Variable Format    Q#/Freq            Description/Label
 
BASEID   $BSIDFMT                      Unique SP Identification Number          
                          7,380        LOW-HIGH          BASEID Count                            
 
SURVEYYR SVYRFMT                       Survey Year                              
                          7,380                    2017  2017                                    
 
VERSION  VERSFMT                       Version Number                           
                          7,380                       1  Version 1                               
 
TRGT_DT  MMDDYYn8                      Target Date                              
                          7,380        MMDDYYYY          Date as MMDDYYYY                        
 
SUB_DT   MMDDYYn8                      Submission Date                          
                          7,380        MMDDYYYY          Date as MMDDYYYY                        
 
SPEC_VCD                               Data Submission Spec Vers                
                          7,380        Range of values   Range of Values                         
 
ITM_SVC                                Item Set Vers                            
                          7,380        Range of values   Range of Values                         
 
PRCSD_TS MMDDYYn8                      Processed Timestamp                      
                          7,380        MMDDYYYY          Date as MMDDYYYY                        
 
Age                                    Res Age                                  
                          7,380        Range of values   Range of Values                         
 
RSDT_MCI                               Res Match Criteria ID                    
                          7,380        LOW-HIGH          Range of Values                         
 
CURCD                                  CBSA Urban/Rural                         
                          7,380        Range of values   Range of Values                         
 
A0050    $M3RCTYP                      Type of Record                           
                          7,084        1                 Add a new record                        
                            296        2                 Modify existing record                  
 
A0200    $M3PROV                       Type of Provider                         
                          7,380        1                 Nursing home (SNF/NF)                   
 
A0310A   $M3OBRA                       Federal OBRA Rsn for Asmt                
                            761        01                Admission                               
                          1,888        02                Quarterly                               
                            462        03                Annual                                  
                            210        04                Significant change in status            
                          4,059        99                Not OBRA required                       
 
A0310B   $MCASS                        PPS Asmt                                 
                            786        01                Sched. 5-day assessment                 
                            519        02                Sched 14-day assessment                 
                            229        03                Sched 30-day assessment                 
                             63        04                Sched 60-day assessment                 
                             23        05                Sched 90-day assessment                 
                            139        07                Unsched assessment                      
                          5,621        99                None of the above                       
 
A0310C   $M3PPSOT                      PPS Oth Mcare Req Asmt (OMRA)            
                          7,136        0                 No                                      
                             33        1                 Start of therapy                        
                             31        2                 End of therapy                          
                            180        4                 Change of therapy                       
 
A0310E   $M3YESNO                      First Asmt Since Most Rec Admsn          
                          6,200        0                 No                                      
                          1,180        1                 Yes                                     
 
A0310F   $M3REPO                       Entry/Dis                                
                          1,360        01                Entry                                   
                            740        10                Discharge, return not anticipated       
                            480        11                Discharge, return anticipated           
                            201        12                Death in facility                       
                          4,599        99                None of the above                       
 
A0310G   $M3DIS                        Planned Dis                              
                          6,160                          Missing                                 
                            700        1                 Planned                                 
                            520        2                 Unplanned                               
 
A0410    $M3SUBRQ                      Submission Req                           
                          7,380        3                 Federal required                        
 
A0800    $SEXFMT                       Sex                                   
                          2,586        1                 Male                                    
                          4,794        2                 Female                                  
 
A0900    MMDDYYn8                      Birth Date                               
                          7,380        MMDDYYYY          Date as MMDDYYYY                        
 
A1000A   $M3INDIC                      R/E: American Indian or Alaskan Native   
                              7        -                 Not assessed/no information             
                          7,312        0                 Not indicated                           
                             61        1                 Indicated                               
 
A1000B   $M3INDIC                      R/E: Asian                               
                              7        -                 Not assessed/no information             
                          7,290        0                 Not indicated                           
                             83        1                 Indicated                               
 
A1000C   $M3INDIC                      R/E: African American                    
                              7        -                 Not assessed/no information             
                          6,754        0                 Not indicated                           
                            619        1                 Indicated                               
 
A1000D   $M3INDIC                      R/E: Hispanic                            
                              7        -                 Not assessed/no information             
                          6,973        0                 Not indicated                           
                            400        1                 Indicated                               
 
A1000E   $M3INDIC                      R/E: Native Hawaiian/Pacific Islander    
                              7        -                 Not assessed/no information             
                          7,361        0                 Not indicated                           
                             12        1                 Indicated                               
 
A1000F   $M3INDIC                      R/E: White                               
                              7        -                 Not assessed/no information             
                          1,366        0                 Not indicated                           
                          6,007        1                 Indicated                               
 
A1100A   $M3YNDET                      Res Need Interpreter                     
                          1,564                          Missing                                 
                              5        -                 Not assessed/no information             
                          5,640        0                 No                                      
                            161        1                 Yes                                     
                             10        9                 Unable to determine                     
 
A1200    $M3MARTL                      Marital Stat                             
                            171        -                 Not assessed/no information             
                            976        1                 Never married                           
                          1,692        2                 Married                                 
                          3,644        3                 Widowed                                 
                             60        4                 Separated                               
                            837        5                 Divorced                                
 
A1300A                                 Medical Record Num                       
                          7,380                          Range of Values                         
 
A1300D                                 Lifetime Occupation(s) Text              
                          7,380                          Range of Values                         
 
A1500    $M3SMI                        (PASRR)                                  
                          5,947                          Missing                                 
                              2        -                 Not assessed/no information             
                          1,338        0                 No                                      
                             55        1                 Yes                                     
                             38        9                 Not a Medicaid-certified unit           
 
A1510A   $M3INDIC                      Serious Mntl Illness                     
                          7,323                          Missing                                 
                              2        -                 Not assessed/no information             
                             16        0                 Not indicated                           
                             39        1                 Indicated                               
 
A1510B   $M3INDIC                      Intellectual Disability                  
                          7,323                          Missing                                 
                              2        -                 Not assessed/no information             
                             40        0                 Not indicated                           
                             15        1                 Indicated                               
 
A1510C   $M3INDIC                      Oth Related Conds                        
                          7,323                          Missing                                 
                              2        -                 Not assessed/no information             
                             50        0                 Not indicated                           
                              5        1                 Indicated                               
 
A1550A   $M3INDIC                      ID/DD Stat: Down Syndrome                
                          6,619                          Missing                                 
                              2        -                 Not assessed/no information             
                            759        0                 Not indicated                           
 
A1550B   $M3INDIC                      ID/DD Stat: Autism                       
                          6,619                          Missing                                 
                              2        -                 Not assessed/no information             
                            759        0                 Not indicated                           
 
A1550C   $M3INDIC                      ID/DD Stat: Epilepsy                     
                          6,619                          Missing                                 
                              2        -                 Not assessed/no information             
                            758        0                 Not indicated                           
                              1        1                 Indicated                               
 
A1550D   $M3INDIC                      ID/DD Stat: Oth Org ID/DD Cond           
                          6,619                          Missing                                 
                              2        -                 Not assessed/no information             
                            758        0                 Not indicated                           
                              1        1                 Indicated                               
 
A1550E   $M3INDIC                      ID/DD Stat: ID/DD W No Org Cond          
                          6,619                          Missing                                 
                              2        -                 Not assessed/no information             
                            758        0                 Not indicated                           
                              1        1                 Indicated                               
 
A1550Z   $M3INDIC                      ID/DD Stat: None of the Above            
                          6,619                          Missing                                 
                              2        -                 Not assessed/no information             
                              3        0                 Not indicated                           
                            756        1                 Indicated                               
 
A1600    MMDDYYn8                      Entry Date                               
                          7,380        MMDDYYYY          Date as MMDDYYYY                        
 
A1700    $M3TYP                        Type of Entry                            
                          4,823        1                 Admission                               
                          2,557        2                 Reentry                                 
 
A1800    $M3ADFRM                      Entered From                             
                            473        01                Community                               
                            325        02                Another nursing home or swing bed       
                          6,414        03                Acute hospital                          
                             67        04                Psychiatric hospital                    
                             41        05                Inpatient rehabilitation facility       
                             24        07                Hospice                                 
                             20        09                Long Term Care Hospital (LTCH)          
                             16        99                Other                                   
 
A2000    MMDDYYn8                      Dis Date                                 
                          5,959                       .  Inapplicable                            
                          1,421        MMDDYYYY          Date as MMDDYYYY                        
 
A2100    $M3ADFRM                      Dis Stat                                 
                          5,959                          Missing                                 
                            655        01                Community                               
                             40        02                Another nursing home or swing bed       
                            499        03                Acute hospital                          
                              8        04                Psychiatric hospital                    
                              3        05                Inpatient rehabilitation facility       
                              1        06                ID/DD facility                          
                              6        07                Hospice                                 
                            201        08                Deceased                                
                              4        09                Long Term Care Hospital (LTCH)          
                              4        99                Other                                   
 
A2300    MMDDYYn8                      Asmt Ref Date                            
                          1,561                       .  Inapplicable                            
                          5,819        MMDDYYYY          Date as MMDDYYYY                        
 
A2400A   $M3YESNO                      Had a Mcare Stay Since Most Rec Admsn    
                          3,244        0                 No                                      
                          4,136        1                 Yes                                     
 
A2400B   MMDDYYn8                      Start Date of Most Rec Mcare Stay        
                          3,244                       .  Inapplicable                            
                          4,136        MMDDYYYY          Date as MMDDYYYY                        
 
A2400C   MMDDYYn8                      End Date of Most Rec Mcare Stay          
                          5,674                       .  Inapplicable                            
                          1,706        MMDDYYYY          Date as MMDDYYYY                        
 
B0100    $M3YESNO                      Comatose                                 
                          1,726                          Missing                                 
                              6        -                 Not assessed/no information             
                          5,648        0                 No                                      
 
B0200    $M3HEAR                       Hearing                                  
                          2,993                          Missing                                 
                             16        -                 Not assessed/no information             
                          3,008        0                 Adequate                                
                            881        1                 Minimal difficulty                      
                            409        2                 Moderate difficulty                     
                             73        3                 Highly impaired                         
 
B0300    $M3YESNO                      Hearing Aide                             
                          2,993                          Missing                                 
                              8        -                 Not assessed/no information             
                          3,916        0                 No                                      
                            463        1                 Yes                                     
 
B0600    $M3CLEAR                      Speech Clarity                           
                          2,993                          Missing                                 
                              6        -                 Not assessed/no information             
                          3,854        0                 Clear speech                            
                            412        1                 Unclear speech                          
                            115        2                 No speech                               
 
B0700    $M3UNDER                      Makes Self Understood                    
                          2,859                          Missing                                 
                             13        -                 Not assessed/no information             
                          3,033        0                 Understood                              
                            803        1                 Usually understood                      
                            387        2                 Sometimes understood                    
                            285        3                 Rarely/Never understood                 
 
B0800    $M3UNDRR                      Ability to Understand Oth                
                          2,993                          Missing                                 
                             12        -                 Not assessed/no information             
                          2,706        0                 Understands                             
                            973        1                 Usually understands                     
                            471        2                 Sometimes understands                   
                            225        3                 Rarely/Never understands                
 
B1000    $M3ADQT                       Vision                                   
                          2,993                          Missing                                 
                             33        -                 Not assessed/no information             
                          3,103        0                 Adequate                                
                            706        1                 Impaired                                
                            248        2                 Moderately impaired                     
                            219        3                 Highly impaired                         
                             78        4                 Severely impaired                       
 
B1200    $M3YESNO                      Corr Lenses                              
                          2,993                          Missing                                 
                             14        -                 Not assessed/no information             
                          1,900        0                 No                                      
                          2,473        1                 Yes                                     
 
C0100    $M3YESNO                      Brief Int for Mntl Stat Be Cond          
                          2,185                          Missing                                 
                            126        -                 Not assessed/no information             
                            488        0                 No                                      
                          4,581        1                 Yes                                     
 
C0200    $M3REP3W                      BIMS: Num of Words Rep After First Att   
                          2,673                          Missing                                 
                            164        -                 Not assessed/no information             
                            247        0                 None                                    
                             83        1                 One                                     
                            241        2                 Two                                     
                          3,972        3                 Three                                   
 
C0300A   $M31ORNT                      BIMS: Temp Ortn - Able to Rep Corr Yr    
                          2,673                          Missing                                 
                            174        -                 Not assessed/no information             
                          1,507        0                 Missed by >5 years or no answer         
                            141        1                 Missed by 2-5 years                     
                            161        2                 Missed by 1 year                        
                          2,724        3                 Correct                                 
 
C0300B   $M31ORNT                      BIMS: Temp Ortn - Able to Rep Corr Mon   
                          2,673                          Missing                                 
                            175        -                 Not assessed/no information             
                          1,295        0                 Missed by >5 years or no answer         
                            304        1                 Missed by 2-5 years                     
                          2,933        2                 Missed by 1 year                        
 
C0300C   $M31ORNT                      BIMS: Temp Ortn - Able to Rep Corr Day   
                          2,673                          Missing                                 
                            184        -                 Not assessed/no information             
                          2,083        0                 Missed by >5 years or no answer         
                          2,440        1                 Missed by 2-5 years                     
 
C0400A   $M3CUE                        BIMS: Rcl - Able to Rcl Sock             
                          2,673                          Missing                                 
                            250        -                 Not assessed/no information             
                          1,338        0                 No - could not recall                   
                            749        1                 Yes, after cueing                       
                          2,370        2                 Yes, no cue required                    
 
C0400B   $M3CUE                        BIMS: Rcl - Able to Rcl Blue             
                          2,673                          Missing                                 
                            251        -                 Not assessed/no information             
                          1,028        0                 No - could not recall                   
                            877        1                 Yes, after cueing                       
                          2,551        2                 Yes, no cue required                    
 
C0400C   $M3CUE                        BIMS: Rcl - Able to Rcl Bed              
                          2,673                          Missing                                 
                            252        -                 Not assessed/no information             
                          1,454        0                 No - could not recall                   
                            954        1                 Yes, after cueing                       
                          2,047        2                 Yes, no cue required                    
 
C0500                                  Brief Int for Mntl Stat (BIMS) Score Num 
                          7,380                          Range of Values                         
 
C0600    $M3YESNO                      Staff to Cond Brief Int for Mntl Stat    
                          2,673                          Missing                                 
                             66        -                 Not assessed/no information             
                          4,346        0                 No                                      
                            295        1                 Yes                                     
 
C0700    $M3MEMRY                      SA of Mntl Stat - Short Term Memory      
                          6,072                          Missing                                 
                            152        -                 Not assessed/no information             
                            213        0                 Memory OK                               
                            943        1                 Memory problem                          
 
C0800    $M3MEMRY                      SA of Mntl Stat - Long Term Memory       
                          6,634                          Missing                                 
                             56        -                 Not assessed/no information             
                             43        0                 Memory OK                               
                            647        1                 Memory problem                          
 
C0900A   $M3INDIC                      SA of Mntl Stat - Rcls Cur Season        
                          6,634                          Missing                                 
                             56        -                 Not assessed/no information             
                            646        0                 Not indicated                           
                             44        1                 Indicated                               
 
C0900B   $M3INDIC                      SA of Mntl Stat - Rcls Loc of Room       
                          6,634                          Missing                                 
                             54        -                 Not assessed/no information             
                            553        0                 Not indicated                           
                            139        1                 Indicated                               
 
C0900C   $M3INDIC                      SA of Mntl Stat - Rcls Staff Name        
                          6,634                          Missing                                 
                             54        -                 Not assessed/no information             
                            521        0                 Not indicated                           
                            171        1                 Indicated                               
 
