                          
                          2,696                          Missing                                 
                              2        -                 Not assessed/no information             
                            557        0                 No                                      
                          3,933        1                 Yes                                     
 
M0210    $M3YESNO                      One or More S1 or Higher UPU             
                          1,481                          Missing                                 
                              4        -                 Not assessed/no information             
                          5,086        0                 No                                      
                            617        1                 Yes                                     
 
M0300A                                 Stage 1 Press Ulcr Num                   
                          7,188                          Range of Values                         
 
M0300B1                                Stage 2 Press Ulcr Num                   
                          7,188                          Range of Values                         
 
M0300B2                                Stage 2 Press Ulcr Present on Admsn Num  
                          7,188                          Range of Values                         
 
M0300B3  MMDDYYn8                      Date of Oldest Stage 2 Press Ulcr        
                          7,077                       .  Inapplicable                            
                            111        MMDDYYYY          Date as MMDDYYYY                        
 
M0300C1                                Stage 3 Press Ulcr Num                   
                          7,188                          Range of Values                         
 
M0300C2                                Stage 3 Press Ulcr Present on Admsn Num  
                          7,188                          Range of Values                         
 
M0300D1                                Stage 4 Press Ulcr Num                   
                          7,188                          Range of Values                         
 
M0300D2                                Stage 4 Press Ulcr Present on Admsn Num  
                          7,188                          Range of Values                         
 
M0300E1                                UPU Due To Drsng Num                     
                          7,188                          Range of Values                         
 
M0300E2                                UPU Due To Drsng on Admsn Num            
                          7,188                          Range of Values                         
 
M0300F1                                UPU W Slough or Eschar Num               
                          7,188                          Range of Values                         
 
M0300F2                                UPU W Slough or Eschar on Admsn Num      
                          7,188                          Range of Values                         
 
M0300G1                                UPU W Deep Tiss Inj Num                  
                          7,188                          Range of Values                         
 
M0300G2                                UPU W Deep Tiss Inj on Admsn Num         
                          7,188                          Range of Values                         
 
M0610A                                 Unhealed Stage 3-4 Press Ulcr Length Num 
                          7,188                          Range of Values                         
 
M0610B                                 Unhealed Stage 3-4 Press Ulcr Width Num  
                          7,188                          Range of Values                         
 
M0610C                                 Unhealed Stage 3-4 Press Ulcr Depth Num  
                          7,188                          Range of Values                         
 
M0700    $M3TISSU                      Most Severe Press Ulcr Tiss Type         
                          6,706                          Missing                                 
                             10        -                 Not assessed/no information             
                             97        1                 Epithelial tissue                       
                            105        2                 Granulation tissue                      
                             70        3                 Slough                                  
                             81        4                 Necrotic tissue (Eschar)                
                            119        9                 None of the above                       
 
M0800A                                 Wrsng S2 Press Ulcr Since Prior Asmt Num 
                          7,188                          Range of Values                         
 
M0800B                                 Wrsng S3 Press Ulcr Since Prior Asmt Num 
                          7,188                          Range of Values                         
 
M0800C                                 Wrsng S4 Press Ulcr Since Prior Asmt Num 
                          7,188                          Range of Values                         
 
M0900A   $M3YESNO                      Healed Press Ulcr Present on Prior Asmt  
                          2,803                          Missing                                 
                              6        -                 Not assessed/no information             
                          4,047        0                 No                                      
                            332        1                 Yes                                     
 
M0900B                                 Healed Stage 2 Press Ulcr Num            
                          7,188                          Range of Values                         
 
M0900C                                 Healed Stage 3 Press Ulcr Num            
                          7,188                          Range of Values                         
 
M0900D                                 Healed Stage 4 Press Ulcr Num            
                          7,188                          Range of Values                         
 
M1030                                  Venous and Arterial Ulcr Num             
                          7,188                          Range of Values                         
 
M1040A   $M3INDIC                      Oth Foot Skin Probs: Foot Infn           
                          2,545                          Missing                                 
                          4,621        0                 Not indicated                           
                             22        1                 Indicated                               
 
M1040B   $M3INDIC                      Oth Foot Skin Probs: Diab Foot Ulcr      
                          2,545                          Missing                                 
                          4,613        0                 Not indicated                           
                             30        1                 Indicated                               
 
M1040C   $M3INDIC                      Oth Foot Skin Probs: Oth Open Les Foot   
                          2,545                          Missing                                 
                          4,627        0                 Not indicated                           
                             16        1                 Indicated                               
 
M1040D   $M3INDIC                      O/S/P: Oth Than Ulcrs, Rashes, Cuts      
                          2,545                          Missing                                 
                          4,585        0                 Not indicated                           
                             58        1                 Indicated                               
 
