Variable Format    Q#/Freq            Description/Label
 
BASEID   $BSIDFMT                      Unique SP Identification Number          
                          5,447        LOW-HIGH          BASEID Count                            
 
SURVEYYR SVYRFMT                       Survey Year                              
                          5,447                    2017  2017                                    
 
VERSION  VERSFMT                       Version Number                           
                          5,447                       1  Version 1                               
 
M0010_CM                               M0010 CMS Certification Number (CCN)     
                          5,447        Range of values   Range of Values                         
 
M0014_BR                               M0014 Branch State Code                  
                          5,447                          Range of Values                         
 
M0016_BR                               M0016 Branch ID                          
                          5,447        Range of values   Range of Values                         
 
M0018_NN                               M0018 NPI Physician ID                   
                          5,447                          Range of Values                         
 
M0018_NU $INDICOA                      M0018 NPI Physician ID Unknown           
                          5,343        0                 Not indicated                           
                            104        1                 Indicated                               
 
M0030_ST MMDDYYn8                      M0030 Start of Care Date                 
                          5,447        MMDDYYYY          Date as MMDDYYYY                        
 
M0032_RO MMDDYYn8                      M0032 Resumption of Care Date            
                          5,020                       .  Inapplicable                            
                            427        MMDDYYYY          Date as MMDDYYYY                        
 
M0032_RN $YESNOOA                      M0032 Resumption of Care Date NA         
                            427        0                 No                                      
                          5,020        1                 Yes                                     
 
M0069_GN $SEXFMT                       M0069 Patient Sex                     
                          1,990        1                 Male                                    
                          3,457        2                 Female                                  
 
M0080_AS $DISCIOA                      M0080 Disc of Person Completing Assess   
                          4,363        01                RN                                      
                            939        02                PT                                      
                             46        03                SLP/ST                                  
                             99        04                OT                                      
 
M0090_AS MMDDYYn8                      M0090 Date Assessment Completed          
                          5,447        MMDDYYYY          Date as MMDDYYYY                        
 
M0100_RS $ACOMPOA                      M0100 Reason for Assessment              
                          1,877        01                S/R; Start; further visits planned      
                            285        03                S/R; Resumption of care                 
                          1,184        04                Follow-up; Recertification              
                             17        05                Follow-up; Other                        
                            469        06                Transfer to inpat fac; Patient not disch
                             62        07                Transfer to inpat fac; Patient disch    
                             10        08                Disch from agency; Death at home        
                          1,543        09                Disch from agency; Disch from agency    
 
M0102_PD MMDDYYn8                      M0102 Phys Ordered SOC or ROC Date       
                          4,737                       .  Inapplicable                            
                            710        MMDDYYYY          Date as MMDDYYYY                        
 
M0102_PN $INDICOA                      M0102 Phys Ordered SOC or ROC Date NA    
                          3,306                          Missing                                 
                            689        0                 Not indicated                           
                          1,452        1                 Indicated                               
 
M0104_RF MMDDYYn8                      M0104 Date Of Referral                   
                          3,995                       .  Inapplicable                            
                          1,452        MMDDYYYY          Date as MMDDYYYY                        
 
M0110_EP $EPSDFMT                      M0110 Episode Timing                     
                          2,084                          Missing                                 
                          2,280        01                Early                                   
                            891        02                Later                                   
                             78        NA                No case mix group defined               
                            114        UK                Unknown                                 
 
M0140_AM $INDICOA                      M0140 Race/Eth:Amer Indian/Alaskan Nat   
                          3,285                          Missing                                 
                          2,147        0                 Not indicated                           
                             15        1                 Indicated                               
 
M0140_AS $INDICOA                      M0140 Race/Ethnicity: Asian              
                          3,285                          Missing                                 
                          2,121        0                 Not indicated                           
                             41        1                 Indicated                               
 
M0140_AF $INDICOA                      M0140 Race/Eth:Black or African-American 
                          3,285                          Missing                                 
                          1,925        0                 Not indicated                           
                            237        1                 Indicated                               
 
M0140_HS $INDICOA                      M0140 Race/Ethnicity: Hispanic or Latino 
                          3,285                          Missing                                 
                          1,990        0                 Not indicated                           
                            172        1                 Indicated                               
 
M0140_NT $INDICOA                      M0140 Race/Eth:Nat Hawaii/Oth Pacific Isl
                          3,285                          Missing                                 
                          2,157        0                 Not indicated                           
                              5        1                 Indicated                               
 