C0900D   $M3INDIC                      SA of Mntl Stat - Rcls Nrs Home          
                          6,634                          Missing                                 
                             53        -                 Not assessed/no information             
                            567        0                 Not indicated                           
                            126        1                 Indicated                               
 
C0900Z   $M3INDIC                      SA of Mntl Stat - Rcls None of Above     
                          6,634                          Missing                                 
                             53        -                 Not assessed/no information             
                            269        0                 Not indicated                           
                            424        1                 Indicated                               
 
C1000    $M3DECIS                      Cog Skills for Decision Making           
                          6,072                          Missing                                 
                            151        -                 Not assessed/no information             
                            135        0                 Independent                             
                            147        1                 Modified independence                   
                            356        2                 Moderately impaired                     
                            519        3                 Severely impaired                       
 
D0100    $M3YESNO                      Res Mood Int Be Cond                     
                          2,185                          Missing                                 
                            143        -                 Not assessed/no information             
                            517        0                 No                                      
                          4,535        1                 Yes                                     
 
D0200A1  $M3YNNOR                      Res Mood Int - Interest Loss             
                          2,702                          Missing                                 
                            173        -                 Not assessed/no information             
                          3,921        0                 No                                      
                            409        1                 Yes                                     
                            175        9                 No Response                             
 
D0200A2  $M3DEPRB                      Res Mood Int - Interest Loss Freq        
                          2,877                          Missing                                 
                            178        -                 Not assessed/no information             
                          3,930        0                 Never or 1 day                          
                            182        1                 2 - 6 days                              
                            104        2                 7 - 11 days                             
                            109        3                 12-14 days                              
 
D0200B1  $M3YNNOR                      Res Mood Int - Feel Down                 
                          2,702                          Missing                                 
                            175        -                 Not assessed/no information             
                          3,289        0                 No                                      
                          1,057        1                 Yes                                     
                            157        9                 No Response                             
 
D0200B2  $M3DEPRB                      Res Mood Int - Feel Down Freq            
                          2,859                          Missing                                 
                            182        -                 Not assessed/no information             
                          3,315        0                 Never or 1 day                          
                            607        1                 2 - 6 days                              
                            248        2                 7 - 11 days                             
                            169        3                 12-14 days                              
 
D0200C1  $M3YNNOR                      Res Mood Int - Trouble Sleep             
                          2,702                          Missing                                 
                            175        -                 Not assessed/no information             
                          3,441        0                 No                                      
                            895        1                 Yes                                     
                            167        9                 No Response                             
 
D0200C2  $M3DEPRB                      Res Mood Int - Trouble Sleep Freq        
                          2,869                          Missing                                 
                            176        -                 Not assessed/no information             
                          3,458        0                 Never or 1 day                          
                            471        1                 2 - 6 days                              
                            204        2                 7 - 11 days                             
                            202        3                 12-14 days                              
 
D0200D1  $M3YNNOR                      Res Mood Int - Little Energy             
                          2,702                          Missing                                 
                            189        -                 Not assessed/no information             
                          2,793        0                 No                                      
                          1,547        1                 Yes                                     
                            149        9                 No Response                             
 
D0200D2  $M3DEPRB                      Res Mood Int - Little Energy Freq        
                          2,851                          Missing                                 
                            191        -                 Not assessed/no information             
                          2,817        0                 Never or 1 day                          
                            785        1                 2 - 6 days                              
                            346        2                 7 - 11 days                             
                            390        3                 12-14 days                              
 
D0200E1  $M3YNNOR                      Res Mood Int - Poor Appetite             
                          2,702                          Missing                                 
                            203        -                 Not assessed/no information             
                          3,718        0                 No                                      
                            600        1                 Yes                                     
                            157        9                 No Response                             
 
D0200E2  $M3DEPRB                      Res Mood Int - Poor Appetite Freq        
                          2,859                          Missing                                 
                            204        -                 Not assessed/no information             
                          3,728        0                 Never or 1 day                          
                            314        1                 2 - 6 days                              
                            140        2                 7 - 11 days                             
                            135        3                 12-14 days                              
 
D0200F1  $M3YNNOR                      Res Mood Int - Self Dprcn                
                          2,702                          Missing                                 
                            201        -                 Not assessed/no information             
                          4,008        0                 No                                      
                            295        1                 Yes                                     
                            174        9                 No Response                             
 
D0200F2  $M3DEPRB                      Res Mood Int - Self Dprcn Freq           
                          2,876                          Missing                                 
                            202        -                 Not assessed/no information             
                          4,018        0                 Never or 1 day                          
                            145        1                 2 - 6 days                              
                             62        2                 7 - 11 days                             
                             77        3                 12-14 days                              
 
D0200G1  $M3YNNOR                      Res Mood Int - Lack of Conc              
                          2,702                          Missing                                 
                            205        -                 Not assessed/no information             
                          3,713        0                 No                                      
                            597        1                 Yes                                     
                            163        9                 No Response                             
 
D0200G2  $M3DEPRB                      Res Mood Int - Lack of Conc Freq         
                          2,865                          Missing                                 
                            206        -                 Not assessed/no information             
                          3,728        0                 Never or 1 day                          
                            301        1                 2 - 6 days                              
                            113        2                 7 - 11 days                             
                            167        3                 12-14 days                              
 
D0200H1  $M3YNNOR                      Res Mood Int - Movement Diff             
                          2,702                          Missing                                 
                            202        -                 Not assessed/no information             
                          3,954        0                 No                                      
                            352        1                 Yes                                     
                            170        9                 No Response                             
 
D0200H2  $M3DEPRB                      Res Mood Int - Movement Diff Freq        
                          2,872                          Missing                                 
                            202        -                 Not assessed/no information             
                          3,963        0                 Never or 1 day                          
                            198        1                 2 - 6 days                              
                             53        2                 7 - 11 days                             
                             92        3                 12-14 days                              
 
D0200I1  $M3YNNOR                      Res Mood Int - Neg Stmnt                 
                          2,702                          Missing                                 
                            202        -                 Not assessed/no information             
                          4,267        0                 No                                      
                             46        1                 Yes                                     
                            163        9                 No Response                             
 
D0200I2  $M3DEPRB                      Res Mood Int - Neg Stmnt Freq            
                          2,865                          Missing                                 
                            203        -                 Not assessed/no information             
                          4,271        0                 Never or 1 day                          
                             23        1                 2 - 6 days                              
                              5        2                 7 - 11 days                             
                             13        3                 12-14 days                              
 
D0300                                  Res Mood Int - Tot Svrty Mood Score      
                          7,380                          Range of Values                         
 
D0350    $M3YESNO                      Res Mood Int - Neg Stmnts Notify Staff   
                          7,334                          Missing                                 
                              1        0                 No                                      
                             45        1                 Yes                                     
 
D0500A1  $M3YESNO                      SA of Res Mood - Interest Loss           
                          6,491                          Missing                                 
                             77        -                 Not assessed/no information             
                            687        0                 No                                      
                            125        1                 Yes                                     
 
D0500A2  $M3DEPRB                      SA of Res Mood - Interest Loss Freq      
                          6,491                          Missing                                 
                             78        -                 Not assessed/no information             
                            687        0                 Never or 1 day                          
                             35        1                 2 - 6 days                              
                             45        2                 7 - 11 days                             
                             44        3                 12-14 days                              
 
D0500B1  $M3YESNO                      SA of Res Mood - Feel Down               
                          6,491                          Missing                                 
                             80        -                 Not assessed/no information             
                            705        0                 No                                      
                            104        1                 Yes                                     
 
D0500B2  $M3DEPRB                      SA of Res Mood - Feel Down Freq          
                          6,491                          Missing                                 
                             81        -                 Not assessed/no information             
                            708        0                 Never or 1 day                          
                             54        1                 2 - 6 days                              
                             24        2                 7 - 11 days                             
                             22        3                 12-14 days                              
 
D0500C1  $M3YESNO                      SA of Res Mood - Trouble Sleep           
                          6,491                          Missing                                 
                             72        -                 Not assessed/no information             
                            696        0                 No                                      
                            121        1                 Yes                                     
 
D0500C2  $M3DEPRB                      SA of Res Mood - Trouble Sleep Freq      
                          6,491                          Missing                                 
                             72        -                 Not assessed/no information             
                            697        0                 Never or 1 day                          
                             37        1                 2 - 6 days                              
                             51        2                 7 - 11 days                             
                             32        3                 12-14 days                              
 
D0500D1  $M3YESNO                      SA of Res Mood - Little Energy           
                          6,491                          Missing                                 
                             83        -                 Not assessed/no information             
                            600        0                 No                                      
                            206        1                 Yes                                     
 
D0500D2  $M3DEPRB                      SA of Res Mood - Little Energy Freq      
                          6,491                          Missing                                 
                             83        -                 Not assessed/no information             
                            604        0                 Never or 1 day                          
                             74        1                 2 - 6 days                              
                             64        2                 7 - 11 days                             
                             64        3                 12-14 days                              
 
D0500E1  $M3YESNO                      SA of Res Mood - Poor Appetite           
                          6,491                          Missing                                 
                             71        -                 Not assessed/no information             
                            644        0                 No                                      
                            174        1                 Yes                                     
 
D0500E2  $M3DEPRB                      SA of Res Mood - Poor Appetite Freq      
                          6,491                          Missing                                 
                             72        -                 Not assessed/no information             
                            646        0                 Never or 1 day                          
                            104        1                 2 - 6 days                              
                             36        2                 7 - 11 days                             
                             31        3                 12-14 days                              
 
D0500F1  $M3YESNO                      SA of Res Mood - Self Dprcn              
                          6,491                          Missing                                 
                             84        -                 Not assessed/no information             
                            797        0                 No                                      
                              8        1                 Yes                                     
 
D0500F2  $M3DEPRB                      SA of Res Mood - Self Dprcn Freq         
                          6,491                          Missing                                 
                             87        -                 Not assessed/no information             
                            794        0                 Never or 1 day                          
                              2        1                 2 - 6 days                              
                              2        2                 7 - 11 days                             
                              4        3                 12-14 days                              
 
D0500G1  $M3YESNO                      SA of Res Mood - Conc                    
                          6,491                          Missing                                 
                             85        -                 Not assessed/no information             
                            565        0                 No                                      
                            239        1                 Yes                                     
 
D0500G2  $M3DEPRB                      SA of Res Mood - Conc Freq               
                          6,491                          Missing                                 
                             86        -                 Not assessed/no information             
                            565        0                 Never or 1 day                          
                             41        1                 2 - 6 days                              
                             42        2                 7 - 11 days                             
                            155        3                 12-14 days                              
 
D0500H1  $M3YESNO                      SA of Res Mood - Movement Diff           
                          6,491                          Missing                                 
                             78        -                 Not assessed/no information             
                            735        0                 No                                      
                             76        1                 Yes                                     
 
D0500H2  $M3DEPRB                      SA of Res Mood - Movement Diff Freq      
                          6,491                          Missing                                 
                             78        -                 Not assessed/no information             
                            737        0                 Never or 1 day                          
                             23        1                 2 - 6 days                              
                             26        2                 7 - 11 days                             
                             25        3                 12-14 days                              
 
D0500I1  $M3YESNO                      SA of Res Mood - Neg Stmnt               
                          6,491                          Missing                                 
                             82        -                 Not assessed/no information             
                            805        0                 No                                      
                              2        1                 Yes                                     
 
D0500I2  $M3DEPRB                      SA of Res Mood - Neg Stmnt Freq          
                          6,491                          Missing                                 
                             85        -                 Not assessed/no information             
                            803        0                 Never or 1 day                          
                              1        1                 2 - 6 days                              
 
D0500J1  $M3YESNO                      SA of Res Mood - Short Temper            
                          6,491                          Missing                                 
                             77        -                 Not assessed/no information             
                            693        0                 No                                      
                            119        1                 Yes                                     
 
D0500J2  $M3DEPRB                      SA of Res Mood - Short Temper Freq       
                          6,491                          Missing                                 
                             77        -                 Not assessed/no information             
                            698        0                 Never or 1 day                          
                             64        1                 2 - 6 days                              
                             31        2                 7 - 11 days                             
                             19        3                 12-14 days                              
 
D0600                                  SA Tot Svrty Mood Score                  
                          7,380                          Range of Values                         
 
D0650    $M3YESNO                      SA of Res Mood - Neg Stmnt Notify        
                          7,378                          Missing                                 
                              2        1                 Yes                                     
 
E0100A   $M3INDIC                      Bhvr: Hallucinations                     
                          1,726                          Missing                                 
                             32        -                 Not assessed/no information             
                          5,543        0                 Not indicated                           
                             79        1                 Indicated                               
 
E0100B   $M3INDIC                      Bhvr: Delusion                           
                          1,726                          Missing                                 
                             32        -                 Not assessed/no information             
                          5,415        0                 Not indicated                           
                            207        1                 Indicated                               
 
E0100Z   $M3INDIC                      Bhvr: No Psychosis                       
                          1,726                          Missing                                 
                             32        -                 Not assessed/no information             
                            228        0                 Not indicated                           
                          5,394        1                 Indicated                               
 
E0200A   $M3BEHAV                      Bhvr: Phys Bhvral                        
                          1,726                          Missing                                 
                             50        -                 Not assessed/no information             
                          5,446        0                 Behavior not exhibited                  
                            126        1                 1 to 3 days                             
                             25        2                 4 to 6 days                             
                              7        3                 Behavior exhibited daily                
 
E0200B   $M3BEHAV                      Bhvr: Verbal Bhvral                      
                          1,726                          Missing                                 
                             50        -                 Not assessed/no information             
                          5,339        0                 Behavior not exhibited                  
                            205        1                 1 to 3 days                             
                             44        2                 4 to 6 days                             
                             16        3                 Behavior exhibited daily                
 
E0200C   $M3BEHAV                      Bhvr: Oth Bhvral                         
                          1,726                          Missing                                 
                             50        -                 Not assessed/no information             
                          5,419        0                 Behavior not exhibited                  
                            130        1                 1 to 3 days                             
                             38        2                 4 to 6 days                             
                             17        3                 Behavior exhibited daily                
 
E0300    $M3YESNO                      Overall Pres of Bhvral Sympt             
                          5,842                          Missing                                 
                              1        -                 Not assessed/no information             
                          1,409        0                 No                                      
                            128        1                 Yes                                     
 
E0500A   $M3YESNO                      Bhvr Imp on Res: Risk to Inj Self        
                          7,251                          Missing                                 
                              2        -                 Not assessed/no information             
                            104        0                 No                                      
                             23        1                 Yes                                     
 
E0500B   $M3YESNO                      Bhvr Imp on Res: Int W Care              
                          7,251                          Missing                                 
                              2        -                 Not assessed/no information             
                             88        0                 No                                      
                             39        1                 Yes                                     
 
E0500C   $M3YESNO                      Bhvr Imp on Res: Int W Part              
                          7,251                          Missing                                 
                              2        -                 Not assessed/no information             
                             99        0                 No                                      
                             28        1                 Yes                                     
 
E0600A   $M3YESNO                      Bhvr Imp on Oth: Risk to Inj Oth         
                          7,251                          Missing                                 
                              2        -                 Not assessed/no information             
                            106        0                 No                                      
                             21        1                 Yes                                     
 
E0600B   $M3YESNO                      Bhvr Imp on Oth: Intrude On Priv of Oth  
                          7,251                          Missing                                 
                              2        -                 Not assessed/no information             
                             99        0                 No                                      
                             28        1                 Yes                                     
 