M1040E   $M3INDIC                      O/S/P: Surgical Wound(s)                 
                          2,545                          Missing                                 
                          4,207        0                 Not indicated                           
                            436        1                 Indicated                               
 
M1040F   $M3INDIC                      O/S/P: Burn(s)                           
                          2,545                          Missing                                 
                          4,638        0                 Not indicated                           
                              5        1                 Indicated                               
 
M1040G   $M3INDIC                      O/S/P: Skin Tear(s)                      
                          2,545                          Missing                                 
                          4,296        0                 Not indicated                           
                            347        1                 Indicated                               
 
M1040H   $M3INDIC                      O/S/P: Moisture Assoc Skin Dmge          
                          2,545                          Missing                                 
                              2        -                 Not assessed/no information             
                          4,280        0                 Not indicated                           
                            361        1                 Indicated                               
 
M1040Z   $M3INDIC                      O/S/P: None of Above                     
                          2,545                          Missing                                 
                              2        -                 Not assessed/no information             
                          1,141        0                 Not indicated                           
                          3,500        1                 Indicated                               
 
M1200A   $M3INDIC                      S/U Trtmts: Press Reducng Device in Chr  
                          2,545                          Missing                                 
                              3        -                 Not assessed/no information             
                          1,716        0                 Not indicated                           
                          2,924        1                 Indicated                               
 
M1200B   $M3INDIC                      S/U Trtmts: Press Reducng Device in Bed  
                          2,545                          Missing                                 
                              1        -                 Not assessed/no information             
                            763        0                 Not indicated                           
                          3,879        1                 Indicated                               
 
M1200C   $M3INDIC                      S/U Trtmts: Turning/RePosing Prog        
                          2,545                          Missing                                 
                              3        -                 Not assessed/no information             
                          3,565        0                 Not indicated                           
                          1,075        1                 Indicated                               
 
M1200D   $M3INDIC                      S/U Trtmts: Nutrition/Hydration          
                          2,545                          Missing                                 
                              4        -                 Not assessed/no information             
                          3,912        0                 Not indicated                           
                            727        1                 Indicated                               
 
M1200E   $M3INDIC                      S/U Trtmts: Ulcr Care                    
                          2,545                          Missing                                 
                              1        -                 Not assessed/no information             
                          4,153        0                 Not indicated                           
                            489        1                 Indicated                               
 
M1200F   $M3INDIC                      S/U Trtmts: Surgical Wound Care          
                          2,545                          Missing                                 
                              1        -                 Not assessed/no information             
                          4,256        0                 Not indicated                           
                            386        1                 Indicated                               
 
M1200G   $M3INDIC                      S/U Trtmts: App Nonsurgical Drsng        
                          2,545                          Missing                                 
                              1        -                 Not assessed/no information             
                          3,864        0                 Not indicated                           
                            778        1                 Indicated                               
 
M1200H   $M3INDIC                      S/U Trtmts: App Ointments/Meds           
                          2,545                          Missing                                 
                          2,312        0                 Not indicated                           
                          2,331        1                 Indicated                               
 
M1200I   $M3INDIC                      S/U Trtmts: App Drsngs to Foot           
                          2,545                          Missing                                 
                              1        -                 Not assessed/no information             
                          4,417        0                 Not indicated                           
                            225        1                 Indicated                               
 
M1200Z   $M3INDIC                      S/U Trtmts: None of Above                
                          2,545                          Missing                                 
                              1        -                 Not assessed/no information             
                          4,317        0                 Not indicated                           
                            325        1                 Indicated                               
 
N0300                                  Num of Days Injections of Any Type       
                          7,188                          Range of Values                         
 
N0350A                                 Num of Days Insulin Injections           
                          7,188                          Range of Values                         
 
N0350B                                 Num of Days Insulin Orders Changed       
                          7,188                          Range of Values                         
 
N0400Z   $M3INDIC                      Meds Rcd: None of Above                  
                          5,129                          Missing                                 
                              3        -                 Not assessed/no information             
                          2,047        0                 Not indicated                           
                              9        1                 Indicated                               
 
N0410A                                 Meds Rcd: Antipsychotic Num Days         
                          7,188                          Range of Values                         
 
N0410B                                 Meds Rcd: Antianxiety Num Days           
                          7,188                          Range of Values                         
 
N0410C                                 Meds Rcd: Antidepressant Num Days        
                          7,188                          Range of Values                         
 
N0410D                                 Meds Rcd: Hypnotic Num Days              
                          7,188                          Range of Values                         
 
N0410E                                 Meds Rcd: Anticoagulant Num Days         
                          7,188                          Range of Values                         
 