M0140_WH $INDICOA                      M0140 Race/Eth:White                     
                          3,285                          Missing                                 
                            463        0                 Not indicated                           
                          1,699        1                 Indicated                               
 
M0150_DF $INDICOA                      M0150 Medicaid Fee For Service Payment   
                          5,210        0                 Not indicated                           
                            237        1                 Indicated                               
 
M0150_DH $INDICOA                      M0150 Medicaid HMO/Managed Care Payment  
                          5,340        0                 Not indicated                           
                            107        1                 Indicated                               
 
M0150_RF $INDICOA                      M0150 Medicare Fee For Service Payment   
                          1,694        0                 Not indicated                           
                          3,753        1                 Indicated                               
 
M0150_RH $INDICOA                      M0150 Medicare HMO/Managed Care Payment  
                          3,903        0                 Not indicated                           
                          1,544        1                 Indicated                               
 
M0150_NO $INDICOA                      M0150 No Payment                         
                          5,447        0                 Not indicated                           
 
M0150_OG $INDICOA                      M0150 Other Government Payment           
                          5,420        0                 Not indicated                           
                             27        1                 Indicated                               
 
M0150_OP $INDICOA                      M0150 Other Payment Source               
                          5,425        0                 Not indicated                           
                             22        1                 Indicated                               
 
M0150_PH $INDICOA                      M0150 Private HMO/Managed Care Payment   
                          5,406        0                 Not indicated                           
                             41        1                 Indicated                               
 
M0150_PI $INDICOA                      M0150 Private Insurance Payment          
                          5,364        0                 Not indicated                           
                             83        1                 Indicated                               
 
M0150_SE $INDICOA                      M0150 Self-Pay Payment                   
                          5,412        0                 Not indicated                           
                             35        1                 Indicated                               
 
M0150_TI $INDICOA                      M0150 Title Programs Payment             
                          5,443        0                 Not indicated                           
                              4        1                 Indicated                               
 
M0150_UN $INDICOA                      M0150 Unknown Payment Source             
                          3,285                          Missing                                 
                          2,162        0                 Not indicated                           
 
M0150_WC $INDICOA                      M0150 Workers Compensation Payment       
                          5,445        0                 Not indicated                           
                              2        1                 Indicated                               
 
M0903_LA MMDDYYn8                      M0903 Date of Last Home Visit            
                          3,363                       .  Inapplicable                            
                          2,084        MMDDYYYY          Date as MMDDYYYY                        
 
M0906_DS MMDDYYn8                      M0906 Discharge/Transfer/Death Date      
                          3,363                       .  Inapplicable                            
                          2,084        MMDDYYYY          Date as MMDDYYYY                        
 
M1000_IP $INDICOA                      M1000 Inp Discharg;Short Stay Acut Hosp  
                          3,285                          Missing                                 
                          1,147        0                 Not indicated                           
                          1,015        1                 Indicated                               
 
M1000_IR $INDICOA                      M1000 Inp Discharg;IRF                   
                          3,285                          Missing                                 
                          2,012        0                 Not indicated                           
                            150        1                 Indicated                               
 
M1000_NF $INDICOA                      M1000 Inp Discharg;Nursing Facility      
                          3,285                          Missing                                 
                          2,155        0                 Not indicated                           
                              7        1                 Indicated                               
 
M1000_LT $INDICOA                      M1000 Discharged Past 14 Days;LTCH       
                          3,285                          Missing                                 
                          2,147        0                 Not indicated                           
                             15        1                 Indicated                               
 
M1000_NO $INDICOA                      M1000 No Inp Discharge                   
                          3,285                          Missing                                 
                          1,504        0                 Not indicated                           
                            658        1                 Indicated                               
 
M1000_OT $INDICOA                      M1000 Inp Discharg;Other                 
                          3,285                          Missing                                 
                          2,159        0                 Not indicated                           
                              3        1                 Indicated                               
 
M1000_PS $INDICOA                      M1000 Inp Discharg;Psych Hospital Or Unit
                          3,285                          Missing                                 
                          2,156        0                 Not indicated                           
                              6        1                 Indicated                               
 
M1000_SN $INDICOA                      M1000 Inp Discharg;SNF/TCU Facility      
                          3,285                          Missing                                 
                          1,801        0                 Not indicated                           
                            361        1                 Indicated                               
 