E0600C   $M3YESNO                      Bhvr Imp on Oth: Dis Care or Living Env  
                          7,251                          Missing                                 
                              2        -                 Not assessed/no information             
                             85        0                 No                                      
                             42        1                 Yes                                     
 
E0800    $M3BEHAV                      Rejection of Care: Pres and Freq         
                          1,726                          Missing                                 
                             45        -                 Not assessed/no information             
                          5,223        0                 Behavior not exhibited                  
                            298        1                 1 to 3 days                             
                             65        2                 4 to 6 days                             
                             23        3                 Behavior exhibited daily                
 
E0900    $M3BEHAV                      Wandering: Pres and Freq                 
                          1,726                          Missing                                 
                             47        -                 Not assessed/no information             
                          5,417        0                 Behavior not exhibited                  
                            109        1                 1 to 3 days                             
                             35        2                 4 to 6 days                             
                             46        3                 Behavior exhibited daily                
 
E1000A   $M3YESNO                      Wander Risk Imp                          
                          7,324                          Missing                                 
                              2        -                 Not assessed/no information             
                             41        0                 No                                      
                             13        1                 Yes                                     
 
E1000B   $M3YESNO                      Wandering Intrudes on Priv of Oth        
                          7,324                          Missing                                 
                              2        -                 Not assessed/no information             
                             40        0                 No                                      
                             14        1                 Yes                                     
 
E1100    $M3CHNG                       Change in Bhvr or Oth Sympt              
                          5,842                          Missing                                 
                              5        -                 Not assessed/no information             
                            840        0                 Same                                    
                             30        1                 Improved                                
                             40        2                 Worse                                   
                            623        3                 N/A                                     
 
F0300    $M3YESNO                      Should Dly and Act Pref Int Be Cond      
                          5,842                          Missing                                 
                             13        -                 Not assessed/no information             
                            141        0                 No                                      
                          1,384        1                 Yes                                     
 
F0400A   $M3IMPRT                      Int for Dly Pref: Chooses Clothes        
                          5,983                          Missing                                 
                             16        -                 Not assessed/no information             
                            712        1                 Very important                          
                            391        2                 Somewhat important                      
                            207        3                 Not very important                      
                             43        4                 Not important at all                    
                              5        5                 Important, but cannot do or no choice   
                             23        9                 No response or non-responsive           
 
F0400B   $M3IMPRT                      Int for Dly Pref: Care Personal Items    
                          5,983                          Missing                                 
                             18        -                 Not assessed/no information             
                            878        1                 Very important                          
                            334        2                 Somewhat important                      
                             95        3                 Not very important                      
                             25        4                 Not important at all                    
                             24        5                 Important, but cannot do or no choice   
                             23        9                 No response or non-responsive           
 
F0400C   $M3IMPRT                      Int for Dly Pref: Bathing Option         
                          5,983                          Missing                                 
                             17        -                 Not assessed/no information             
                            852        1                 Very important                          
                            355        2                 Somewhat important                      
                            117        3                 Not very important                      
                             20        4                 Not important at all                    
                             13        5                 Important, but cannot do or no choice   
                             23        9                 No response or non-responsive           
 
F0400D   $M3IMPRT                      Int for Dly Pref: Snack Between Meals    
                          5,983                          Missing                                 
                             18        -                 Not assessed/no information             
                            584        1                 Very important                          
                            487        2                 Somewhat important                      
                            225        3                 Not very important                      
                             53        4                 Not important at all                    
                             10        5                 Important, but cannot do or no choice   
                             20        9                 No response or non-responsive           
 
F0400E   $M3IMPRT                      Int for Dly Pref: Choose Bed Time        
                          5,983                          Missing                                 
                             18        -                 Not assessed/no information             
                            923        1                 Very important                          
                            301        2                 Somewhat important                      
                            106        3                 Not very important                      
                             23        4                 Not important at all                    
                              1        5                 Important, but cannot do or no choice   
                             25        9                 No response or non-responsive           
 
F0400F   $M3IMPRT                      Int for Dly Pref: Fam Involvement        
                          5,983                          Missing                                 
                             19        -                 Not assessed/no information             
                          1,085        1                 Very important                          
                            172        2                 Somewhat important                      
                             55        3                 Not very important                      
                             31        4                 Not important at all                    
                              8        5                 Important, but cannot do or no choice   
                             27        9                 No response or non-responsive           
 
F0400G   $M3IMPRT                      Int for Dly Pref: Priv Phone Time        
                          5,983                          Missing                                 
                             19        -                 Not assessed/no information             
                            455        1                 Very important                          
                            333        2                 Somewhat important                      
                            369        3                 Not very important                      
                            184        4                 Not important at all                    
                             11        5                 Important, but cannot do or no choice   
                             26        9                 No response or non-responsive           
 
F0400H   $M3IMPRT                      Int for Dly Pref: Lock Item              
                          5,983                          Missing                                 
                             20        -                 Not assessed/no information             
                            448        1                 Very important                          
                            313        2                 Somewhat important                      
                            396        3                 Not very important                      
                            188        4                 Not important at all                    
                              8        5                 Important, but cannot do or no choice   
                             24        9                 No response or non-responsive           
 
F0500A   $M3IMPRT                      Int for Act Pref: Reading Mat Available  
                          5,983                          Missing                                 
                             18        -                 Not assessed/no information             
                            531        1                 Very important                          
                            420        2                 Somewhat important                      
                            295        3                 Not very important                      
                             89        4                 Not important at all                    
                             22        5                 Important, but cannot do or no choice   
                             22        9                 No response or non-responsive           
 
F0500B   $M3IMPRT                      Int for Act Pref: Music                  
                          5,983                          Missing                                 
                             18        -                 Not assessed/no information             
                            676        1                 Very important                          
                            473        2                 Somewhat important                      
                            166        3                 Not very important                      
                             37        4                 Not important at all                    
                              5        5                 Important, but cannot do or no choice   
                             22        9                 No response or non-responsive           
 
F0500C   $M3IMPRT                      Int for Act Pref: Animal Pres            
                          7,244                          Missing                                 
                            132        E                 E                                       
                              4        S                 S                                       
 
F0500D   $M3IMPRT                      Int for Act Pref: News                   
                          5,983                          Missing                                 
                             18        -                 Not assessed/no information             
                            670        1                 Very important                          
                            424        2                 Somewhat important                      
                            195        3                 Not very important                      
                             64        4                 Not important at all                    
                              2        5                 Important, but cannot do or no choice   
                             24        9                 No response or non-responsive           
 
F0500E   $M3IMPRT                      Int for Act Pref: Group Act              
                          5,983                          Missing                                 
                             18        -                 Not assessed/no information             
                            434        1                 Very important                          
                            536        2                 Somewhat important                      
                            295        3                 Not very important                      
                             80        4                 Not important at all                    
                              7        5                 Important, but cannot do or no choice   
                             27        9                 No response or non-responsive           
 
F0500F   $M3IMPRT                      Int for Act Pref: Favorite Act           
                          5,983                          Missing                                 
                             18        -                 Not assessed/no information             
                            803        1                 Very important                          
                            436        2                 Somewhat important                      
                             80        3                 Not very important                      
                             16        4                 Not important at all                    
                             18        5                 Important, but cannot do or no choice   
                             26        9                 No response or non-responsive           
 
F0500G   $M3IMPRT                      Int for Act Pref: Time Outdoors          
                          5,983                          Missing                                 
                             18        -                 Not assessed/no information             
                            746        1                 Very important                          
                            426        2                 Somewhat important                      
                            146        3                 Not very important                      
                             23        4                 Not important at all                    
                             14        5                 Important, but cannot do or no choice   
                             24        9                 No response or non-responsive           
 
F0500H   $M3IMPRT                      Int for Act Pref: Religion               
                          5,983                          Missing                                 
                             18        -                 Not assessed/no information             
                            655        1                 Very important                          
                            376        2                 Somewhat important                      
                            229        3                 Not very important                      
                             88        4                 Not important at all                    
                              6        5                 Important, but cannot do or no choice   
                             25        9                 No response or non-responsive           
 
F0600    $M3PRIRS                      Dly and Act Pref Primary Respondent      
                          5,983                          Missing                                 
                             17        -                 Not assessed/no information             
                          1,203        1                 Resident                                
                            149        2                 Family or significant other             
                             28        9                 Interview could not be completed        
 
F0700    $M3YESNO                      Cond SA of Dly and Act Pref              
                          5,983                          Missing                                 
                             10        -                 Not assessed/no information             
                          1,352        0                 No                                      
                             35        1                 Yes                                     
 
F0800A   $M3INDIC                      SA: Chooses Clothes                      
                          7,194                          Missing                                 
                             10        -                 Not assessed/no information             
                            137        0                 Not indicated                           
                             39        1                 Indicated                               
 
F0800B   $M3INDIC                      SA: Care Personal Item                   
                          7,194                          Missing                                 
                             11        -                 Not assessed/no information             
                            137        0                 Not indicated                           
                             38        1                 Indicated                               
 
F0800C   $M3INDIC                      SA: Tub Bath                             
                          7,194                          Missing                                 
                             12        -                 Not assessed/no information             
                            160        0                 Not indicated                           
                             14        1                 Indicated                               
 
F0800D   $M3INDIC                      SA: Shower                               
                          7,194                          Missing                                 
                             10        -                 Not assessed/no information             
                             56        0                 Not indicated                           
                            120        1                 Indicated                               
 
F0800E   $M3INDIC                      SA: Bed Bath                             
                          7,194                          Missing                                 
                             11        -                 Not assessed/no information             
                            137        0                 Not indicated                           
                             38        1                 Indicated                               
 
F0800F   $M3INDIC                      SA: Sponge Bath                          
                          7,194                          Missing                                 
                             11        -                 Not assessed/no information             
                            146        0                 Not indicated                           
                             29        1                 Indicated                               
 
F0800G   $M3INDIC                      SA: Snacks Between                       
                          7,194                          Missing                                 
                             11        -                 Not assessed/no information             
                             80        0                 Not indicated                           
                             95        1                 Indicated                               
 
F0800H   $M3INDIC                      SA: Bed Time                             
                          7,194                          Missing                                 
                             11        -                 Not assessed/no information             
                            143        0                 Not indicated                           
                             32        1                 Indicated                               
 
F0800I   $M3INDIC                      SA: Fam Involvement                      
                          7,194                          Missing                                 
                             10        -                 Not assessed/no information             
                             43        0                 Not indicated                           
                            133        1                 Indicated                               
 
F0800J   $M3INDIC                      SA: Priv Phone                           
                          7,194                          Missing                                 
                             11        -                 Not assessed/no information             
                            160        0                 Not indicated                           
                             15        1                 Indicated                               
 
F0800K   $M3INDIC                      SA: Lock Item                            
                          7,194                          Missing                                 
                             10        -                 Not assessed/no information             
                            141        0                 Not indicated                           
                             35        1                 Indicated                               
 
F0800L   $M3INDIC                      SA: Reading Mat Available                
                          7,194                          Missing                                 
                             13        -                 Not assessed/no information             
                            135        0                 Not indicated                           
                             38        1                 Indicated                               
 
F0800M   $M3INDIC                      SA: Music                                
                          7,194                          Missing                                 
                             10        -                 Not assessed/no information             
                             35        0                 Not indicated                           
                            141        1                 Indicated                               
 
F0800N   $M3INDIC                      SA: Animal Pres                          
                          7,194                          Missing                                 
                             10        -                 Not assessed/no information             
                            122        0                 Not indicated                           
                             54        1                 Indicated                               
 
F0800O   $M3INDIC                      SA: News                                 
                          7,194                          Missing                                 
                             12        -                 Not assessed/no information             
                            148        0                 Not indicated                           
                             26        1                 Indicated                               
 
F0800P   $M3INDIC                      SA: Group Act                            
                          7,194                          Missing                                 
                             12        -                 Not assessed/no information             
                             87        0                 Not indicated                           
                             87        1                 Indicated                               
 
F0800Q   $M3INDIC                      SA: Favorite Act                         
                          7,194                          Missing                                 
                             12        -                 Not assessed/no information             
                             68        0                 Not indicated                           
                            106        1                 Indicated                               
 
F0800R   $M3INDIC                      SA: Time Away Nrs Home                   
                          7,194                          Missing                                 
                             10        -                 Not assessed/no information             
                            168        0                 Not indicated                           
                              8        1                 Indicated                               
 
F0800S   $M3INDIC                      SA: Time Outdoors                        
                          7,194                          Missing                                 
                             10        -                 Not assessed/no information             
                            107        0                 Not indicated                           
                             69        1                 Indicated                               
 
F0800T   $M3INDIC                      SA: Part in Rel Act                      
                          7,194                          Missing                                 
                             11        -                 Not assessed/no information             
                             77        0                 Not indicated                           
                             98        1                 Indicated                               
 
F0800Z   $M3INDIC                      SA: None of Above Act                    
                          7,194                          Missing                                 
                             10        -                 Not assessed/no information             
                            163        0                 Not indicated                           
                             13        1                 Indicated                               
 
G0110A1  $M3ADLCT                      ADL Ass: Bed Mob Self Perf               
                          1,723                          Missing                                 
                              2        -                 Not assessed/no information             
                            291        0                 Independent                             
                            568        1                 Supervision                             
                            858        2                 Limited assistance                      
                          3,533        3                 Extensive assistance                    
                            389        4                 Total dependence                        
                             15        7                 Activity occurred only once or twice    
                              1        8                 Activity did not occur                  
 
G0110A2  $M3ADLSP                      ADL Ass: Bed Mob Supp Prov               
                          2,856                          Missing                                 
                            177        0                 No setup or physical help from staff    
                            254        1                 Setup help only                         
                          2,214        2                 One person physical assist              
                          1,879        3                 Two+ persons physical assist            
 
G0110B1  $M3ADLCT                      ADL Ass: Trans Self Perf                 
                          1,723                          Missing                                 
                              2        -                 Not assessed/no information             
                            223        0                 Independent                             
                            590        1                 Supervision                             
                            943        2                 Limited assistance                      
                          3,131        3                 Extensive assistance                    
                            581        4                 Total dependence                        
                             92        7                 Activity occurred only once or twice    
                             95        8                 Activity did not occur                  
 
G0110B2  $M3ADLSP                      ADL Ass: Trans Self Supp Prov            
                          2,856                          Missing                                 
                              1        -                 Not assessed/no information             
                            160        0                 No setup or physical help from staff    
                            252        1                 Setup help only                         
                          2,061        2                 One person physical assist              
                          1,982        3                 Two+ persons physical assist            
                             68        8                 ADL activity did not occur              
 
G0110C1  $M3ADLCT                      ADL Ass: Wlk In Room Self Perf           
                          1,859                          Missing                                 
                              3        -                 Not assessed/no information             
                            244        0                 Independent                             
                            757        1                 Supervision                             
                            884        2                 Limited assistance                      
                            853        3                 Extensive assistance                    
                             11        4                 Total dependence                        
                            331        7                 Activity occurred only once or twice    
                          2,438        8                 Activity did not occur                  
 
G0110C2  $M3ADLSP                      ADL Ass: Wlk In Room Supp Prov           
                          2,993                          Missing                                 
                              1        -                 Not assessed/no information             
                            196        0                 No setup or physical help from staff    
                            356        1                 Setup help only                         
                          1,565        2                 One person physical assist              
                            198        3                 Two+ persons physical assist            
                          2,071        8                 ADL activity did not occur              
 