N0410F                                 Meds Rcd: Antibiotic Num Days            
                          7,188                          Range of Values                         
 
N0410G                                 Meds Rcd: Diuretic Num Days              
                          7,188                          Range of Values                         
 
O0100A1  $M3INDIC                      Spcl T/P: ChemOthapy Pre-admit           
                          5,896                          Missing                                 
                              5        -                 Not assessed/no information             
                          1,284        0                 Not indicated                           
                              3        1                 Indicated                               
 
O0100A2  $M3INDIC                      Spcl T/P: ChemOthapy Post-admit          
                          2,545                          Missing                                 
                             10        -                 Not assessed/no information             
                          4,621        0                 Not indicated                           
                             12        1                 Indicated                               
 
O0100B1  $M3INDIC                      Spcl T/P: Radiation Pre-admit            
                          5,896                          Missing                                 
                              5        -                 Not assessed/no information             
                          1,287        0                 Not indicated                           
 
O0100B2  $M3INDIC                      Spcl T/P: Radiation Post-admit           
                          2,545                          Missing                                 
                             10        -                 Not assessed/no information             
                          4,629        0                 Not indicated                           
                              4        1                 Indicated                               
 
O0100C1  $M3INDIC                      Spcl T/P: Oxygen Pre-admit               
                          5,896                          Missing                                 
                             11        -                 Not assessed/no information             
                            936        0                 Not indicated                           
                            345        1                 Indicated                               
 
O0100C2  $M3INDIC                      Spcl T/P: Oxygen Post-admit              
                          2,545                          Missing                                 
                              9        -                 Not assessed/no information             
                          3,773        0                 Not indicated                           
                            861        1                 Indicated                               
 
O0100D1  $M3INDIC                      Spcl T/P: Suctioning Pre-admit           
                          5,896                          Missing                                 
                              4        -                 Not assessed/no information             
                          1,285        0                 Not indicated                           
                              3        1                 Indicated                               
 
O0100D2  $M3INDIC                      Spcl T/P: Suctioning Post-admit          
                          2,696                          Missing                                 
                              9        -                 Not assessed/no information             
                          4,456        0                 Not indicated                           
                             27        1                 Indicated                               
 
O0100E1  $M3INDIC                      Spcl T/P: Tracheostomy Pre-admit         
                          5,896                          Missing                                 
                              4        -                 Not assessed/no information             
                          1,286        0                 Not indicated                           
                              2        1                 Indicated                               
 
O0100E2  $M3INDIC                      Spcl T/P: Tracheostomy Post-admit        
                          2,541                          Missing                                 
                              9        -                 Not assessed/no information             
                          4,614        0                 Not indicated                           
                             24        1                 Indicated                               
 
O0100F1  $M3INDIC                      Spcl T/P: Ventilator Pre-admit           
                          5,896                          Missing                                 
                              4        -                 Not assessed/no information             
                          1,279        0                 Not indicated                           
                              9        1                 Indicated                               
 
O0100F2  $M3INDIC                      Spcl T/P: Ventilator Post-admit          
                          2,541                          Missing                                 
                              9        -                 Not assessed/no information             
                          4,623        0                 Not indicated                           
                             15        1                 Indicated                               
 
O0100G1  $M3INDIC                      Spcl T/P: Cont Pos Arwy Press Pre-A      
                          6,354                          Missing                                 
                              2        -                 Not assessed/no information             
                            817        0                 Not indicated                           
                             15        1                 Indicated                               
 
O0100G2  $M3INDIC                      Spcl T/P: Cont Pos Arwy Press Post-A     
                          5,618                          Missing                                 
                              2        -                 Not assessed/no information             
                          1,551        0                 Not indicated                           
                             17        1                 Indicated                               
 
O0100H1  $M3INDIC                      Spcl T/P: Intravenous Med Pre-admit      
                          5,896                          Missing                                 
                              8        -                 Not assessed/no information             
                            751        0                 Not indicated                           
                            533        1                 Indicated                               
 
O0100H2  $M3INDIC                      Spcl T/P: Intravenous Med Post-admit     
                          2,545                          Missing                                 
                              9        -                 Not assessed/no information             
                          4,486        0                 Not indicated                           
                            148        1                 Indicated                               
 
O0100I1  $M3INDIC                      Spcl T/P: Transfusion Pre-admit          
                          5,896                          Missing                                 
                              6        -                 Not assessed/no information             
                          1,250        0                 Not indicated                           
                             36        1                 Indicated                               
 
O0100I2  $M3INDIC                      Spcl T/P: Transfusion Post-admit         
                          2,545                          Missing                                 
                              9        -                 Not assessed/no information             
                          4,626        0                 Not indicated                           
                              8        1                 Indicated                               
 