M1005_IU $INDICOA                      M1005 Inpat Discharge Date Unknown       
                          3,943                          Missing                                 
                          1,466        0                 Not indicated                           
                             38        1                 Indicated                               
 
M1005_ID MMDDYYn8                      M1005 Most Recent Inpat Discharge Date   
                          3,981                       .  Inapplicable                            
                          1,466        MMDDYYYY          Date as MMDDYYYY                        
 
M1018_IC $INDICOA                      M1018 Pri Cond;Indwelling/SuprapubicCathe
                          3,285                          Missing                                 
                          2,116        0                 Not indicated                           
                             46        1                 Indicated                               
 
M1018_DB $INDICOA                      M1018 Pri Cond;Disruptive Behavior       
                          3,285                          Missing                                 
                          2,128        0                 Not indicated                           
                             34        1                 Indicated                               
 
M1018_ID $INDICOA                      M1018 Pri Cond;Impaired Decision-Making  
                          3,285                          Missing                                 
                          1,752        0                 Not indicated                           
                            410        1                 Indicated                               
 
M1018_IP $INDICOA                      M1018 Pri Cond;Intractable Pain          
                          3,285                          Missing                                 
                          1,832        0                 Not indicated                           
                            330        1                 Indicated                               
 
M1018_ML $INDICOA                      M1018 Pri Cond;Memory Loss               
                          3,285                          Missing                                 
                          1,883        0                 Not indicated                           
                            279        1                 Indicated                               
 
M1018_NA $INDICOA                      M1018 Pri Cond;Not Applicable            
                          3,285                          Missing                                 
                          1,987        0                 Not indicated                           
                            175        1                 Indicated                               
 
M1018_NO $INDICOA                      M1018 Pri Cond;None of the Above         
                          3,285                          Missing                                 
                          1,399        0                 Not indicated                           
                            763        1                 Indicated                               
 
M1018_UN $INDICOA                      M1018 Pri Cond;Unknown                   
                          3,285                          Missing                                 
                          2,148        0                 Not indicated                           
                             14        1                 Indicated                               
 
M1018_UI $INDICOA                      M1018 Pri Cond;Urinary Incontinence      
                          3,285                          Missing                                 
                          1,291        0                 Not indicated                           
                            871        1                 Indicated                               
 
M1030_HE $INDICOA                      M1030 Home Thera; Enteral Nutrition      
                          2,084                          Missing                                 
                          3,326        0                 Not indicated                           
                             37        1                 Indicated                               
 
M1030_HI $INDICOA                      M1030 Home Thera; Intravenous/Infusion Th
                          2,084                          Missing                                 
                          3,305        0                 Not indicated                           
                             58        1                 Indicated                               
 
M1030_HN $INDICOA                      M1030 Home Thera; None of the Above      
                          2,084                          Missing                                 
                            103        0                 Not indicated                           
                          3,260        1                 Indicated                               
 
M1030_HP $INDICOA                      M1030 Home Thera; Parenteral Nutrition   
                          2,084                          Missing                                 
                          3,355        0                 Not indicated                           
                              8        1                 Indicated                               
 
M1034_OV $STATUOA                      M1034 Overall Status                     
                          3,285                          Missing                                 
                            109        00                SP is stable with no heightened risk    
                          1,121        01                SP is temporarily facing high health ris
                            821        02                SP is likely to remain in fragile health
                            109        03                SP has serious progressive conditions   
                              2        UK                Unknown                                 
 
M1036_RA $INDICOA                      M1036 Risk Factor - Alcohol Dependency   
                          3,285                          Missing                                 
                          2,104        0                 Not indicated                           
                             58        1                 Indicated                               
 
M1036_RD $INDICOA                      M1036 Risk Factor - Drug Dependency      
                          3,285                          Missing                                 
                          2,120        0                 Not indicated                           
                             42        1                 Indicated                               
 
M1036_RN $INDICOA                      M1036 Risk Factor - None of the Above    
                          3,285                          Missing                                 
                            986        0                 Not indicated                           
                          1,176        1                 Indicated                               
 
M1036_RO $INDICOA                      M1036 Risk Factor - Obesity              
                          3,285                          Missing                                 
                          1,576        0                 Not indicated                           
                            586        1                 Indicated                               
 
M1036_RS $INDICOA                      M1036 Risk Factor - Smoking              
                          3,285                          Missing                                 
                          1,697        0                 Not indicated                           
                            465        1                 Indicated                               
 