G0110D1  $M3ADLCT                      ADL Ass: Wlk In Corr Self Perf           
                          1,859                          Missing                                 
                              4        -                 Not assessed/no information             
                            211        0                 Independent                             
                            756        1                 Supervision                             
                            797        2                 Limited assistance                      
                            751        3                 Extensive assistance                    
                             11        4                 Total dependence                        
                            417        7                 Activity occurred only once or twice    
                          2,574        8                 Activity did not occur                  
 
G0110D2  $M3ADLSP                      ADL Ass: Wlk In Corr Self Supp Prov      
                          2,993                          Missing                                 
                              2        -                 Not assessed/no information             
                            193        0                 No setup or physical help from staff    
                            348        1                 Setup help only                         
                          1,499        2                 One person physical assist              
                            155        3                 Two+ persons physical assist            
                          2,190        8                 ADL activity did not occur              
 
G0110E1  $M3ADLCT                      ADL Ass: Loc On Self Perf                
                          1,859                          Missing                                 
                              4        -                 Not assessed/no information             
                            382        0                 Independent                             
                          1,025        1                 Supervision                             
                            889        2                 Limited assistance                      
                          2,085        3                 Extensive assistance                    
                            760        4                 Total dependence                        
                            161        7                 Activity occurred only once or twice    
                            215        8                 Activity did not occur                  
 
G0110E2  $M3ADLSP                      ADL Ass: Loc On Supp Prov                
                          2,993                          Missing                                 
                            253        0                 No setup or physical help from staff    
                            493        1                 Setup help only                         
                          3,320        2                 One person physical assist              
                            144        3                 Two+ persons physical assist            
                            177        8                 ADL activity did not occur              
 
G0110F1  $M3ADLCT                      ADL Ass: Loc Off Self Perf               
                          1,859                          Missing                                 
                              4        -                 Not assessed/no information             
                            316        0                 Independent                             
                            948        1                 Supervision                             
                            690        2                 Limited assistance                      
                          1,824        3                 Extensive assistance                    
                            871        4                 Total dependence                        
                            408        7                 Activity occurred only once or twice    
                            460        8                 Activity did not occur                  
 
G0110F2  $M3ADLSP                      ADL Ass: Loc Off Supp Prov               
                          2,993                          Missing                                 
                            228        0                 No setup or physical help from staff    
                            461        1                 Setup help only                         
                          3,205        2                 One person physical assist              
                            112        3                 Two+ persons physical assist            
                            381        8                 ADL activity did not occur              
 
G0110G1  $M3ADLCT                      ADL Ass: Dress Self Perf                 
                          1,859                          Missing                                 
                              4        -                 Not assessed/no information             
                            151        0                 Independent                             
                            453        1                 Supervision                             
                            807        2                 Limited assistance                      
                          3,563        3                 Extensive assistance                    
                            511        4                 Total dependence                        
                             27        7                 Activity occurred only once or twice    
                              5        8                 Activity did not occur                  
 
G0110G2  $M3ADLSP                      ADL Ass: Dress Supp Prov                 
                          2,993                          Missing                                 
                             75        0                 No setup or physical help from staff    
                            165        1                 Setup help only                         
                          3,459        2                 One person physical assist              
                            685        3                 Two+ persons physical assist            
                              3        8                 ADL activity did not occur              
 
G0110H1  $M3ADLCT                      ADL Ass: Eating Self Perf                
                          1,723                          Missing                                 
                              2        -                 Not assessed/no information             
                          1,383        0                 Independent                             
                          2,563        1                 Supervision                             
                            582        2                 Limited assistance                      
                            806        3                 Extensive assistance                    
                            286        4                 Total dependence                        
                             27        7                 Activity occurred only once or twice    
                              8        8                 Activity did not occur                  
 
G0110H2  $M3ADLSP                      ADL Ass: Eating Supp Prov                
                          2,856                          Missing                                 
                             92        0                 No setup or physical help from staff    
                          2,470        1                 Setup help only                         
                          1,939        2                 One person physical assist              
                             17        3                 Two+ persons physical assist            
                              6        8                 ADL activity did not occur              
 
G0110I1  $M3ADLCT                      ADL Ass: Toileting Self Perf             
                          1,723                          Missing                                 
                              2        -                 Not assessed/no information             
                            174        0                 Independent                             
                            476        1                 Supervision                             
                            798        2                 Limited assistance                      
                          3,524        3                 Extensive assistance                    
                            649        4                 Total dependence                        
                             25        7                 Activity occurred only once or twice    
                              9        8                 Activity did not occur                  
 
G0110I2  $M3ADLSP                      ADL Ass: Toileting Supp Prov             
                          2,856                          Missing                                 
                             99        0                 No setup or physical help from staff    
                            198        1                 Setup help only                         
                          2,695        2                 One person physical assist              
                          1,527        3                 Two+ persons physical assist            
                              5        8                 ADL activity did not occur              
 
G0110J1  $M3ADLCT                      ADL Ass: Personal Hygiene Self Perf      
                          1,859                          Missing                                 
                              3        -                 Not assessed/no information             
                            202        0                 Independent                             
                            685        1                 Supervision                             
                            971        2                 Limited assistance                      
                          3,055        3                 Extensive assistance                    
                            555        4                 Total dependence                        
                             38        7                 Activity occurred only once or twice    
                             12        8                 Activity did not occur                  
 
G0110J2  $M3ADLSP                      ADL Ass: Personal Hygiene Supp Prov      
                          2,993                          Missing                                 
                             74        0                 No setup or physical help from staff    
                            301        1                 Setup help only                         
                          3,566        2                 One person physical assist              
                            438        3                 Two+ persons physical assist            
                              8        8                 ADL activity did not occur              
 
G0120A   $M3ADLCT                      ADL Ass: Bathing Self Perf               
                          1,859                          Missing                                 
                             11        -                 Not assessed/no information             
                             82        0                 Independent                             
                            199        1                 Supervision                             
                            321        2                 Limited assistance                      
                          2,644        3                 Extensive assistance                    
                          1,975        4                 Total dependence                        
                            289        8                 Activity did not occur                  
 
G0120B   $M3ADLSP                      ADL Ass: Bathing Supp Prov               
                          2,993                          Missing                                 
                              5        -                 Not assessed/no information             
                             34        0                 No setup or physical help from staff    
                            120        1                 Setup help only                         
                          3,317        2                 One person physical assist              
                            710        3                 Two+ persons physical assist            
                            201        8                 ADL activity did not occur              
 
G0300A   $M3BAL                        Blnce Dur Seated to Standing Pos         
                          2,993                          Missing                                 
                             15        -                 Not assessed/no information             
                            260        0                 Steady at all times                     
                            741        1                 Not steady, but able to stabilize w/o as
                          2,672        2                 Not steady, only able to stabilize w/ as
                            699        8                 Activity did not occur                  
 
G0300B   $M3BAL                        Blnce Dur Wlking                         
                          2,993                          Missing                                 
                             13        -                 Not assessed/no information             
                            262        0                 Steady at all times                     
                            774        1                 Not steady, but able to stabilize w/o as
                          1,459        2                 Not steady, only able to stabilize w/ as
                          1,879        8                 Activity did not occur                  
 
G0300C   $M3BAL                        Blnce When Turning Around                
                          2,993                          Missing                                 
                             26        -                 Not assessed/no information             
                            252        0                 Steady at all times                     
                            739        1                 Not steady, but able to stabilize w/o as
                          1,291        2                 Not steady, only able to stabilize w/ as
                          2,079        8                 Activity did not occur                  
 
G0300D   $M3BAL                        Blnce Moving On and Off Toilet           
                          2,993                          Missing                                 
                             14        -                 Not assessed/no information             
                            247        0                 Steady at all times                     
                            681        1                 Not steady, but able to stabilize w/o as
                          2,537        2                 Not steady, only able to stabilize w/ as
                            908        8                 Activity did not occur                  
 
G0300E   $M3BAL                        Blnce W Surface to Surface Trans         
                          2,993                          Missing                                 
                              7        -                 Not assessed/no information             
                            252        0                 Steady at all times                     
                            703        1                 Not steady, but able to stabilize w/o as
                          3,254        2                 Not steady, only able to stabilize w/ as
                            171        8                 Activity did not occur                  
 
G0400A   $M3RANGE                      Func Lim in ROM: Upper Ext Mtn           
                          2,993                          Missing                                 
                             10        -                 Not assessed/no information             
                          3,461        0                 No impairment                           
                            572        1                 Impairment on one side                  
                            344        2                 Impairment on both sides                
 
G0400B   $M3RANGE                      Func Lim in ROM: Lower Ext Mtn           
                          2,993                          Missing                                 
                              8        -                 Not assessed/no information             
                          2,984        0                 No impairment                           
                            717        1                 Impairment on one side                  
                            678        2                 Impairment on both sides                
 
G0600A   $M3INDIC                      Mob Devices: Cane                        
                          2,993                          Missing                                 
                          4,283        0                 Not indicated                           
                            104        1                 Indicated                               
 
G0600B   $M3INDIC                      Mob Devices: Wlker                       
                          2,993                          Missing                                 
                              2        -                 Not assessed/no information             
                          2,356        0                 Not indicated                           
                          2,029        1                 Indicated                               
 
G0600C   $M3INDIC                      Mob Devices: Wheelchair                  
                          2,993                          Missing                                 
                            871        0                 Not indicated                           
                          3,516        1                 Indicated                               
 
G0600D   $M3INDIC                      Mob Devices: Limb Prosthesis             
                          2,993                          Missing                                 
                          4,378        0                 Not indicated                           
                              9        1                 Indicated                               
 
G0600Z   $M3INDIC                      Mob Devices: None of Above               
                          2,993                          Missing                                 
                          3,944        0                 Not indicated                           
                            443        1                 Indicated                               
 
G0900A   $M3YNDET                      Func Rehab Pot: Res Increased Ind        
                          6,619                          Missing                                 
                              6        -                 Not assessed/no information             
                             45        0                 No                                      
                            652        1                 Yes                                     
                             58        9                 Unable to determine                     
 
G0900B   $M3YESNO                      Func Rehab Pot: Staff Increased Ind      
                          6,619                          Missing                                 
                              6        -                 Not assessed/no information             
                             63        0                 No                                      
                            692        1                 Yes                                     
 
H0100A   $M3INDIC                      Bldr and Bwl App: Indwelling Cath        
                          1,859                          Missing                                 
                          5,139        0                 Not indicated                           
                            382        1                 Indicated                               
 
H0100B   $M3INDIC                      Bldr and Bwl App: Ext Cath               
                          1,859                          Missing                                 
                          5,508        0                 Not indicated                           
                             13        1                 Indicated                               
 
H0100C   $M3INDIC                      Bldr and Bwl App: Ostomy                 
                          1,859                          Missing                                 
                          5,423        0                 Not indicated                           
                             98        1                 Indicated                               
 
H0100D   $M3INDIC                      Bldr and Bwl App: Imt Cath               
                          1,859                          Missing                                 
                          5,498        0                 Not indicated                           
                             23        1                 Indicated                               
 
H0100Z   $M3INDIC                      Bldr and Bwl App: No Urny App            
                          1,859                          Missing                                 
                            479        0                 Not indicated                           
                          5,042        1                 Indicated                               
 
H0200A   $M3YNDET                      Urny Toil Prog: Trial Toileting Prog     
                          2,856                          Missing                                 
                              9        -                 Not assessed/no information             
                          4,008        0                 No                                      
                            459        1                 Yes                                     
                             48        9                 Unable to determine                     
 
H0200B   $M3TOILT                      Urny Toil Prog: Resp To Toileting Prog   
                          7,232                          Missing                                 
                             11        -                 Not assessed/no information             
                             64        0                 No improvement                          
                             28        1                 Decreased wetness                       
                             15        2                 Completely dry                          
                             30        9                 Unable to determine                     
 
H0200C   $M3YESNO                      Urny Toil Prog: Cur Toileting Prog       
                          6,864                          Missing                                 
                             12        -                 Not assessed/no information             
                            200        0                 No                                      
                            304        1                 Yes                                     
 
H0300    $M3CONT                       Urny Continence                          
                          1,859                          Missing                                 
                              5        -                 Not assessed/no information             
                          1,281        0                 Always continent                        
                          1,190        1                 Occasionally incontinent                
                          1,448        2                 Frequently incontinent                  
                          1,260        3                 Always incontinent                      
                            337        9                 Not rated                               
 
H0400    $M3CONT                       Bwl Continence                           
                          1,859                          Missing                                 
                              5        -                 Not assessed/no information             
                          2,240        0                 Always continent                        
                            647        1                 Occasionally incontinent                
                          1,161        2                 Frequently incontinent                  
                          1,346        3                 Always incontinent                      
                            122        9                 Not rated                               
 
H0500    $M3YESNO                      Bwl Toileting Prog                       
                          2,856                          Missing                                 
                              5        -                 Not assessed/no information             
                          4,378        0                 No                                      
                            141        1                 Yes                                     
 
H0600    $M3YESNO                      Constipation                             
                          5,842                          Missing                                 
                          1,467        0                 No                                      
                             71        1                 Yes                                     
 
I0100    $M3INDIC                      Actv Diag: Cancer                        
                          5,842                          Missing                                 
                          1,420        0                 Not indicated                           
                            118        1                 Indicated                               
 
I0200    $M3INDIC                      Actv Diag: Anemia                        
                          2,993                          Missing                                 
                              1        -                 Not assessed/no information             
                          3,167        0                 Not indicated                           
                          1,219        1                 Indicated                               
 
I0300    $M3INDIC                      Actv Diag: Dysrhythmia                   
                          5,842                          Missing                                 
                          1,153        0                 Not indicated                           
                            385        1                 Indicated                               
 
I0400    $M3INDIC                      Actv Diag: Coronary Artery Dis (CAD)     
                          5,842                          Missing                                 
                              1        -                 Not assessed/no information             
                          1,192        0                 Not indicated                           
                            345        1                 Indicated                               
 
I0500    $M3INDIC                      Actv Diag: Deep Vein Thrombosis (DVT)    
                          5,842                          Missing                                 
                          1,485        0                 Not indicated                           
                             53        1                 Indicated                               
 
I0600    $M3INDIC                      Actv Diag: Heart Failure (CHF)           
                          2,993                          Missing                                 
                          3,318        0                 Not indicated                           
                          1,069        1                 Indicated                               
 
I0700    $M3INDIC                      Actv Diag: Hypertension                  
                          2,993                          Missing                                 
                            931        0                 Not indicated                           
                          3,456        1                 Indicated                               
 
I0800    $M3INDIC                      Actv Diag: Hypotension                   
                          2,993                          Missing                                 
                          4,300        0                 Not indicated                           
                             87        1                 Indicated                               
 
I0900    $M3INDIC                      Actv Diag: (PVD)                         
                          1,859                          Missing                                 
                              1        -                 Not assessed/no information             
                          4,845        0                 Not indicated                           
                            675        1                 Indicated                               
 
I1100    $M3INDIC                      Actv Diag: Cirrhosis                     
                          5,842                          Missing                                 
                          1,524        0                 Not indicated                           
                             14        1                 Indicated                               
 
I1200    $M3INDIC                      Actv Diag:  (GERD)                       
                          5,842                          Missing                                 
                          1,002        0                 Not indicated                           
                            536        1                 Indicated                               
 
I1300    $M3INDIC                      Actv Diag: Ulcrative Colitis             
                          5,842                          Missing                                 
                          1,520        0                 Not indicated                           
                             18        1                 Indicated                               
 