O0100J1  $M3INDIC                      Spcl T/P: Dialysis Pre-admit             
                          5,896                          Missing                                 
                              5        -                 Not assessed/no information             
                          1,262        0                 Not indicated                           
                             25        1                 Indicated                               
 
O0100J2  $M3INDIC                      Spcl T/P: Dialysis Post-admit            
                          2,545                          Missing                                 
                              9        -                 Not assessed/no information             
                          4,571        0                 Not indicated                           
                             63        1                 Indicated                               
 
O0100K1  $M3INDIC                      Spcl T/P: Hospice Pre-admit              
                          6,354                          Missing                                 
                              2        -                 Not assessed/no information             
                            821        0                 Not indicated                           
                             11        1                 Indicated                               
 
O0100K2  $M3INDIC                      Spcl T/P: Hospice Post-admit             
                          1,665                          Missing                                 
                             15        -                 Not assessed/no information             
                          5,285        0                 Not indicated                           
                            223        1                 Indicated                               
 
O0100L2  $M3INDIC                      Spcl T/P: Respite Post-admit             
                          5,618                          Missing                                 
                              2        -                 Not assessed/no information             
                          1,564        0                 Not indicated                           
                              4        1                 Indicated                               
 
O0100M1  $M3INDIC                      Spcl T/P: Isolation Pre-admit            
                          6,354                          Missing                                 
                              2        -                 Not assessed/no information             
                            828        0                 Not indicated                           
                              4        1                 Indicated                               
 
O0100M2  $M3INDIC                      Spcl T/P: Isolation Post-admit           
                          2,541                          Missing                                 
                             14        -                 Not assessed/no information             
                          4,612        0                 Not indicated                           
                             21        1                 Indicated                               
 
O0100Z1  $M3INDIC                      Spcl T/P: None Above Pre-A Trtmt Prior   
                          6,354                          Missing                                 
                              6        -                 Not assessed/no information             
                            440        0                 Not indicated                           
                            388        1                 Indicated                               
 
O0100Z2  $M3INDIC                      Spcl T/P: None Above Trtmt Post-admit    
                          5,618                          Missing                                 
                              2        -                 Not assessed/no information             
                            457        0                 Not indicated                           
                          1,111        1                 Indicated                               
 
O0250A   $M3YESNO                      Influenza Rcd                            
                          1,665                          Missing                                 
                            102        -                 Not assessed/no information             
                          3,011        0                 No                                      
                          2,410        1                 Yes                                     
 
O0250B   MMDDYYn8                      Influenza Rcd Date                       
                          4,782                       .  Inapplicable                            
                          2,406        MMDDYYYY          Date as MMDDYYYY                        
 
O0250C   $M3FLRSN                      Rsn Influenza Not Rcd                    
                          4,075                          Missing                                 
                            131        -                 Not assessed/no information             
                            505        1                 Resident not in facility                
                          1,284        2                 Received outside the facility           
                             66        3                 Not eligible                            
                            825        4                 Offered and declined                    
                            111        5                 Not offered                             
                              6        6                 Inability to obtain vaccine             
                            185        9                 None of the above                       
 
O0300A   $M3YESNO                      Pneumococcal Vaccination                 
                          1,665                          Missing                                 
                            127        -                 Not assessed/no information             
                          1,492        0                 No                                      
                          3,904        1                 Yes                                     
 
O0300B   $M3PNRSN                      Rsn Pneumococcal Vaccination Not Rcd     
                          5,569                          Missing                                 
                            213        -                 Not assessed/no information             
                             56        1                 Not eligible                            
                          1,101        2                 Offered and declined                    
                            249        3                 Not offered                             
 
O0400A1                                Speech Ther/Aud Individual Minutes Num   
                          7,188                          Range of Values                         
 
O0400A2                                Speech Ther/Aud ConCur Minutes Num       
                          7,188                          Range of Values                         
 
O0400A3                                Speech Ther/Aud Group Minutes Num        
                          7,188                          Range of Values                         
 
O0400A4                                Num of Days Speech Ther/Aud Admin        
                          7,188                          Range of Values                         
 
O0400A5  MMDDYYn8                      Speech Ther/Audiology Start Date         
                          5,234                       .  Inapplicable                            
                          1,954        MMDDYYYY          Date as MMDDYYYY                        
 
O0400A6  MMDDYYn8                      Speech Ther/Audiology End Date           
                          6,102                       .  Inapplicable                            
                          1,086        MMDDYYYY          Date as MMDDYYYY                        
 
O0400B1                                Occupational Ther Individual Minutes Num 
                          7,188                          Range of Values                         
 
O0400B2                                Occupational Ther ConCur Minutes Num     
                          7,188                          Range of Values                         
 