M1036_RU $INDICOA                      M1036 Risk Factor - Unknown              
                          3,285                          Missing                                 
                          2,122        0                 Not indicated                           
                             40        1                 Indicated                               
 
M1100_PT $PTLVG                        M1100 Patient Living Arrangement         
                          3,285                          Missing                                 
                            204        01                Lives alone, 24 hour assistance         
                             62        02                Lives alone, daytime assistance         
                             15        03                Lives alone, nighttime assistance       
                            291        04                Lives alone, occasional/short-term asst 
                             20        05                Lives alone, no assistance              
                          1,100        06                Lives at home w/others, 24 hr assistance
                             37        07                Lives at home w/others, daytime assist  
                             80        08                Lives at home w/others, nighttime assist
                             58        09                Lives at home w/others, occas/short-term
                              3        10                Lives at home w/others, no assistance av
                            274        11                Lives in congregate situation, 24 hour a
                              2        12                Lives in congregate situation, daytime a
                             16        14                Lives in congregate situation, occasiona
 
M1200_VS $VISIOOA                      M1200 Vision                             
                          2,084                          Missing                                 
                          2,126        00                Normal vision                           
                          1,151        01                Partially impaired                      
                             86        02                Severely impaired                       
 
M1210_HE $HEARCOA                      M1210 Hearing                            
                          3,285                          Missing                                 
                          1,212        00                Adequate                                
                            915        01                Mildly to moderately impaired           
                             31        02                Severely impaired                       
                              4        UK                Unable to assess hearing                
 
M1220_UN $VERBAOA                      M1220 Understand Verbal Content          
                          3,285                          Missing                                 
                          1,134        00                Understands                             
                            867        01                Usually understands                     
                            145        02                Sometimes understands                   
                              9        03                Never understands                       
                              7        UK                Unable to assess hearing                
 
M1230_VR $SPEECOA                      M1230 Verbal Expression                  
                          1,742                          Missing                                 
                          2,261        00                No observable impairement               
                          1,124        01                Minimal difficulty                      
                            235        02                Moderate difficulty                     
                             66        03                Severe difficulty                       
                             10        04                Unable to express basic needs           
                              9        05                Nonresponsive or unable to speak        
 
M1240_PA $PAINAOA                      M1240 Formal Pain Assess                 
                          3,285                          Missing                                 
                              8        00                No standardized assessment              
                          1,668        01                Yes, severe pain not indicated          
                            486        02                Yes, severe pain indicated              
 
M1242_PA $FREQCOA                      M1242 Freq Of Pain Interfere W Activity  
                            541                          Missing                                 
                          1,250        00                No pain                                 
                            590        01                Pain does not interfere                 
                            696        02                Less often than daily                   
                          1,871        03                Daily, but not constantly               
                            499        04                All of the time                         
 
M1300_PR $ULASSOA                      M1300 Pressure Ulcer Assess              
                          3,285                          Missing                                 
                             12        00                No assessment conducted                 
                             99        01                Yes, based on eval of clinical factors  
                          2,051        02                Yes, using a standardized tool          
 
M1302_PR $YESNOOA                      M1302 Risk Of Devel Press Ulcers         
                          3,297                          Missing                                 
                          1,034        0                 No                                      
                          1,116        1                 Yes                                     
 
M1306_PR $YESNOOA                      M1306 Unheal Press Ulcers; St II+        
                            541                          Missing                                 
                          4,732        0                 No                                      
                            174        1                 Yes                                     
 
M1307_PD $OLDPUL                       M1307 Oldest St II Press Ulcer Onset Date
                          5,431                          Missing                                 
                             12        01                Was present at most recent SOC/ROC asses
                              2        02                Developed since most recent SOC/ROC asse
                              2        NA                None present at discharge               
 
M1307_PS MMDDYYn8                      M1307 Oldest St II Press Ulcer Since SOC/
                          5,445                       .  Inapplicable                            
                              2        MMDDYYYY          Date as MMDDYYYY                        
 
M1320_PR $ULSTAPO                      M1320 Status, Most Problemat Press Ulcer 
                          5,339                          Missing                                 
                              5        02                Early/Partial granulation               
                            103        03                Not healing                             
 
M1322_ST $ULNUMOA                      M1322 Curr # Of Stage I Press Ulcers     
                            541                          Missing                                 
                          4,832        00                None                                    
                             61        01                One                                     
                              8        02                Two                                     
                              4        03                Three                                   
                              1        04                Four or more                            
 