I1400    $M3INDIC                      Actv Diag: (BPH)                         
                          5,842                          Missing                                 
                          1,398        0                 Not indicated                           
                            140        1                 Indicated                               
 
I1500    $M3INDIC                      Actv Diag: (ESRD)                        
                          5,842                          Missing                                 
                          1,246        0                 Not indicated                           
                            292        1                 Indicated                               
 
I1550    $M3INDIC                      Actv Diag: Neurogenic Bldr               
                          1,859                          Missing                                 
                              1        -                 Not assessed/no information             
                          5,380        0                 Not indicated                           
                            140        1                 Indicated                               
 
I1650    $M3INDIC                      Actv Diag: Obstructive Uropathy          
                          1,859                          Missing                                 
                              1        -                 Not assessed/no information             
                          5,447        0                 Not indicated                           
                             73        1                 Indicated                               
 
I1700    $M3INDIC                      Actv Diag: (MDRO)                        
                          2,993                          Missing                                 
                          4,361        0                 Not indicated                           
                             26        1                 Indicated                               
 
I2000    $M3INDIC                      Actv Diag: Pneumonia                     
                          2,859                          Missing                                 
                          4,283        0                 Not indicated                           
                            238        1                 Indicated                               
 
I2100    $M3INDIC                      Actv Diag: Septicemia                    
                          2,859                          Missing                                 
                          4,444        0                 Not indicated                           
                             77        1                 Indicated                               
 
I2200    $M3INDIC                      Actv Diag: Tuberculosis                  
                          2,993                          Missing                                 
                          4,385        0                 Not indicated                           
                              2        1                 Indicated                               
 
I2300    $M3INDIC                      Actv Diag: Urny Tract Infn (UTI)         
                          1,859                          Missing                                 
                              2        -                 Not assessed/no information             
                          5,144        0                 Not indicated                           
                            375        1                 Indicated                               
 
I2400    $M3INDIC                      Actv Diag: Viral Hepatitis               
                          2,993                          Missing                                 
                          4,357        0                 Not indicated                           
                             30        1                 Indicated                               
 
I2500    $M3INDIC                      Wound Infn                               
                          2,993                          Missing                                 
                          4,360        0                 Not indicated                           
                             27        1                 Indicated                               
 
I2900    $M3INDIC                      Actv Diag: Diabetes Mellitus (DM)        
                          1,726                          Missing                                 
                              1        -                 Not assessed/no information             
                          3,713        0                 Not indicated                           
                          1,940        1                 Indicated                               
 
I3100    $M3INDIC                      Actv Diag: Hyponatremia                  
                          2,993                          Missing                                 
                          4,302        0                 Not indicated                           
                             85        1                 Indicated                               
 
I3200    $M3INDIC                      Actv Diag: Hyperkalemia                  
                          2,993                          Missing                                 
                          4,323        0                 Not indicated                           
                             64        1                 Indicated                               
 
I3300    $M3INDIC                      Actv Diag: Hyperlipidemia                
                          2,993                          Missing                                 
                              1        -                 Not assessed/no information             
                          2,373        0                 Not indicated                           
                          2,013        1                 Indicated                               
 
I3400    $M3INDIC                      Actv Diag: Thyroid                       
                          5,842                          Missing                                 
                              1        -                 Not assessed/no information             
                          1,152        0                 Not indicated                           
                            385        1                 Indicated                               
 
I3700    $M3INDIC                      Actv Diag: Arthritis                     
                          5,842                          Missing                                 
                          1,054        0                 Not indicated                           
                            484        1                 Indicated                               
 
I3800    $M3INDIC                      Actv Diag: Osteoporosis                  
                          5,842                          Missing                                 
                          1,337        0                 Not indicated                           
                            201        1                 Indicated                               
 
I3900    $M3INDIC                      Actv Diag: Hip Fracture                  
                          2,993                          Missing                                 
                          4,187        0                 Not indicated                           
                            200        1                 Indicated                               
 
I4000    $M3INDIC                      Actv Diag: Oth Fracture                  
                          2,993                          Missing                                 
                              3        -                 Not assessed/no information             
                          4,065        0                 Not indicated                           
                            319        1                 Indicated                               
 
I4200    $M3INDIC                      Actv Diag: Alzheimers Disease            
                          2,993                          Missing                                 
                          3,751        0                 Not indicated                           
                            636        1                 Indicated                               
 
I4300    $M3INDIC                      Actv Diag: Aphasia                       
                          2,993                          Missing                                 
                              1        -                 Not assessed/no information             
                          4,258        0                 Not indicated                           
                            128        1                 Indicated                               
 
I4400    $M3INDIC                      Actv Diag: Cerebral Palsy                
                          2,859                          Missing                                 
                          4,510        0                 Not indicated                           
                             11        1                 Indicated                               
 
I4500    $M3INDIC                      Actv Diag: (CVA or TIA or Stroke)        
                          2,993                          Missing                                 
                          3,916        0                 Not indicated                           
                            471        1                 Indicated                               
 
I4800    $M3INDIC                      Actv Diag: Dementia                      
                          2,993                          Missing                                 
                              5        -                 Not assessed/no information             
                          2,551        0                 Not indicated                           
                          1,831        1                 Indicated                               
 
I4900    $M3INDIC                      Actv Diag: Hemiplegia                    
                          2,859                          Missing                                 
                          4,173        0                 Not indicated                           
                            348        1                 Indicated                               
 
I5000    $M3INDIC                      Actv Diag: Paraplegia                    
                          2,993                          Missing                                 
                          4,377        0                 Not indicated                           
                             10        1                 Indicated                               
 
I5100    $M3INDIC                      Actv Diag: Quadriplegia                  
                          2,859                          Missing                                 
                          4,492        0                 Not indicated                           
                             29        1                 Indicated                               
 
I5200    $M3INDIC                      Actv Diag: Multiple Sclerosis            
                          2,859                          Missing                                 
                          4,503        0                 Not indicated                           
                             18        1                 Indicated                               
 
I5250    $M3INDIC                      Actv Diag: Huntingtons                   
                          1,859                          Missing                                 
                              1        -                 Not assessed/no information             
                          5,512        0                 Not indicated                           
                              8        1                 Indicated                               
 
I5300    $M3INDIC                      Actv Diag: Parkinsons                    
                          2,859                          Missing                                 
                          4,212        0                 Not indicated                           
                            309        1                 Indicated                               
 
I5350    $M3INDIC                      Tourettes                                
                          1,859                          Missing                                 
                              1        -                 Not assessed/no information             
                          5,520        0                 Not indicated                           
 
I5400    $M3INDIC                      Actv Diag: Seizure                       
                          2,993                          Missing                                 
                          4,060        0                 Not indicated                           
                            327        1                 Indicated                               
 
I5500    $M3INDIC                      Actv Diag: Traumatic Brain Inj (TBI)     
                          2,993                          Missing                                 
                          4,358        0                 Not indicated                           
                             29        1                 Indicated                               
 
I5600    $M3INDIC                      Actv Diag: Malnutrition                  
                          1,859                          Missing                                 
                              1        -                 Not assessed/no information             
                          5,319        0                 Not indicated                           
                            201        1                 Indicated                               
 
I5700    $M3INDIC                      Actv Diag: Anxiety Disorder              
                          1,859                          Missing                                 
                          4,023        0                 Not indicated                           
                          1,498        1                 Indicated                               
 
I5800    $M3INDIC                      Actv Diag: Depression                    
                          2,993                          Missing                                 
                          2,259        0                 Not indicated                           
                          2,128        1                 Indicated                               
 
I5900    $M3INDIC                      Actv Diag: Manic Depression              
                          1,859                          Missing                                 
                              1        -                 Not assessed/no information             
                          5,339        0                 Not indicated                           
                            181        1                 Indicated                               
 
I5950    $M3INDIC                      Actv Diag: Psychotic                     
                          1,859                          Missing                                 
                              1        -                 Not assessed/no information             
                          5,192        0                 Not indicated                           
                            328        1                 Indicated                               
 
I6000    $M3INDIC                      Actv Diag: Schizophrenia                 
                          1,859                          Missing                                 
                              1        -                 Not assessed/no information             
                          5,228        0                 Not indicated                           
                            292        1                 Indicated                               
 
I6100    $M3INDIC                      Actv Diag:  (PTSD)                       
                          1,859                          Missing                                 
                              1        -                 Not assessed/no information             
                          5,514        0                 Not indicated                           
                              6        1                 Indicated                               
 
I6200    $M3INDIC                      Actv Diag: Asth, COPD, Chron Lung Dis    
                          2,859                          Missing                                 
                          3,479        0                 Not indicated                           
                          1,042        1                 Indicated                               
 
I6300    $M3INDIC                      Actv Diag: Resp Failure                  
                          2,859                          Missing                                 
                          4,347        0                 Not indicated                           
                            174        1                 Indicated                               
 
I6500    $M3INDIC                      Actv Diag: Cataracts, Glauc or Mac Deg   
                          5,842                          Missing                                 
                          1,291        0                 Not indicated                           
                            247        1                 Indicated                               
 
I7900    $M3INDIC                      Actv Diag: No Actv Disease               
                          5,842                          Missing                                 
                          1,524        0                 Not indicated                           
                             14        1                 Indicated                               
 
I8000A                                 Addl Actv Diag: ICD 1                    
                          7,380                          Range of Values                         
 
I8000B                                 Addl Actv Diag: ICD 2                    
                          7,380                          Range of Values                         
 
I8000C                                 Addl Actv Diag: ICD 3                    
                          7,380                          Range of Values                         
 
I8000D                                 Addl Actv Diag: ICD 4                    
                          7,380                          Range of Values                         
 
I8000E                                 Addl Actv Diag: ICD 5                    
                          7,380                          Range of Values                         
 
I8000F                                 Addl Actv Diag: ICD 6                    
                          7,380                          Range of Values                         
 
I8000G                                 Addl Actv Diag: ICD 7                    
                          7,380                          Range of Values                         
 
I8000H                                 Addl Actv Diag: ICD 8                    
                          7,380                          Range of Values                         
 
I8000I                                 Addl Actv Diag: ICD 9                    
                          7,380                          Range of Values                         
 
I8000J                                  Addl Actv Diag: ICD 10                  
                          7,380                          Range of Values                         
 
J0100A   $M3YESNO                      Pain management: Scheduled Pain Med      
                          1,859                          Missing                                 
                              6        -                 Not assessed/no information             
                          3,274        0                 No                                      
                          2,241        1                 Yes                                     
 
J0100B   $M3YESNO                      Pain management: PRN Pain Med            
                          1,859                          Missing                                 
                              7        -                 Not assessed/no information             
                          3,284        0                 No                                      
                          2,230        1                 Yes                                     
 
J0100C   $M3YESNO                      Pain management: Oth Pain Intervention   
                          1,859                          Missing                                 
                             31        -                 Not assessed/no information             
                          4,282        0                 No                                      
                          1,208        1                 Yes                                     
 
J0200    $M3YESNO                      Should Pain Asmt be Cond                 
                          2,318                          Missing                                 
                             86        -                 Not assessed/no information             
                            421        0                 No                                      
                          4,555        1                 Yes                                     
 
J0300    $M3YNANS                      Pain Asmt Int: Pain Pres                 
                          2,739                          Missing                                 
                            132        -                 Not assessed/no information             
                          2,662        0                 No                                      
                          1,649        1                 Yes                                     
                            198        9                 Unable to answer                        
 
J0400    $M31PAIN                      Pain Asmt Int: Pain Freq                 
                          5,599                          Missing                                 
                            134        -                 Not assessed/no information             
                             90        1                 Almost constantly                       
                            362        2                 Frequently                              
                          1,011        3                 Occasionally                            
                            161        4                 Rarely                                  
                             23        9                 Unable to answer                        
 
J0500A   $M3YNANS                      Pain Asmt Int: Pain Effect Sleep         
                          5,599                          Missing                                 
                            134        -                 Not assessed/no information             
                          1,405        0                 No                                      
                            233        1                 Yes                                     
                              9        9                 Unable to answer                        
 
J0500B   $M3YNANS                      Pain Asmt Int: Pain Effect Act           
                          5,599                          Missing                                 
                            134        -                 Not assessed/no information             
                          1,290        0                 No                                      
                            339        1                 Yes                                     
                             18        9                 Unable to answer                        
 
J0600A                                 Pain Intensity Numeric Rating Scale Num  
                          7,380                          Range of Values                         
 
J0600B   $M32PAIN                      Pain Intensity Verbal Descr Scale Num    
                          6,673                          Missing                                 
                            171        -                 Not assessed/no information             
                            257        1                 Mild                                    
                            227        2                 Moderate                                
                             33        3                 Severe                                  
                              7        4                 Very severe, horrible                   
                             12        9                 Unable to answer                        
 
J0700    $M3YESNO                      Staff Cond Pain Asmt                     
                          5,911                          Missing                                 
                             70        -                 Not assessed/no information             
                          1,356        0                 No                                      
                             43        1                 Yes                                     
 
J0800A   $M3INDIC                      SA for Pain: Nonverbal Sound             
                          6,692                          Missing                                 
                             35        -                 Not assessed/no information             
                            597        0                 Not indicated                           
                             56        1                 Indicated                               
 
J0800B   $M3INDIC                      SA for Pain: Vocal Complaint             
                          6,692                          Missing                                 
                             33        -                 Not assessed/no information             
                            564        0                 Not indicated                           
                             91        1                 Indicated                               
 
J0800C   $M3INDIC                      SA for Pain: Facial Expression           
                          6,692                          Missing                                 
                             34        -                 Not assessed/no information             
                            595        0                 Not indicated                           
                             59        1                 Indicated                               
 
J0800D   $M3INDIC                      SA for Pain: Protective Movement         
                          6,692                          Missing                                 
                             34        -                 Not assessed/no information             
                            627        0                 Not indicated                           
                             27        1                 Indicated                               
 
J0800Z   $M3INDIC                      SA for Pain: None Above Signs of Pain    
                          6,692                          Missing                                 
                             33        -                 Not assessed/no information             
                            153        0                 Not indicated                           
                            502        1                 Indicated                               
 
J0850    $M3PAINI                      SA for Pain: Nonverbal Sound             
                          7,194                          Missing                                 
                             34        -                 Not assessed/no information             
                             92        1                 Indicators of pain 1-2 days             
                             34        2                 Indicators of pain 3-4 days             
                             26        3                 Indicators of pain daily                
 
J1100A   $M3INDIC                      Shortness of Breath W Exertion           
                          1,859                          Missing                                 
                             21        -                 Not assessed/no information             
                          4,996        0                 Not indicated                           
                            504        1                 Indicated                               
 
J1100B   $M3INDIC                      Shortness of Breath When Sitting         
                          1,859                          Missing                                 
                             19        -                 Not assessed/no information             
                          5,307        0                 Not indicated                           
                            195        1                 Indicated                               
 
J1100C   $M3INDIC                      Shortness of Breath When Lying Flat      
                          1,726                          Missing                                 
                             24        -                 Not assessed/no information             
                          5,219        0                 Not indicated                           
                            411        1                 Indicated                               
 
J1100Z   $M3INDIC                      None of Above Shortness of Breath        
                          1,859                          Missing                                 
                             21        -                 Not assessed/no information             
                            725        0                 Not indicated                           
                          4,775        1                 Indicated                               
 
J1300    $M3YESNO                      Tobacco Use                              
                          5,842                          Missing                                 
                          1,506        0                 No                                      
                             32        1                 Yes                                     
 