O0400B3                                Occupational Ther Group Minutes Num      
                          7,188                          Range of Values                         
 
O0400B4                                Num of Days Occ Ther Administered        
                          7,188                          Range of Values                         
 
O0400B5  MMDDYYn8                      Occupational Ther Start Date             
                          3,313                       .  Inapplicable                            
                          3,875        MMDDYYYY          Date as MMDDYYYY                        
 
O0400B6  MMDDYYn8                      Occupational Ther End Date               
                          5,486                       .  Inapplicable                            
                          1,702        MMDDYYYY          Date as MMDDYYYY                        
 
O0400C1                                Phys Ther Individual Minutes Num         
                          7,188                          Range of Values                         
 
O0400C2                                Phys Ther ConCur Minutes Num             
                          7,188                          Range of Values                         
 
O0400C3                                Phys Ther Group Minutes Num              
                          7,188                          Range of Values                         
 
O0400C4                                Num of Days Phys Ther Administered       
                          7,188                          Range of Values                         
 
O0400C5  MMDDYYn8                      Phys Ther Start Date                     
                          3,224                       .  Inapplicable                            
                          3,964        MMDDYYYY          Date as MMDDYYYY                        
 
O0400C6  MMDDYYn8                      Phys Ther End Date                       
                          5,465                       .  Inapplicable                            
                          1,723        MMDDYYYY          Date as MMDDYYYY                        
 
O0400D1                                Resp Ther Minutes Num                    
                          7,188                          Range of Values                         
 
O0400D2                                Num of Days Resp Ther Administered       
                          7,188                          Range of Values                         
 
O0400E1                                Psych Ther Minutes Num                   
                          7,188                          Range of Values                         
 
O0400E2                                Num of Days Psych Ther Administered      
                          7,188                          Range of Values                         
 
O0400F1                                Rec Ther Minutes Num                     
                          7,188                          Range of Values                         
 
O0400F2                                Num of Days Rec Ther Administered        
                          7,188                          Range of Values                         
 
O0450A   $M3YESNO                      Has Ther Resumed                         
                          7,153                          Missing                                 
                              1        -                 Not assessed/no information             
                             32        0                 No                                      
                              2        1                 Yes                                     
 
O0450B   MMDDYYn8                      Date Ther Resumed                        
                          7,186                       .  Inapplicable                            
                              2        MMDDYYYY          Date as MMDDYYYY                        
 
O0500A                                 Rest Nrs: Passive Range of Mtn Num       
                          7,188                          Range of Values                         
 
O0500B                                 Rest Nrs: Actv Range of Mtn Num          
                          7,188                          Range of Values                         
 
O0500C                                 Rest Nrs: Splint/Brace Ass Num           
                          7,188                          Range of Values                         
 
O0500D                                 Rest Nrs: Bed Mob Training Num           
                          7,188                          Range of Values                         
 
O0500E                                 Rest Nrs: Trans Training Num             
                          7,188                          Range of Values                         
 
O0500F                                 Rest Nrs: Wlking Training Num            
                          7,188                          Range of Values                         
 
O0500G                                 Rest Nrs: Drsng/Grooming Training Num    
                          7,188                          Range of Values                         
 
O0500H                                 Rest Nrs: Eating/Swall Training Num      
                          7,188                          Range of Values                         
 
O0500I                                 Rest Nrs: Amp/Prosthes Care Training Num 
                          7,188                          Range of Values                         
 
O0500J                                 Rest Nrs: Communication Training Num     
                          7,188                          Range of Values                         
 
O0600                                  Physician Exam Day Num                   
                          7,188                          Range of Values                         
 
O0700                                  Physician Order Day Num                  
                          7,188                          Range of Values                         
 
P0100A   $M3USED                       Phys Rstrnts in Bed: Bed Rail            
                          1,665                          Missing                                 
                              4        -                 Not assessed/no information             
                          5,489        0                 Not used                                
                              1        1                 Used less than daily                    
                             29        2                 Used daily                              
 
P0100B   $M3USED                       Phys Rstrnts in Bed: Trunk Rstrnt Bed    
                          1,665                          Missing                                 
                              4        -                 Not assessed/no information             
                          5,519        0                 Not used                                
 
P0100C   $M3USED                       Phys Rstrnts in Bed: Limb Rstrnt Bed     
                          1,665                          Missing                                 
                              4        -                 Not assessed/no information             
                          5,516        0                 Not used                                
                              3        2                 Used daily                              
 
P0100D   $M3USED                       Phys Rstrnts in Bed: Oth Rstrnt Bed      
                          1,665                          Missing                                 
                              3        -                 Not assessed/no information             
                          5,518        0                 Not used                                
                              1        1                 Used less than daily                    
                              1        2                 Used daily                              
 