M1324_PR $ULSTGOA                      M1324 Stage, Most Problemat Press Ulcer  
                            541                          Not assessed/no information             
                             53        01                Stage one                               
                            106        02                Stage two                               
                             28        03                Stage three                             
                             14        04                Stage four                              
                          4,705        NA                No observable pressure ulcer            
 
M1330_ST $STASUOA                      M1330 Stasis Ulcer Present               
                            541                          Missing                                 
                          4,825        00                No                                      
                              7        01                Yes, BOTH observable and unobservable   
                             69        02                Yes, Observable only                    
                              5        03                Yes, Unobservable only                  
 
M1332_ST $ULNUMOA                      M1332 Curr # Of Stasis Ulcer             
                          5,371                          Missing                                 
                             38        01                One                                     
                             12        02                Two                                     
                              8        03                Three                                   
                             18        04                Four or more                            
 
M1334_ST $ULSTAQO                      M1334 Status, Most Problemat Stasis Ulcer
                          5,371                          Missing                                 
                              9        01                Fully granulating                       
                             21        02                Early/Partial granulation               
                             46        03                Not healing                             
 
M1340_SR $SURGWOA                      M1340 Surgical Wound Present             
                            541                          Missing                                 
                          4,156        00                No                                      
                            613        01                Yes, observable                         
                            137        02                Yes, not observable                     
 
M1342_SR $ULSTAQO                      M1342 Status, Most Problemat Surg Wound  
                          4,834                          Missing                                 
                            329        00                Newly epithelialized                    
                             35        01                Fully granulating                       
                             43        02                Early/Partial granulation               
                            206        03                Not healing                             
 
M1350_OP $YESNOOA                      M1350 Skin Lesion Or Open Wound          
                          3,285                          Missing                                 
                          1,619        0                 No                                      
                            543        1                 Yes                                     
 
M1400_SO $SBREAOA                      M1400 When Is Patient Dyspneic or SOB    
                            541                          Missing                                 
                          1,546        00                Never                                   
                          1,263        01                When walking more than 20 feet          
                          1,340        02                With moderate exertion                  
                            637        03                With minimal exertion                   
                            120        04                At rest (day or night)                  
 
M1410_CP $INDICOA                      M1410 Resp Treat @ Home;CPAP/BPAP        
                          3,285                          Missing                                 
                          2,070        0                 Not indicated                           
                             92        1                 Indicated                               
 
M1410_RS $INDICOA                      M1410 Resp Treat @ Home;None of the Above
                          3,285                          Missing                                 
                            454        0                 Not indicated                           
                          1,708        1                 Indicated                               
 
M1410_OX $INDICOA                      M1410 Resp Treat @ Home;Oxygen           
                          3,285                          Missing                                 
                          1,761        0                 Not indicated                           
                            401        1                 Indicated                               
 
M1410_VN $INDICOA                      M1410 Resp Treat @ Home;Ventilator       
                          3,285                          Missing                                 
                          2,162        0                 Not indicated                           
 
M1600_UT $UTINFOA                      M1600 UTI Treatment                      
                          1,742                          Missing                                 
                          3,387        00                No                                      
                            267        01                Yes                                     
                             39        NA                Patient on prophylactic treatment       
                             12        UK                Unknown                                 
 
M1610_UR $UIUCPOA                      M1610 Urinar Incont Or Catheter Presence 
                            541                          Missing                                 
                          2,019        00                No incontinence or catheter             
                          2,663        01                Patient is incintinent                  
                            224        02                Patient requires a urinary catheter     
 
M1615_UR $URINCOO                      M1615 Urinar Incont Timing               
                          3,534                          Missing                                 
                            159        00                Timed-voiding deters incontinence       
                            799        01                Occasional stress incontinence          
                             74        02                During the night only                   
                             31        03                During the day only                     
                            850        04                During the day and night                
 
M1620_BW $BWINCOA                      M1620 Bowel Incontinence Frequency       
                            541                          Missing                                 
                          4,021        00                Very rarely or never has bowel incont   
                            311        01                Less than once weekly                   
                            236        02                One to three times weekly               
                             73        03                Four to six times weekly                
                            140        04                On a daily basis                        
                             24        05                More often than once daily              
                            100        NA                Patient has ostomy for bowel elimination
                              1        UK                Unknown                                 
 