J1400    $M3YESNO                      Life Prognosis Less Than Six Mons        
                          1,859                          Missing                                 
                              5        -                 Not assessed/no information             
                          5,292        0                 No                                      
                            224        1                 Yes                                     
 
J1550A   $M3INDIC                      Prob Conds: Fever                        
                          1,726                          Missing                                 
                             10        -                 Not assessed/no information             
                          5,571        0                 Not indicated                           
                             73        1                 Indicated                               
 
J1550B   $M3INDIC                      Prob Conds: Vomiting                     
                          1,726                          Missing                                 
                             11        -                 Not assessed/no information             
                          5,559        0                 Not indicated                           
                             84        1                 Indicated                               
 
J1550C   $M3INDIC                      Prob Conds: Dehydration                  
                          1,859                          Missing                                 
                             10        -                 Not assessed/no information             
                          5,497        0                 Not indicated                           
                             14        1                 Indicated                               
 
J1550D   $M3INDIC                      Prob Conds: Internal Bleeding            
                          1,859                          Missing                                 
                              9        -                 Not assessed/no information             
                          5,478        0                 Not indicated                           
                             34        1                 Indicated                               
 
J1550Z   $M3INDIC                      Prob Conds: None of Above                
                          1,859                          Missing                                 
                              9        -                 Not assessed/no information             
                            182        0                 Not indicated                           
                          5,330        1                 Indicated                               
 
J1700A   $M3YNDET                      Fall History on Admsn: Fall 30 Day       
                          6,238                          Missing                                 
                             10        -                 Not assessed/no information             
                            647        0                 No                                      
                            444        1                 Yes                                     
                             41        9                 Unable to determine                     
 
J1700B   $M3YNDET                      Fall History on Admsn: Fall 31-180 Day   
                          6,238                          Missing                                 
                             10        -                 Not assessed/no information             
                            768        0                 No                                      
                            279        1                 Yes                                     
                             85        9                 Unable to determine                     
 
J1700C   $M3YNDET                      Fall History on Admsn: Fall Six Mon      
                          6,238                          Missing                                 
                              7        -                 Not assessed/no information             
                            879        0                 No                                      
                            210        1                 Yes                                     
                             46        9                 Unable to determine                     
 
J1800    $M3YESNO                      Falls Since Admsn or Prior Asmt          
                          1,697                          Missing                                 
                              1        -                 Not assessed/no information             
                          4,882        0                 No                                      
                            800        1                 Yes                                     
 
J1900A   $M3FALLS                      Falls Since Adm/Prior Asmt W No Inj      
                          6,579                          Missing                                 
                              1        -                 Not assessed/no information             
                            166        0                 None                                    
                            463        1                 One                                     
                            171        2                 Two or more                             
 
J1900B   $M3FALLS                      Falls Since Adm/Prior Asmt W Inj Ex Maj  
                          6,579                          Missing                                 
                              1        -                 Not assessed/no information             
                            564        0                 None                                    
                            202        1                 One                                     
                             34        2                 Two or more                             
 
J1900C   $M3FALLS                      Falls Since Adm/Prior Asmt W Maj Inj     
                          6,579                          Missing                                 
                              3        -                 Not assessed/no information             
                            762        0                 None                                    
                             36        1                 One                                     
 
K0100A   $M3INDIC                      Swall Disorder: Loss Mouth Eating        
                          2,993                          Missing                                 
                              4        -                 Not assessed/no information             
                          4,352        0                 Not indicated                           
                             31        1                 Indicated                               
 
K0100B   $M3INDIC                      Swall Disorder: Hold Food Mouth          
                          2,993                          Missing                                 
                              3        -                 Not assessed/no information             
                          4,344        0                 Not indicated                           
                             40        1                 Indicated                               
 
K0100C   $M3INDIC                      Swall Disorder: Choke Drinking Meal      
                          2,993                          Missing                                 
                              3        -                 Not assessed/no information             
                          4,297        0                 Not indicated                           
                             87        1                 Indicated                               
 
K0100D   $M3INDIC                      Swall Disorder: Complaint Swall          
                          2,993                          Missing                                 
                              2        -                 Not assessed/no information             
                          4,305        0                 Not indicated                           
                             80        1                 Indicated                               
 
K0100Z   $M3INDIC                      Swall Disorder: None of Above            
                          2,993                          Missing                                 
                              2        -                 Not assessed/no information             
                            172        0                 Not indicated                           
                          4,213        1                 Indicated                               
 
K0200A                                 Height Num                               
                          7,380                          Range of Values                         
 
K0200B                                 Weight Num                               
                          7,380                          Range of Values                         
 
K0300    $M3WGHT                       Weight Loss                              
                          1,726                          Missing                                 
                             31        -                 Not assessed/no information             
                          5,132        0                 No or unknown                           
                             70        1                 Yes, on physician-prescribed regimen    
                            421        2                 Yes, not on physician-prescribed regimen
 
K0310    $M3WGHT                       Weight Gain                              
                          1,726                          Missing                                 
                             26        -                 Not assessed/no information             
                          5,360        0                 No or unknown                           
                             66        1                 Yes, on physician-prescribed regimen    
                            202        2                 Yes, not on physician-prescribed regimen
 
K0510A1  $M3INDIC                      Nutr App: Prior Par/IV Feeding           
                          7,106                          Missing                                 
                             21        -                 Not assessed/no information             
                            248        0                 Not indicated                           
                              5        1                 Indicated                               
 
K0510A2  $M3INDIC                      Nutr App: Post Par/IV Feeding            
                          1,726                          Missing                                 
                             12        -                 Not assessed/no information             
                          5,595        0                 Not indicated                           
                             47        1                 Indicated                               
 
K0510B1  $M3INDIC                      Nutr App: Prior Feeding Tube             
                          7,106                          Missing                                 
                             18        -                 Not assessed/no information             
                            249        0                 Not indicated                           
                              7        1                 Indicated                               
 
K0510B2  $M3INDIC                      Nutr App: Post Feeding Tube              
                          1,726                          Missing                                 
                             12        -                 Not assessed/no information             
                          5,496        0                 Not indicated                           
                            146        1                 Indicated                               
 
K0510C1  $M3INDIC                      Nutr App: Prior Mech Alt Diet            
                          7,141                          Missing                                 
                             19        -                 Not assessed/no information             
                            185        0                 Not indicated                           
                             35        1                 Indicated                               
 
K0510C2  $M3INDIC                      Nutr App: Post Mech Alt Diet             
                          2,318                          Missing                                 
                              6        -                 Not assessed/no information             
                          3,427        0                 Not indicated                           
                          1,629        1                 Indicated                               
 
K0510D1  $M3INDIC                      Nutr App: Prior Ther Diet                
                          7,141                          Missing                                 
                             20        -                 Not assessed/no information             
                            142        0                 Not indicated                           
                             77        1                 Indicated                               
 
K0510D2  $M3INDIC                      Nutr App: Post Ther Diet                 
                          2,318                          Missing                                 
                              6        -                 Not assessed/no information             
                          2,621        0                 Not indicated                           
                          2,435        1                 Indicated                               
 
K0510Z1  $M3INDIC                      Nutr App: Prior None of Above            
                          7,141                          Missing                                 
                             20        -                 Not assessed/no information             
                            107        0                 Not indicated                           
                            112        1                 Indicated                               
 
K0510Z2  $M3INDIC                      Nutr App: Post None of Above             
                          2,318                          Missing                                 
                              7        -                 Not assessed/no information             
                          3,392        0                 Not indicated                           
                          1,663        1                 Indicated                               
 
L0200A   $M3INDIC                      Dental Stat: Broken Denture              
                          2,993                          Missing                                 
                             44        -                 Not assessed/no information             
                          4,300        0                 Not indicated                           
                             43        1                 Indicated                               
 
L0200B   $M3INDIC                      Dental Stat: No Teeth                    
                          5,842                          Missing                                 
                              7        -                 Not assessed/no information             
                          1,245        0                 Not indicated                           
                            286        1                 Indicated                               
 
L0200C   $M3INDIC                      Dental Stat: Abnormal Mouth Tiss         
                          5,842                          Missing                                 
                              6        -                 Not assessed/no information             
                          1,530        0                 Not indicated                           
                              2        1                 Indicated                               
 
L0200D   $M3INDIC                      Dental Stat: Cavity                      
                          5,842                          Missing                                 
                              6        -                 Not assessed/no information             
                          1,422        0                 Not indicated                           
                            110        1                 Indicated                               
 
L0200E   $M3INDIC                      Dental Stat: Inflamed Gum                
                          5,842                          Missing                                 
                              6        -                 Not assessed/no information             
                          1,529        0                 Not indicated                           
                              3        1                 Indicated                               
 
L0200F   $M3INDIC                      Dental Stat: Mouth or Facial Pain        
                          2,993                          Missing                                 
                             37        -                 Not assessed/no information             
                          4,318        0                 Not indicated                           
                             32        1                 Indicated                               
 
L0200G   $M3INDIC                      Dental Stat: Unable to Examine           
                          5,842                          Missing                                 
                              4        -                 Not assessed/no information             
                          1,520        0                 Not indicated                           
                             14        1                 Indicated                               
 
L0200Z   $M3INDIC                      Dental Stat: None of Above               
                          5,842                          Missing                                 
                              7        -                 Not assessed/no information             
                            432        0                 Not indicated                           
                          1,099        1                 Indicated                               
 
M0100A   $M3INDIC                      Det of Press Ulcr Risk: Ulcr Visible     
                          1,859                          Missing                                 
                             11        -                 Not assessed/no information             
                          4,986        0                 Not indicated                           
                            524        1                 Indicated                               
 
M0100B   $M3INDIC                      Det of Press Ulcr Risk: Frml Asmt/Instr  
                          2,993                          Missing                                 
                              3        -                 Not assessed/no information             
                            784        0                 Not indicated                           
                          3,600        1                 Indicated                               
 
M0100C   $M3INDIC                      Det of Press Ulcr Risk: Clinical Asmt    
                          2,993                          Missing                                 
                            401        0                 Not indicated                           
                          3,986        1                 Indicated                               
 
M0100Z   $M3INDIC                      Det of Press Ulcr Risk: None of Above    
                          2,993                          Missing                                 
                          4,239        0                 Not indicated                           
                            148        1                 Indicated                               
 
M0150    $M3YESNO                      Press Ulcr Risk                          
                          2,993                          Missing                                 
                              6        -                 Not assessed/no information             
                            577        0                 No                                      
                          3,804        1                 Yes                                     
 
M0210    $M3YESNO                      One or More S1 or Higher UPU             
                          1,564                          Missing                                 
                              5        -                 Not assessed/no information             
                          5,258        0                 No                                      
                            553        1                 Yes                                     
 
M0300A                                 Stage 1 Press Ulcr Num                   
                          7,380                          Range of Values                         
 
M0300B1                                Stage 2 Press Ulcr Num                   
                          7,380                          Range of Values                         
 
M0300B2                                Stage 2 Press Ulcr Present on Admsn Num  
                          7,380                          Range of Values                         
 
M0300B3  MMDDYYn8                      Date of Oldest Stage 2 Press Ulcr        
                          7,291                       .  Inapplicable                            
                             89        MMDDYYYY          Date as MMDDYYYY                        
 
M0300C1                                Stage 3 Press Ulcr Num                   
                          7,380                          Range of Values                         
 
M0300C2                                Stage 3 Press Ulcr Present on Admsn Num  
                          7,380                          Range of Values                         
 
M0300D1                                Stage 4 Press Ulcr Num                   
                          7,380                          Range of Values                         
 
M0300D2                                Stage 4 Press Ulcr Present on Admsn Num  
                          7,380                          Range of Values                         
 
M0300E1                                UPU Due To Drsng Num                     
                          7,380                          Range of Values                         
 
M0300E2                                UPU Due To Drsng on Admsn Num            
                          7,380                          Range of Values                         
 
M0300F1                                UPU W Slough or Eschar Num               
                          7,380                          Range of Values                         
 
M0300F2                                UPU W Slough or Eschar on Admsn Num      
                          7,380                          Range of Values                         
 
M0300G1                                UPU W Deep Tiss Inj Num                  
                          7,380                          Range of Values                         
 
M0300G2                                UPU W Deep Tiss Inj on Admsn Num         
                          7,380                          Range of Values                         
 
M0610A                                 Unhealed Stage 3-4 Press Ulcr Length Num 
                          7,380                          Range of Values                         
 
M0610B                                 Unhealed Stage 3-4 Press Ulcr Width Num  
                          7,380                          Range of Values                         
 
M0610C                                 Unhealed Stage 3-4 Press Ulcr Depth Num  
                          7,380                          Range of Values                         
 
M0700    $M3TISSU                      Most Severe Press Ulcr Tiss Type         
                          6,970                          Missing                                 
                             10        -                 Not assessed/no information             
                             93        1                 Epithelial tissue                       
                             86        2                 Granulation tissue                      
                             63        3                 Slough                                  
                             48        4                 Necrotic tissue (Eschar)                
                            110        9                 None of the above                       
 
M0800A                                 Wrsng S2 Press Ulcr Since Prior Asmt Num 
                          7,380                          Range of Values                         
 
M0800B                                 Wrsng S3 Press Ulcr Since Prior Asmt Num 
                          7,380                          Range of Values                         
 
M0800C                                 Wrsng S4 Press Ulcr Since Prior Asmt Num 
                          7,380                          Range of Values                         
 
M0900A   $M3YESNO                      Healed Press Ulcr Present on Prior Asmt  
                          3,039                          Missing                                 
                              3        -                 Not assessed/no information             
                          4,072        0                 No                                      
                            266        1                 Yes                                     
 
M0900B                                 Healed Stage 2 Press Ulcr Num            
                          7,380                          Range of Values                         
 
M0900C                                 Healed Stage 3 Press Ulcr Num            
                          7,380                          Range of Values                         
 
M0900D                                 Healed Stage 4 Press Ulcr Num            
                          7,380                          Range of Values                         
 
M1030                                  Venous and Arterial Ulcr Num             
                          7,380                          Range of Values                         
 
M1040A   $M3INDIC                      Oth Foot Skin Probs: Foot Infn           
                          2,859                          Missing                                 
                              1        -                 Not assessed/no information             
                          4,509        0                 Not indicated                           
                             11        1                 Indicated                               
 
M1040B   $M3INDIC                      Oth Foot Skin Probs: Diab Foot Ulcr      
                          2,859                          Missing                                 
                              1        -                 Not assessed/no information             
                          4,487        0                 Not indicated                           
                             33        1                 Indicated                               
 
M1040C   $M3INDIC                      Oth Foot Skin Probs: Oth Open Les Foot   
                          2,859                          Missing                                 
                              1        -                 Not assessed/no information             
                          4,495        0                 Not indicated                           
                             25        1                 Indicated                               
 
M1040D   $M3INDIC                      O/S/P: Oth Than Ulcrs, Rashes, Cuts      
                          2,859                          Missing                                 
                              1        -                 Not assessed/no information             
                          4,451        0                 Not indicated                           
                             69        1                 Indicated                               
 
M1040E   $M3INDIC                      O/S/P: Surgical Wound(s)                 
                          2,859                          Missing                                 
                          4,073        0                 Not indicated                           
                            448        1                 Indicated                               
 
M1040F   $M3INDIC                      O/S/P: Burn(s)                           
                          2,859                          Missing                                 
                              1        -                 Not assessed/no information             
                          4,517        0                 Not indicated                           
                              3        1                 Indicated                               
 