P0100E   $M3USED                       Phys Rstrnts Chair: Trunk Rstrnt Chair   
                          1,665                          Missing                                 
                              3        -                 Not assessed/no information             
                          5,514        0                 Not used                                
                              1        1                 Used less than daily                    
                              5        2                 Used daily                              
 
P0100F   $M3USED                       Phys Rstrnts Chair: Limb Rstrnt Chair    
                          1,665                          Missing                                 
                              3        -                 Not assessed/no information             
                          5,514        0                 Not used                                
                              6        2                 Used daily                              
 
P0100G   $M3USED                       Phys Rstrnts Chair: Chair Prevent Rise   
                          1,665                          Missing                                 
                              3        -                 Not assessed/no information             
                          5,508        0                 Not used                                
                             12        2                 Used daily                              
 
P0100H   $M3USED                       Phys Rstrnts Chair: Oth Rstrnt Chair     
                          1,665                          Missing                                 
                              4        -                 Not assessed/no information             
                          5,509        0                 Not used                                
                              3        1                 Used less than daily                    
                              7        2                 Used daily                              
 
Q0100A   $M3YESNO                      Res Part in Asmt                         
                          2,541                          Missing                                 
                             33        -                 Not assessed/no information             
                            637        0                 No                                      
                          3,977        1                 Yes                                     
 
Q0100B   $M3FAMPR                      Fam Part in Asmt                         
                          2,541                          Missing                                 
                             29        -                 Not assessed/no information             
                          3,033        0                 No                                      
                          1,556        1                 Yes                                     
                             29        9                 No family or significant other available
 
Q0100C   $M3GUAPR                      Guardian Part in Asmt                    
                          2,541                          Missing                                 
                             31        -                 Not assessed/no information             
                          3,357        0                 No                                      
                            373        1                 Yes                                     
                            886        9                 No guardian or legally auth rep availabl
 
Q0300A   $M3OGOAL                      Res Overall Goal                         
                          6,091                          Missing                                 
                             15        -                 -                                       
                            720        1                 Discharged to the community             
                            282        2                 Remain in this facility                 
                             26        3                 Discharged to another facility          
                             54        9                 Unknown or uncertain                    
 
Q0300B   $M3SOURC                      Overall Goal Source                      
                          6,091                          Missing                                 
                             17        -                 -                                       
                            799        1                 Resident                                
                            244        2                 Family or sig other                     
                             28        3                 Guardian or legally auth rep            
                              9        9                 9                                       
 
Q0400A   $M3YESNO                      Dis Plan                                 
                          1,665                          Missing                                 
                             41        -                 Not assessed/no information             
                          3,575        0                 No                                      
                          1,907        1                 Yes                                     
 
Q0490    $M3NOINF                      Ress Pref Answering Q0500B               
                          4,873                          Missing                                 
                             44        -                 Not assessed/no information             
                          1,022        0                 No                                      
                          1,196        1                 Yes                                     
                             53        8                 Information not available               
 
Q0500B   $M3WNTLK                      Staff Asked Res or Fam Abt Rtn To Comm   
                          5,134                          Missing                                 
                             54        -                 -                                       
                          1,770        0                 No                                      
                             97        1                 Yes                                     
                            133        9                 Unknown or uncertain                    
 
Q0550A   $M3NOINF                      Pref In Answering Q0550B                 
                          5,134                          Missing                                 
                             67        -                 Not assessed/no information             
                          1,669        0                 No                                      
                            213        1                 Yes                                     
                            105        8                 Information not available               
 
Q0550B   $M3SOURC                      Source Answering Q0550A                  
                          5,134                          Missing                                 
                             63        -                 -                                       
                          1,009        1                 Resident                                
                            761        2                 Family or sig other                     
                            126        3                 Guardian or legally auth rep            
                             76        8                 No information source available         
                             19        9                 9                                       
 
Q0600    $M3REFER                      Local Contact Agency Referral            
                          1,665                          Missing                                 
                             39        -                 -                                       
                          5,136        0                 No - referral not needed                
                            177        1                 No - referral may be needed             
                            171        2                 Yes                                     
 
V0100A   $M3CASS                       Prior Asmt Federal OBRA Rsn for Asmt     
                          6,569                                                                  
                              8        01                5 day sched assessment                  
                            530        02                14 day sched assessment                 
                             20        03                30 day sched assessment                 
                             17        04                60 day sched assessment                 
                             44        99                None of above                           
 