M1630_OS $BWOSTOA                      M1630 Ostomy For Bowel Elimination       
                          2,084                          Missing                                 
                          3,281        00                Does not have an ostomy                 
                             64        01                Ostomy was not related to inpatient stay
                             18        02                Ostomy was related to inpatient stay    
 
M1700_CG $COGFUOA                      M1700 Cognitive Functioning              
                          1,742                          Missing                                 
                          2,077        00                Alert/Oriented                          
                          1,141        01                Req prompting                           
                            370        02                Req assist and some direction           
                             95        03                Req conciderable assist in routine situa
                             22        04                Totally dependent due to disturbances   
 
M1710_CN $WCONFOA                      M1710 When Confused Frequency            
                          1,742                          Missing                                 
                          1,853        00                Never                                   
                          1,336        01                In new or complex situations            
                             72        02                On awakening or at night only           
                            324        03                During the day or evening               
                            113        04                Constantly                              
                              7        NA                Patient nonresponsive                   
 
M1720_AN $WANXIOA                      M1720 When Anxious Frequency             
                          1,742                          Missing                                 
                          2,198        00                None of the time                        
                            938        01                Less often than daily                   
                            536        02                Daily, but not constantly               
                             25        03                All of the time                         
                              8        NA                Patient nonresponsive                   
 
M1730_DS $DEPRAOA                      M1730 Depression Screening               
                          3,285                          Missing                                 
                             58        00                No                                      
                          2,021        01                Yes, PHQ-2 scale                        
                             13        02                Yes, other, further evaluation          
                             70        03                Yes, other, no further evaluation       
 
M1730_PD $DEPRBOA                      M1730 PHQ2 Down/Depressed/Hopeless       
                          3,426                          Missing                                 
                          1,611        00                Not at all (0-1)                        
                            320        01                Several days (2-6)                      
                             57        02                More than half of the days (7-11)       
                             18        03                Nearly every day (12-14)                
                             15        NA                Patient nonresponsive                   
 
M1730_PI $DEPRBOA                      M1730 PHQ2 Little Interest/Pleasure      
                          3,426                          Missing                                 
                          1,630        00                Not at all (0-1)                        
                            303        01                Several days (2-6)                      
                             57        02                More than half of the days (7-11)       
                             15        03                Nearly every day (12-14)                
                             16        NA                Patient nonresponsive                   
 
M1740_DL $INDICOA                      M1740 Cog/Behav/Psych; Delusional        
                          1,742                          Missing                                 
                          3,666        0                 Not indicated                           
                             39        1                 Indicated                               
 
M1740_IM $INDICOA                      M1740 Cog/Behav/Psych;Impaired Decision_m
                          1,742                          Missing                                 
                          2,999        0                 Not indicated                           
                            706        1                 Indicated                               
 
M1740_ME $INDICOA                      M1740 Cog/Behav/Psych;Memory Deficit     
                          1,742                          Missing                                 
                          3,073        0                 Not indicated                           
                            632        1                 Indicated                               
 
M1740_CG $INDICOA                      M1740 Cog/Behav/Psych;None of the Above  
                          1,742                          Missing                                 
                            981        0                 Not indicated                           
                          2,724        1                 Indicated                               
 
M1740_PH $INDICOA                      M1740 Cog/Behav/Psych;Physical Aggression
                          1,742                          Missing                                 
                          3,673        0                 Not indicated                           
                             32        1                 Indicated                               
 
M1740_DS $INDICOA                      M1740 Cog/Behav/Psych;Disruptive/Inapprop
                          1,742                          Missing                                 
                          3,677        0                 Not indicated                           
                             28        1                 Indicated                               
 
M1740_VR $INDICOA                      M1740 Cog/Behav/Psych;Verbal Disruption  
                          1,742                          Missing                                 
                          3,668        0                 Not indicated                           
                             37        1                 Indicated                               
 
M1745_DS $FREQBOA                      M1745 Freq Of Disruptive Behav Symptoms  
                          1,742                          Missing                                 
                          2,975        00                Never                                   
                            113        01                Less than once a month                  
                             21        02                One a month                             
                             85        03                Several times each month                
                            161        04                Several times a week                    
                            350        05                At least daily                          
 
M1750_PH $YESNOOA                      M1750 Receives Psych Nursing Services    
                          3,285                          Missing                                 
                          2,147        0                 No                                      
                             15        1                 Yes                                     
 