M1040G   $M3INDIC                      O/S/P: Skin Tear(s)                      
                          2,859                          Missing                                 
                              1        -                 Not assessed/no information             
                          4,255        0                 Not indicated                           
                            265        1                 Indicated                               
 
M1040H   $M3INDIC                      O/S/P: Moisture Assoc Skin Dmge          
                          2,859                          Missing                                 
                              1        -                 Not assessed/no information             
                          4,246        0                 Not indicated                           
                            274        1                 Indicated                               
 
M1040Z   $M3INDIC                      O/S/P: None of Above                     
                          2,859                          Missing                                 
                          1,013        0                 Not indicated                           
                          3,508        1                 Indicated                               
 
M1200A   $M3INDIC                      S/U Trtmts: Press Reducng Device in Chr  
                          2,859                          Missing                                 
                             10        -                 Not assessed/no information             
                          1,806        0                 Not indicated                           
                          2,705        1                 Indicated                               
 
M1200B   $M3INDIC                      S/U Trtmts: Press Reducng Device in Bed  
                          2,859                          Missing                                 
                              1        -                 Not assessed/no information             
                            759        0                 Not indicated                           
                          3,761        1                 Indicated                               
 
M1200C   $M3INDIC                      S/U Trtmts: Turning/RePosing Prog        
                          2,859                          Missing                                 
                          3,686        0                 Not indicated                           
                            835        1                 Indicated                               
 
M1200D   $M3INDIC                      S/U Trtmts: Nutrition/Hydration          
                          2,859                          Missing                                 
                          3,965        0                 Not indicated                           
                            556        1                 Indicated                               
 
M1200E   $M3INDIC                      S/U Trtmts: Ulcr Care                    
                          2,859                          Missing                                 
                          4,120        0                 Not indicated                           
                            401        1                 Indicated                               
 
M1200F   $M3INDIC                      S/U Trtmts: Surgical Wound Care          
                          2,859                          Missing                                 
                          4,154        0                 Not indicated                           
                            367        1                 Indicated                               
 
M1200G   $M3INDIC                      S/U Trtmts: App Nonsurgical Drsng        
                          2,859                          Missing                                 
                          3,889        0                 Not indicated                           
                            632        1                 Indicated                               
 
M1200H   $M3INDIC                      S/U Trtmts: App Ointments/Meds           
                          2,859                          Missing                                 
                              3        -                 Not assessed/no information             
                          2,343        0                 Not indicated                           
                          2,175        1                 Indicated                               
 
M1200I   $M3INDIC                      S/U Trtmts: App Drsngs to Foot           
                          2,859                          Missing                                 
                          4,332        0                 Not indicated                           
                            189        1                 Indicated                               
 
M1200Z   $M3INDIC                      S/U Trtmts: None of Above                
                          2,859                          Missing                                 
                              1        -                 Not assessed/no information             
                          4,150        0                 Not indicated                           
                            370        1                 Indicated                               
 
N0300                                  Num of Days Injections of Any Type       
                          7,380                          Range of Values                         
 
N0350A                                 Num of Days Insulin Injections           
                          7,380                          Range of Values                         
 
N0350B                                 Num of Days Insulin Orders Changed       
                          7,380                          Range of Values                         
 
N0400Z   $M3INDIC                      Meds Rcd: None of Above                  
                          2,856                          Missing                                 
                             10        -                 Not assessed/no information             
                          4,493        0                 Not indicated                           
                             21        1                 Indicated                               
 
N0410A                                 Meds Rcd: Antipsychotic Num Days         
                          7,380                          Range of Values                         
 
N0410B                                 Meds Rcd: Antianxiety Num Days           
                          7,380                          Range of Values                         
 
N0410C                                 Meds Rcd: Antidepressant Num Days        
                          7,380                          Range of Values                         
 
N0410D                                 Meds Rcd: Hypnotic Num Days              
                          7,380                          Range of Values                         
 
N0410E                                 Meds Rcd: Anticoagulant Num Days         
                          7,380                          Range of Values                         
 
N0410F                                 Meds Rcd: Antibiotic Num Days            
                          7,380                          Range of Values                         
 
N0410G                                 Meds Rcd: Diuretic Num Days              
                          7,380                          Range of Values                         
 
O0100A1  $M3INDIC                      Spcl T/P: ChemOthapy Pre-admit           
                          6,058                          Missing                                 
                             13        -                 Not assessed/no information             
                          1,301        0                 Not indicated                           
                              8        1                 Indicated                               
 
O0100A2  $M3INDIC                      Spcl T/P: ChemOthapy Post-admit          
                          2,859                          Missing                                 
                             10        -                 Not assessed/no information             
                          4,488        0                 Not indicated                           
                             23        1                 Indicated                               
 
O0100B1  $M3INDIC                      Spcl T/P: Radiation Pre-admit            
                          6,058                          Missing                                 
                             13        -                 Not assessed/no information             
                          1,306        0                 Not indicated                           
                              3        1                 Indicated                               
 
O0100B2  $M3INDIC                      Spcl T/P: Radiation Post-admit           
                          2,859                          Missing                                 
                             10        -                 Not assessed/no information             
                          4,509        0                 Not indicated                           
                              2        1                 Indicated                               
 
O0100C1  $M3INDIC                      Spcl T/P: Oxygen Pre-admit               
                          6,058                          Missing                                 
                             20        -                 Not assessed/no information             
                            905        0                 Not indicated                           
                            397        1                 Indicated                               
 
O0100C2  $M3INDIC                      Spcl T/P: Oxygen Post-admit              
                          2,859                          Missing                                 
                             12        -                 Not assessed/no information             
                          3,595        0                 Not indicated                           
                            914        1                 Indicated                               
 
O0100D1  $M3INDIC                      Spcl T/P: Suctioning Pre-admit           
                          6,058                          Missing                                 
                             14        -                 Not assessed/no information             
                          1,299        0                 Not indicated                           
                              9        1                 Indicated                               
 
O0100D2  $M3INDIC                      Spcl T/P: Suctioning Post-admit          
                          2,993                          Missing                                 
                             10        -                 Not assessed/no information             
                          4,351        0                 Not indicated                           
                             26        1                 Indicated                               
 
O0100E1  $M3INDIC                      Spcl T/P: Tracheostomy Pre-admit         
                          6,058                          Missing                                 
                             13        -                 Not assessed/no information             
                          1,302        0                 Not indicated                           
                              7        1                 Indicated                               
 
O0100E2  $M3INDIC                      Spcl T/P: Tracheostomy Post-admit        
                          2,856                          Missing                                 
                             10        -                 Not assessed/no information             
                          4,493        0                 Not indicated                           
                             21        1                 Indicated                               
 
O0100F1  $M3INDIC                      Spcl T/P: Ventilator Pre-admit           
                          6,058                          Missing                                 
                             13        -                 Not assessed/no information             
                          1,297        0                 Not indicated                           
                             12        1                 Indicated                               
 
O0100F2  $M3INDIC                      Spcl T/P: Ventilator Post-admit          
                          2,856                          Missing                                 
                             10        -                 Not assessed/no information             
                          4,500        0                 Not indicated                           
                             14        1                 Indicated                               
 
O0100G1  $M3INDIC                      Spcl T/P: Cont Pos Arwy Press Pre-A      
                          6,554                          Missing                                 
                              5        -                 Not assessed/no information             
                            792        0                 Not indicated                           
                             29        1                 Indicated                               
 
O0100G2  $M3INDIC                      Spcl T/P: Cont Pos Arwy Press Post-A     
                          5,842                          Missing                                 
                              2        -                 Not assessed/no information             
                          1,498        0                 Not indicated                           
                             38        1                 Indicated                               
 
O0100H1  $M3INDIC                      Spcl T/P: Intravenous Med Pre-admit      
                          6,058                          Missing                                 
                             25        -                 Not assessed/no information             
                            723        0                 Not indicated                           
                            574        1                 Indicated                               
 
O0100H2  $M3INDIC                      Spcl T/P: Intravenous Med Post-admit     
                          2,859                          Missing                                 
                             11        -                 Not assessed/no information             
                          4,359        0                 Not indicated                           
                            151        1                 Indicated                               
 
O0100I1  $M3INDIC                      Spcl T/P: Transfusion Pre-admit          
                          6,058                          Missing                                 
                             15        -                 Not assessed/no information             
                          1,280        0                 Not indicated                           
                             27        1                 Indicated                               
 
O0100I2  $M3INDIC                      Spcl T/P: Transfusion Post-admit         
                          2,859                          Missing                                 
                             10        -                 Not assessed/no information             
                          4,506        0                 Not indicated                           
                              5        1                 Indicated                               
 
O0100J1  $M3INDIC                      Spcl T/P: Dialysis Pre-admit             
                          6,058                          Missing                                 
                             14        -                 Not assessed/no information             
                          1,282        0                 Not indicated                           
                             26        1                 Indicated                               
 
O0100J2  $M3INDIC                      Spcl T/P: Dialysis Post-admit            
                          2,859                          Missing                                 
                             10        -                 Not assessed/no information             
                          4,443        0                 Not indicated                           
                             68        1                 Indicated                               
 
O0100K1  $M3INDIC                      Spcl T/P: Hospice Pre-admit              
                          6,554                          Missing                                 
                              5        -                 Not assessed/no information             
                            809        0                 Not indicated                           
                             12        1                 Indicated                               
 
O0100K2  $M3INDIC                      Spcl T/P: Hospice Post-admit             
                          1,859                          Missing                                 
                             19        -                 Not assessed/no information             
                          5,274        0                 Not indicated                           
                            228        1                 Indicated                               
 
O0100L2  $M3INDIC                      Spcl T/P: Respite Post-admit             
                          5,842                          Missing                                 
                              2        -                 Not assessed/no information             
                          1,536        0                 Not indicated                           
 
O0100M1  $M3INDIC                      Spcl T/P: Isolation Pre-admit            
                          6,554                          Missing                                 
                              7        -                 Not assessed/no information             
                            816        0                 Not indicated                           
                              3        1                 Indicated                               
 
O0100M2  $M3INDIC                      Spcl T/P: Isolation Post-admit           
                          2,856                          Missing                                 
                             12        -                 Not assessed/no information             
                          4,494        0                 Not indicated                           
                             18        1                 Indicated                               
 
O0100Z1  $M3INDIC                      Spcl T/P: None Above Pre-A Trtmt Prior   
                          6,554                          Missing                                 
                             10        -                 Not assessed/no information             
                            486        0                 Not indicated                           
                            330        1                 Indicated                               
 
O0100Z2  $M3INDIC                      Spcl T/P: None Above Trtmt Post-admit    
                          5,842                          Missing                                 
                              2        -                 Not assessed/no information             
                            490        0                 Not indicated                           
                          1,046        1                 Indicated                               
 
O0250A   $M3YESNO                      Influenza Rcd                            
                          1,859                          Missing                                 
                             92        -                 Not assessed/no information             
                          3,130        0                 No                                      
                          2,299        1                 Yes                                     
 
O0250B   MMDDYYn8                      Influenza Rcd Date                       
                          5,081                       .  Inapplicable                            
                          2,299        MMDDYYYY          Date as MMDDYYYY                        
 
O0250C   $M3FLRSN                      Rsn Influenza Not Rcd                    
                          4,158                          Missing                                 
                            142        -                 Not assessed/no information             
                            496        1                 Resident not in facility                
                          1,372        2                 Received outside the facility           
                             80        3                 Not eligible                            
                            869        4                 Offered and declined                    
                            110        5                 Not offered                             
                             11        6                 Inability to obtain vaccine             
                            142        9                 None of the above                       
 
O0300A   $M3YESNO                      Pneumococcal Vaccination                 
                          1,859                          Missing                                 
                            141        -                 Not assessed/no information             
                          1,581        0                 No                                      
                          3,799        1                 Yes                                     
 
O0300B   $M3PNRSN                      Rsn Pneumococcal Vaccination Not Rcd     
                          5,658                          Missing                                 
                            275        -                 Not assessed/no information             
                             65        1                 Not eligible                            
                          1,145        2                 Offered and declined                    
                            237        3                 Not offered                             
 
O0400A1                                Speech Ther/Aud Individual Minutes Num   
                          7,380                          Range of Values                         
 
O0400A2                                Speech Ther/Aud ConCur Minutes Num       
                          7,380                          Range of Values                         
 
O0400A3                                Speech Ther/Aud Group Minutes Num        
                          7,380                          Range of Values                         
 
O0400A4                                Num of Days Speech Ther/Aud Admin        
                          7,380                          Range of Values                         
 
O0400A5  MMDDYYn8                      Speech Ther/Audiology Start Date         
                          5,464                       .  Inapplicable                            
                          1,916        MMDDYYYY          Date as MMDDYYYY                        
 
O0400A6  MMDDYYn8                      Speech Ther/Audiology End Date           
                          6,375                       .  Inapplicable                            
                          1,005        MMDDYYYY          Date as MMDDYYYY                        
 
O0400B1                                Occupational Ther Individual Minutes Num 
                          7,380                          Range of Values                         
 
O0400B2                                Occupational Ther ConCur Minutes Num     
                          7,380                          Range of Values                         
 
O0400B3                                Occupational Ther Group Minutes Num      
                          7,380                          Range of Values                         
 
O0400B4                                Num of Days Occ Ther Administered        
                          7,380                          Range of Values                         
 
O0400B5  MMDDYYn8                      Occupational Ther Start Date             
                          3,527                       .  Inapplicable                            
                          3,853        MMDDYYYY          Date as MMDDYYYY                        
 
O0400B6  MMDDYYn8                      Occupational Ther End Date               
                          5,647                       .  Inapplicable                            
                          1,733        MMDDYYYY          Date as MMDDYYYY                        
 
O0400C1                                Phys Ther Individual Minutes Num         
                          7,380                          Range of Values                         
 
O0400C2                                Phys Ther ConCur Minutes Num             
                          7,380                          Range of Values                         
 
O0400C3                                Phys Ther Group Minutes Num              
                          7,380                          Range of Values                         
 
O0400C4                                Num of Days Phys Ther Administered       
                          7,380                          Range of Values                         
 
O0400C5  MMDDYYn8                      Phys Ther Start Date                     
                          3,402                       .  Inapplicable                            
                          3,978        MMDDYYYY          Date as MMDDYYYY                        
 
O0400C6  MMDDYYn8                      Phys Ther End Date                       
                          5,609                       .  Inapplicable                            
                          1,771        MMDDYYYY          Date as MMDDYYYY                        
 
O0400D1                                Resp Ther Minutes Num                    
                          7,380                          Range of Values                         
 
O0400D2                                Num of Days Resp Ther Administered       
                          7,380                          Range of Values                         
 
O0400E1                                Psych Ther Minutes Num                   
                          7,380                          Range of Values                         
 
O0400E2                                Num of Days Psych Ther Administered      
                          7,380                          Range of Values                         
 
O0400F1                                Rec Ther Minutes Num                     
                          7,380                          Range of Values                         
 
O0400F2                                Num of Days Rec Ther Administered        
                          7,380                          Range of Values                         
 
O0450A   $M3YESNO                      Has Ther Resumed                         
                          7,349                          Missing                                 
                              2        -                 Not assessed/no information             
                             29        0                 No                                      
 
O0500A                                 Rest Nrs: Passive Range of Mtn Num       
                          7,380                          Range of Values                         
 
O0500B                                 Rest Nrs: Actv Range of Mtn Num          
                          7,380                          Range of Values                         
 