V0100B   $M3CASS                       Prior Asmt PPS Rsn for Asmt              
                          6,569                                                                  
                             28        01                5 day sched assessment                  
                             13        02                14 day sched assessment                 
                              9        03                30 day sched assessment                 
                              4        04                60 day sched assessment                 
                              1        05                90 day sched assessment                 
                              2        07                Unsched assessment for PPS              
                            562        99                None of above                           
 
V0100C   MMDDYYn8                      Prior Asmt Ref Date                      
                          6,568                       .  Inapplicable                            
                            620        MMDDYYYY          Date as MMDDYYYY                        
 
V0100D                                 Prior Asmt (BIMS) Summary Score Num      
                          7,188                          Range of Values                         
 
V0100E                                 Prior Asmt  (PHQ-9) Tot Svrty Score Num  
                          7,188                          Range of Values                         
 
V0100F                                 Prior Asmt  (PHQ-9) Tot Svrty Score Num  
                          7,188                          Range of Values                         
 
V200A01A $M3INDIC                      Dlrm Care Area Trigger                   
                          5,722                          Missing                                 
                          1,348        0                 Not indicated                           
                            118        1                 Indicated                               
 
V200A01B $M3INDIC                      Dlrm Adrsd in Care Plan                  
                          5,722                          Missing                                 
                            543        -                 Not assessed/no information             
                            856        0                 Not indicated                           
                             67        1                 Indicated                               
 
V200A02A $M3INDIC                      Dementia Care Area Trigger               
                          5,722                          Missing                                 
                            535        0                 Not indicated                           
                            931        1                 Indicated                               
 
V200A02B $M3INDIC                      Dementia Adrsd in Care Plan              
                          5,722                          Missing                                 
                            223        -                 Not assessed/no information             
                            396        0                 Not indicated                           
                            847        1                 Indicated                               
 
V200A03A $M3INDIC                      Visual Func Care Area Trigger            
                          5,722                          Missing                                 
                            950        0                 Not indicated                           
                            516        1                 Indicated                               
 
V200A03B $M3INDIC                      Visual Func Adrsd in Care Plan           
                          5,722                          Missing                                 
                            381        -                 Not assessed/no information             
                            642        0                 Not indicated                           
                            443        1                 Indicated                               
 
V200A04A $M3INDIC                      Communication Care Area Trigger          
                          5,722                          Missing                                 
                            711        0                 Not indicated                           
                            755        1                 Indicated                               
 
V200A04B $M3INDIC                      Communication Adrsd in Care Plan         
                          5,722                          Missing                                 
                            299        -                 Not assessed/no information             
                            489        0                 Not indicated                           
                            678        1                 Indicated                               
 
V200A05A $M3INDIC                      ADL Care Area Trigger                    
                          5,722                          Missing                                 
                            334        0                 Not indicated                           
                          1,132        1                 Indicated                               
 
V200A05B $M3INDIC                      ADL Adrsd in Care Plan                   
                          5,722                          Missing                                 
                            123        -                 Not assessed/no information             
                            224        0                 Not indicated                           
                          1,119        1                 Indicated                               
 
V200A06A $M3INDIC                      Urny Care Area Trigger                   
                          5,722                          Missing                                 
                             76        0                 Not indicated                           
                          1,390        1                 Indicated                               
 
V200A06B $M3INDIC                      Urny Adrsd in Care Plan                  
                          5,722                          Missing                                 
                             45        -                 Not assessed/no information             
                            200        0                 Not indicated                           
                          1,221        1                 Indicated                               
 
V200A07A $M3INDIC                      Psychosocial Care Area Trigger           
                          5,722                          Missing                                 
                          1,167        0                 Not indicated                           
                            299        1                 Indicated                               
 
V200A07B $M3INDIC                      Psychosocial Adrsd in Care Plan          
                          5,722                          Missing                                 
                            482        -                 Not assessed/no information             
                            729        0                 Not indicated                           
                            255        1                 Indicated                               
 
V200A08A $M3INDIC                      Mood Care Area Trigger                   
                          5,722                          Missing                                 
                          1,271        0                 Not indicated                           
                            195        1                 Indicated                               
 
V200A08B $M3INDIC                      Mood Adrsd in Care Plan                  
                          5,722                          Missing                                 
                            502        -                 Not assessed/no information             
                            786        0                 Not indicated                           
                            178        1                 Indicated                               
 
V200A09A $M3INDIC                      Bhvral Care Area Trigger                 
                          5,722                          Missing                                 
                          1,237        0                 Not indicated                           
                            229        1                 Indicated                               
 
V200A09B $M3INDIC                      Bhvral Adrsd in Care Plan                
                          5,722                          Missing                                 
                            492        -                 Not assessed/no information             
                            758        0                 Not indicated                           
                            216        1                 Indicated                               
 