M1800_GR $GROOMOA                      M1800 Current Grooming                   
                          1,742                          Missing                                 
                          1,025        00                Able to groom self unaided              
                          1,327        01                Utensils must be placed within reach    
                          1,140        02                Someone must assis patient to groom self
                            213        03                Depends entirely upon another person    
 
M1810_DR $DRESSOA                      M1810 Current Dress Upper Body           
                            541                          Missing                                 
                          1,116        00                No assist needed                        
                          1,681        01                No assist needed if clothing laid out   
                          1,747        02                Assist from another person              
                            362        03                Depends entirely upon another person    
 
M1820_DR $DRESSOA                      M1820 Current Dress Lower Body           
                            541                          Missing                                 
                            971        00                No assist needed                        
                          1,021        01                No assist needed if clothing laid out   
                          2,211        02                Assist from another person              
                            703        03                Depends entirely upon another person    
 
M1830_BA $BATHCOA                      M1830 Ability To Wash Body               
                            541                          Missing                                 
                            387        00                Bathes self independently               
                            621        01                Bathes self with use of devices         
                          1,041        02                Bathes with intermittent assist         
                          1,858        03                Bathes with complete assist/supervision 
                            189        04                Unable, bed/sink/chair, independent     
                            529        05                Unable, bed/sing/chair, assisted        
                            281        06                Unable, totally bathed by another person
 
M1840_TO $TOILEOA                      M1840 Current Toilet Transferring        
                            541                          Missing                                 
                          1,525        00                Toilet, to and from independently       
                          2,323        01                Toilet, when reminded/assist/supervised 
                            640        02                Unable toil, able to bedside commode    
                             88        03                Unable toil/bedside commode, able bedpan
                            330        04                Depends entirely upon another person    
 
M1845_TO $TOILEOA                      M1845 Current Toileting Hygiene          
                          1,742                          Missing                                 
                          1,094        00                Toilet, to and from independently       
                          1,104        01                Toilet, when reminded/assist/supervised 
                          1,231        02                Unable toil, able to bedside commode    
                            276        03                Unable toil/bedside commode, able bedpan
 
M1850_TR $TRANSOA                      M1850 Current Transferring               
                            541                          Missing                                 
                            861        00                Able to independently transfer          
                          1,928        01                Transfers with minimal assist or device 
                          1,665        02                Unable transfer self, able to pivot     
                            363        03                Unable transfer self, unable to pivot   
                             25        04                Bedfast, unable trans, able to positio  
                             64        05                Bedfast, unable trans, unable to positio
 
M1860_AM $AMBUCOA                      M1860 Current Ambulation/Locomotion      
                            541                          Missing                                 
                            439        00                Able to independently walk/stairs       
                            617        01                Able to walk w/ 1 handed device         
                          1,510        02                Able to walk w/ 2 handed device         
                          1,851        03                Able to walk w/ constant assist/supervis
                            233        04                Chairfast, able to wheel self independ  
                            211        05                Chairfast, unable to wheel self independ
                             45        06                Bedfast, unable to ambulate/or chair    
 
M1870_EA $FEEDIOA                      M1870 Current Feeding or Eating          
                          1,742                          Missing                                 
                          1,740        00                Able independently feed self            
                          1,785        01                Able feed self with intermittent assist 
                            145        02                Unable feed self, complete assist/superv
                              9        03                Able take nutri oral, rec tube feedi    
                             20        04                Unable take nutri oral, rec tube feedi  
                              6        05                Unable take nutri oral or tube feedi    
 
M1880_PR $MEALSOA                      M1880 Current Plan/Prepare Light Meal    
                          1,742                          Missing                                 
                            992        00                Able to independently prepare all meals 
                          1,392        01                Unable to prepare meals on regular basis
                          1,321        02                Unable to prepare any meals             
 
M1890_TE $TELEPOA                      M1890 Current Telephone Use              
                          1,742                          Missing                                 
                          2,412        00                Able independently dial/answer calls    
                            309        01                Able use a specif adapted phone and call
                            359        02                Able answer calls, diff placing calls   
                            287        03                Able answer calls only some of the time 
                            124        04                Unable answer phone at all, can listen  
                            116        05                Totaly unable to use the telephone      
                             98        NA                Patient does not have a telephone       
 
M1900_PA $PRADLOA                      M1900 Pri Funct ADL/IADL; Ambulation     
                          3,285                          Missing                                 
                            876        00                Independent                             
                          1,116        01                Needed some help                        
                            170        02                Dependent                               
 