O0500C                                 Rest Nrs: Splint/Brace Ass Num           
                          7,380                          Range of Values                         
 
O0500D                                 Rest Nrs: Bed Mob Training Num           
                          7,380                          Range of Values                         
 
O0500E                                 Rest Nrs: Trans Training Num             
                          7,380                          Range of Values                         
 
O0500F                                 Rest Nrs: Wlking Training Num            
                          7,380                          Range of Values                         
 
O0500G                                 Rest Nrs: Drsng/Grooming Training Num    
                          7,380                          Range of Values                         
 
O0500H                                 Rest Nrs: Eating/Swall Training Num      
                          7,380                          Range of Values                         
 
O0500I                                 Rest Nrs: Amp/Prosthes Care Training Num 
                          7,380                          Range of Values                         
 
O0500J                                 Rest Nrs: Communication Training Num     
                          7,380                          Range of Values                         
 
O0600                                  Physician Exam Day Num                   
                          7,380                          Range of Values                         
 
O0700                                  Physician Order Day Num                  
                          7,380                          Range of Values                         
 
P0100A   $M3USED                       Phys Rstrnts in Bed: Bed Rail            
                          1,859                          Missing                                 
                             28        -                 Not assessed/no information             
                          5,441        0                 Not used                                
                              3        1                 Used less than daily                    
                             49        2                 Used daily                              
 
P0100B   $M3USED                       Phys Rstrnts in Bed: Trunk Rstrnt Bed    
                          1,859                          Missing                                 
                          5,521        0                 Not used                                
 
P0100C   $M3USED                       Phys Rstrnts in Bed: Limb Rstrnt Bed     
                          1,859                          Missing                                 
                          5,521        0                 Not used                                
 
P0100D   $M3USED                       Phys Rstrnts in Bed: Oth Rstrnt Bed      
                          1,859                          Missing                                 
                              1        -                 Not assessed/no information             
                          5,519        0                 Not used                                
                              1        2                 Used daily                              
 
P0100E   $M3USED                       Phys Rstrnts Chair: Trunk Rstrnt Chair   
                          1,859                          Missing                                 
                              2        -                 Not assessed/no information             
                          5,513        0                 Not used                                
                              1        1                 Used less than daily                    
                              5        2                 Used daily                              
 
P0100F   $M3USED                       Phys Rstrnts Chair: Limb Rstrnt Chair    
                          1,859                          Missing                                 
                              1        -                 Not assessed/no information             
                          5,518        0                 Not used                                
                              2        2                 Used daily                              
 
P0100G   $M3USED                       Phys Rstrnts Chair: Chair Prevent Rise   
                          1,859                          Missing                                 
                              1        -                 Not assessed/no information             
                          5,516        0                 Not used                                
                              1        1                 Used less than daily                    
                              3        2                 Used daily                              
 
P0100H   $M3USED                       Phys Rstrnts Chair: Oth Rstrnt Chair     
                          1,859                          Missing                                 
                              1        -                 Not assessed/no information             
                          5,515        0                 Not used                                
                              5        2                 Used daily                              
 
Q0100A   $M3YESNO                      Res Part in Asmt                         
                          2,856                          Missing                                 
                             31        -                 Not assessed/no information             
                            562        0                 No                                      
                          3,931        1                 Yes                                     
 
Q0100B   $M3FAMPR                      Fam Part in Asmt                         
                          2,856                          Missing                                 
                             29        -                 Not assessed/no information             
                          3,063        0                 No                                      
                          1,400        1                 Yes                                     
                             32        9                 No family or significant other available
 
Q0100C   $M3GUAPR                      Guardian Part in Asmt                    
                          2,856                          Missing                                 
                             37        -                 Not assessed/no information             
                          3,375        0                 No                                      
                            351        1                 Yes                                     
                            761        9                 No guardian or legally auth rep availabl
 
Q0300A   $M3OGOAL                      Res Overall Goal                         
                          6,255                          Missing                                 
                             23        -                 Not assessed/no information             
                            758        1                 Discharged to the community             
                            263        2                 Remain in this facility                 
                             31        3                 Discharged to another facility          
                             50        9                 Unknown or uncertain                    
 
Q0300B   $M3SOURC                      Overall Goal Source                      
                          6,255                          Missing                                 
                             24        -                 Not assessed/no information             
                            842        1                 Resident                                
                            222        2                 Family or sig other                     
                             26        3                 Guardian or legally auth rep            
                             11        9                 Unknown or uncertain                    
 
Q0400A   $M3YESNO                      Dis Plan                                 
                          1,859                          Missing                                 
                             53        -                 Not assessed/no information             
                          3,476        0                 No                                      
                          1,992        1                 Yes                                     
 
Q0490    $M3NOINF                      Ress Pref Answering Q0500B               
                          5,100                          Missing                                 
                             48        -                 Not assessed/no information             
                          1,132        0                 No                                      
                          1,100        1                 Yes                                     
 
Q0500B   $M3WNTLK                      Staff Asked Res or Fam Abt Rtn To Comm   
                          5,329                          Missing                                 
                             55        -                 Not assessed/no information             
                          1,795        0                 No                                      
                             99        1                 Yes                                     
                            102        9                 Unknown or uncertain                    
 
Q0550A   $M3NOINF                      Pref In Answering Q0550B                 
                          5,329                          Missing                                 
                             50        -                 Not assessed/no information             
                          1,622        0                 No                                      
                            267        1                 Yes                                     
                            112        8                 Information not available               
 
Q0550B   $M3SOURC                      Source Answering Q0550A                  
                          5,329                          Missing                                 
                             55        -                 Not assessed/no information             
                          1,035        1                 Resident                                
                            716        2                 Family or sig other                     
                            147        3                 Guardian or legally auth rep            
                             98        9                 Unknown or uncertain                    
 
Q0600    $M3REFER                      Local Contact Agency Referral            
                          1,859                          Missing                                 
                             58        -                 Not assessed/no information             
                          5,003        0                 No - referral not needed                
                            249        1                 No - referral may be needed             
                            211        2                 Yes                                     
 
V0100A   $M3CASS                       Prior Asmt Federal OBRA Rsn for Asmt     
                          6,767                                                                  
                             13        01                5 day sched assessment                  
                            516        02                14 day sched assessment                 
                             18        03                30 day sched assessment                 
                             13        04                60 day sched assessment                 
                             53        99                None of above                           
 
V0100B   $M3CASS                       Prior Asmt PPS Rsn for Asmt              
                          6,768                                                                  
                             30        01                5 day sched assessment                  
                             14        02                14 day sched assessment                 
                             12        03                30 day sched assessment                 
                              7        05                90 day sched assessment                 
                            549        99                None of above                           
 
V0100C   MMDDYYn8                      Prior Asmt Ref Date                      
                          6,767                       .  Inapplicable                            
                            613        MMDDYYYY          Date as MMDDYYYY                        
 
V0100D                                 Prior Asmt (BIMS) Summary Score Num      
                          7,380                          Range of Values                         
 
V0100E                                 Prior Asmt  (PHQ-9) Tot Svrty Score Num  
                          7,380                          Range of Values                         
 
V0100F                                 Prior Asmt  (PHQ-9) Tot Svrty Score Num  
                          7,380                          Range of Values                         
 
V200A01A $M3INDIC                      Dlrm Care Area Trigger                   
                          5,947                          Missing                                 
                          1,343        0                 Not indicated                           
                             90        1                 Indicated                               
 
V200A01B $M3INDIC                      Dlrm Adrsd in Care Plan                  
                          5,947                          Missing                                 
                            620        -                 Not assessed/no information             
                            762        0                 Not indicated                           
                             51        1                 Indicated                               
 
V200A02A $M3INDIC                      Dementia Care Area Trigger               
                          5,947                          Missing                                 
                            567        0                 Not indicated                           
                            866        1                 Indicated                               
 
V200A02B $M3INDIC                      Dementia Adrsd in Care Plan              
                          5,947                          Missing                                 
                            296        -                 Not assessed/no information             
                            372        0                 Not indicated                           
                            765        1                 Indicated                               
 
V200A03A $M3INDIC                      Visual Func Care Area Trigger            
                          5,947                          Missing                                 
                            946        0                 Not indicated                           
                            487        1                 Indicated                               
 
V200A03B $M3INDIC                      Visual Func Adrsd in Care Plan           
                          5,947                          Missing                                 
                            481        -                 Not assessed/no information             
                            525        0                 Not indicated                           
                            427        1                 Indicated                               
 
V200A04A $M3INDIC                      Communication Care Area Trigger          
                          5,947                          Missing                                 
                            727        0                 Not indicated                           
                            706        1                 Indicated                               
 
V200A04B $M3INDIC                      Communication Adrsd in Care Plan         
                          5,947                          Missing                                 
                            390        -                 Not assessed/no information             
                            424        0                 Not indicated                           
                            619        1                 Indicated                               
 
V200A05A $M3INDIC                      ADL Care Area Trigger                    
                          5,947                          Missing                                 
                            324        0                 Not indicated                           
                          1,109        1                 Indicated                               
 
V200A05B $M3INDIC                      ADL Adrsd in Care Plan                   
                          5,947                          Missing                                 
                            144        -                 Not assessed/no information             
                            209        0                 Not indicated                           
                          1,080        1                 Indicated                               
 
V200A06A $M3INDIC                      Urny Care Area Trigger                   
                          5,947                          Missing                                 
                             66        0                 Not indicated                           
                          1,367        1                 Indicated                               
 
V200A06B $M3INDIC                      Urny Adrsd in Care Plan                  
                          5,947                          Missing                                 
                             51        -                 Not assessed/no information             
                            187        0                 Not indicated                           
                          1,195        1                 Indicated                               
 
V200A07A $M3INDIC                      Psychosocial Care Area Trigger           
                          5,947                          Missing                                 
                          1,132        0                 Not indicated                           
                            301        1                 Indicated                               
 
V200A07B $M3INDIC                      Psychosocial Adrsd in Care Plan          
                          5,947                          Missing                                 
                            525        -                 Not assessed/no information             
                            653        0                 Not indicated                           
                            255        1                 Indicated                               
 
V200A08A $M3INDIC                      Mood Care Area Trigger                   
                          5,947                          Missing                                 
                          1,252        0                 Not indicated                           
                            181        1                 Indicated                               
 
V200A08B $M3INDIC                      Mood Adrsd in Care Plan                  
                          5,947                          Missing                                 
                            576        -                 Not assessed/no information             
                            705        0                 Not indicated                           
                            152        1                 Indicated                               
 
V200A09A $M3INDIC                      Bhvral Care Area Trigger                 
                          5,947                          Missing                                 
                          1,245        0                 Not indicated                           
                            188        1                 Indicated                               
 
V200A09B $M3INDIC                      Bhvral Adrsd in Care Plan                
                          5,947                          Missing                                 
                            577        -                 Not assessed/no information             
                            683        0                 Not indicated                           
                            173        1                 Indicated                               
 
V200A10A $M3INDIC                      Act Care Area Trigger                    
                          5,947                          Missing                                 
                          1,205        0                 Not indicated                           
                            228        1                 Indicated                               
 
V200A10B $M3INDIC                      Act Adrsd in Care Plan                   
                          5,947                          Missing                                 
                            548        -                 Not assessed/no information             
                            655        0                 Not indicated                           
                            230        1                 Indicated                               
 
V200A11A $M3INDIC                      Fall Care Area Trigger                   
                          5,947                          Missing                                 
                             37        0                 Not indicated                           
                          1,396        1                 Indicated                               
 
V200A11B $M3INDIC                      Fall Adrsd in Care Plan                  
                          5,947                          Missing                                 
                             36        -                 Not assessed/no information             
                             71        0                 Not indicated                           
                          1,326        1                 Indicated                               
 
V200A12A $M3INDIC                      Nutr Care Area Trigger                   
                          5,947                          Missing                                 
                            156        0                 Not indicated                           
                          1,277        1                 Indicated                               
 
V200A12B $M3INDIC                      Nutr Adrsd in Care Plan                  
                          5,947                          Missing                                 
                             96        -                 Not assessed/no information             
                            161        0                 Not indicated                           
                          1,176        1                 Indicated                               
 
V200A13A $M3INDIC                      Feeding Tube Care Area Trigger           
                          5,947                          Missing                                 
                          1,395        0                 Not indicated                           
                             38        1                 Indicated                               
 
V200A13B $M3INDIC                      Feeding Tube Adrsd in Care Plan          
                          5,947                          Missing                                 
                            641        -                 Not assessed/no information             
                            753        0                 Not indicated                           
                             39        1                 Indicated                               
 
V200A14A $M3INDIC                      Dehydration Care Area Trigger            
                          5,947                          Missing                                 
                          1,100        0                 Not indicated                           
                            333        1                 Indicated                               
 
V200A14B $M3INDIC                      Dehydration Adrsd in Care Plan           
                          5,947                          Missing                                 
                            513        -                 Not assessed/no information             
                            632        0                 Not indicated                           
                            288        1                 Indicated                               
 
V200A15A $M3INDIC                      Dental Care Area Trigger                 
                          5,947                          Missing                                 
                          1,053        0                 Not indicated                           
                            380        1                 Indicated                               
 
V200A15B $M3INDIC                      Dental Adrsd in Care Plan                
                          5,947                          Missing                                 
                            490        -                 Not assessed/no information             
                            651        0                 Not indicated                           
                            292        1                 Indicated                               
 
V200A16A $M3INDIC                      Press Ulcr Care Area Trigger             
                          5,947                          Missing                                 
                             19        0                 Not indicated                           
                          1,414        1                 Indicated                               
 
V200A16B $M3INDIC                      Press Ulcr Adrsd in Care Plan            
                          5,947                          Missing                                 
                             28        -                 Not assessed/no information             
                             99        0                 Not indicated                           
                          1,306        1                 Indicated                               
 
V200A17A $M3INDIC                      Psychotropic Drug Care Area Trigger      
                          5,947                          Missing                                 
                            600        0                 Not indicated                           
                            833        1                 Indicated                               
 
V200A17B $M3INDIC                      Psychotropic Drug Adrsd in Care Plan     
                          5,947                          Missing                                 
                            288        -                 Not assessed/no information             
                            362        0                 Not indicated                           
                            783        1                 Indicated                               
 
V200A18A $M3INDIC                      Rstrnt Care Area Trigger                 
                          5,947                          Missing                                 
                          1,415        0                 Not indicated                           
                             18        1                 Indicated                               
 
V200A18B $M3INDIC                      Rstrnt Adrsd in Care Plan                
                          5,947                          Missing                                 
                            642        -                 Not assessed/no information             
                            778        0                 Not indicated                           
                             13        1                 Indicated                               
 
V200A19A $M3INDIC                      Pain Care Area Trigger                   
                          5,947                          Missing                                 
                          1,136        0                 Not indicated                           
                            297        1                 Indicated                               
 
V200A19B $M3INDIC                      Pain Adrsd in Care Plan                  
                          5,947                          Missing                                 
                            512        -                 Not assessed/no information             
                            607        0                 Not indicated                           
                            314        1                 Indicated                               
 
V200A20A $M3INDIC                      Rtn to Comm Care Area Trigger            
                          5,947                          Missing                                 
                          1,352        0                 Not indicated                           
                             81        1                 Indicated                               
 
V200A20B $M3INDIC                      Rtn to Comm Adrsd in Care Plan           
                          5,947                          Missing                                 
                            610        -                 Not assessed/no information             
                            736        0                 Not indicated                           
                             87        1                 Indicated                               
 