V200A10A $M3INDIC                      Act Care Area Trigger                    
                          5,722                          Missing                                 
                          1,234        0                 Not indicated                           
                            232        1                 Indicated                               
 
V200A10B $M3INDIC                      Act Adrsd in Care Plan                   
                          5,722                          Missing                                 
                            498        -                 Not assessed/no information             
                            726        0                 Not indicated                           
                            242        1                 Indicated                               
 
V200A11A $M3INDIC                      Fall Care Area Trigger                   
                          5,722                          Missing                                 
                             37        0                 Not indicated                           
                          1,429        1                 Indicated                               
 
V200A11B $M3INDIC                      Fall Adrsd in Care Plan                  
                          5,722                          Missing                                 
                             31        -                 Not assessed/no information             
                             91        0                 Not indicated                           
                          1,344        1                 Indicated                               
 
V200A12A $M3INDIC                      Nutr Care Area Trigger                   
                          5,722                          Missing                                 
                            143        0                 Not indicated                           
                          1,323        1                 Indicated                               
 
V200A12B $M3INDIC                      Nutr Adrsd in Care Plan                  
                          5,722                          Missing                                 
                             60        -                 Not assessed/no information             
                            195        0                 Not indicated                           
                          1,211        1                 Indicated                               
 
V200A13A $M3INDIC                      Feeding Tube Care Area Trigger           
                          5,722                          Missing                                 
                          1,421        0                 Not indicated                           
                             45        1                 Indicated                               
 
V200A13B $M3INDIC                      Feeding Tube Adrsd in Care Plan          
                          5,722                          Missing                                 
                            559        -                 Not assessed/no information             
                            863        0                 Not indicated                           
                             44        1                 Indicated                               
 
V200A14A $M3INDIC                      Dehydration Care Area Trigger            
                          5,722                          Missing                                 
                          1,084        0                 Not indicated                           
                            382        1                 Indicated                               
 
V200A14B $M3INDIC                      Dehydration Adrsd in Care Plan           
                          5,722                          Missing                                 
                            423        -                 Not assessed/no information             
                            709        0                 Not indicated                           
                            334        1                 Indicated                               
 
V200A15A $M3INDIC                      Dental Care Area Trigger                 
                          5,722                          Missing                                 
                          1,066        0                 Not indicated                           
                            400        1                 Indicated                               
 
V200A15B $M3INDIC                      Dental Adrsd in Care Plan                
                          5,722                          Missing                                 
                            422        -                 Not assessed/no information             
                            749        0                 Not indicated                           
                            295        1                 Indicated                               
 
V200A16A $M3INDIC                      Press Ulcr Care Area Trigger             
                          5,722                          Missing                                 
                             27        0                 Not indicated                           
                          1,439        1                 Indicated                               
 
V200A16B $M3INDIC                      Press Ulcr Adrsd in Care Plan            
                          5,722                          Missing                                 
                             16        -                 Not assessed/no information             
                            116        0                 Not indicated                           
                          1,334        1                 Indicated                               
 
V200A17A $M3INDIC                      Psychotropic Drug Care Area Trigger      
                          5,722                          Missing                                 
                            573        0                 Not indicated                           
                            893        1                 Indicated                               
 
V200A17B $M3INDIC                      Psychotropic Drug Adrsd in Care Plan     
                          5,722                          Missing                                 
                            244        -                 Not assessed/no information             
                            372        0                 Not indicated                           
                            850        1                 Indicated                               
 
V200A18A $M3INDIC                      Rstrnt Care Area Trigger                 
                          5,722                          Missing                                 
                          1,448        0                 Not indicated                           
                             18        1                 Indicated                               
 
V200A18B $M3INDIC                      Rstrnt Adrsd in Care Plan                
                          5,722                          Missing                                 
                            568        -                 Not assessed/no information             
                            883        0                 Not indicated                           
                             15        1                 Indicated                               
 
V200A19A $M3INDIC                      Pain Care Area Trigger                   
                          5,722                          Missing                                 
                          1,138        0                 Not indicated                           
                            328        1                 Indicated                               
 
V200A19B $M3INDIC                      Pain Adrsd in Care Plan                  
                          5,722                          Missing                                 
                            453        -                 Not assessed/no information             
                            680        0                 Not indicated                           
                            333        1                 Indicated                               
 
V200A20A $M3INDIC                      Rtn to Comm Care Area Trigger            
                          5,722                          Missing                                 
                          1,408        0                 Not indicated                           
                             58        1                 Indicated                               
 
V200A20B $M3INDIC                      Rtn to Comm Adrsd in Care Plan           
                          5,722                          Missing                                 
                            565        -                 Not assessed/no information             
                            843        0                 Not indicated                           
                             58        1                 Indicated                               
 