M1900_PH $PRADLOA                      M1900 Pri Funct ADL/IADL; Household Tasks
                          3,285                          Missing                                 
                            464        00                Independent                             
                          1,039        01                Needed some help                        
                            659        02                Dependent                               
 
M1900_PS $PRADLOA                      M1900 Pri Funct ADL/IADL; Self Care      
                          3,285                          Missing                                 
                            798        00                Independent                             
                          1,177        01                Needed some help                        
                            187        02                Dependent                               
 
M1900_PT $PRADLOA                      M1900 Pri Funct ADL/IADL; Transfer       
                          3,285                          Missing                                 
                            952        00                Independent                             
                          1,066        01                Needed some help                        
                            144        02                Dependent                               
 
M1910_FA $FALLMOA                      M1910 Multi-Factor Fall Risk Assessment  
                          3,285                          Missing                                 
                              7        00                No multi-factor fall risk assessment    
                             82        01                Yes, does not indicated a risk for fall 
                          2,073        02                Yes, indicates a risk for falls fall    
 
M2010_DR $YESNAOA                      M2010 Patient/Caregiv High Risk Drug Educ
                          3,293                          Missing                                 
                             54        00                No                                      
                          1,767        01                Yes                                     
                            333        NA                Not applicable                          
 
M2020_OR $MGMRXOA                      M2020 Curr Manag Of Oral Medications     
                          1,750                          Missing                                 
                            851        00                Able to independently take correct med  
                            919        01                Able to take med corect times w/ prepare
                            592        02                Able to take med corect times w/ assist 
                          1,322        03                Unable to take med unless administered  
                             13        NA                No med of this type prescribed          
 
M2030_IN $MGMRXOA                      M2030 Curr Manag Of Injectable Medication
                            549                          Missing                                 
                            204        00                Able to independently take correct med  
                            202        01                Able to take med corect times w/ prepare
                            120        02                Able to take med corect times w/ assist 
                            540        03                Unable to take med unless administered  
                          3,832        NA                No med of this type prescribed          
 
M2040_PR $PRADLOA                      M2040 Prior Medication Manag; Injectable 
                          3,285                          Missing                                 
                            135        00                Independent                             
                            182        01                Needed some help                        
                            149        02                Dependent                               
                          1,696        NA                NA                                      
 
M2110_AD $FREQAOA                      M2110 Freq Of ADL/IADL Assist From Caregi
                          3,285                          Missing                                 
                          1,811        01                Daily                                   
                            171        02                Three or more times per week            
                             91        03                One to two times per week               
                             44        04                Received, but less often than weekly    
                             40        05                No assistance received                  
                              5        UK                Unknown                                 
 
M2200_NA $INDICOA                      M2200 Therapy Need; Not Applicable       
                          2,084                          Missing                                 
                          3,277        0                 Not indicated                           
                             86        1                 Indicated                               
 
M2200_VI                               M2200 Therapy Need; Number Of Visits     
                          5,447                          Range of Values                         
 
M2250_DB $YESNAOA                      M2250 POC Synop; Diabetic Foot Care      
                          3,285                          Missing                                 
                             17        00                No                                      
                            840        01                Yes                                     
                          1,305        NA                Not applicable                          
 
M2250_DT $ASSISOA                      M2250 POC Synop; Depression Intervention 
                          3,285                          Missing                                 
                             30        00                No assistance needed                    
                            589        01                Currently provide assistance            
                          1,543        NA                Not applicable                          
 
M2250_FA $ASSISOA                      M2250 POC Synop; Fall Prevention         
                          3,285                          Missing                                 
                              5        00                No assistance needed                    
                          2,124        01                Currently provide assistance            
                             33        NA                Not applicable                          
 
M2250_PI $YESNAOA                      M2250 POC Synop; Pain Intervention       
                          3,285                          Missing                                 
                             17        00                No                                      
                          1,864        01                Yes                                     
                            281        NA                Not applicable                          
 
M2250_PR $YESNAOA                      M2250 POC Synop; Press Ulcer Prevention  
                          3,285                          Missing                                 
                             17        00                No                                      
                          1,221        01                Yes                                     
                            924        NA                Not applicable                          
 
M2250_PU $YESNAOA                      M2250 POC Synop; Press Ulcer Moist Treatm
                          3,285                          Missing                                 
                              9        00                No                                      
                            102        01                Yes                                     
                          2,051        NA                Not applicable                          
 
M2250_PN $YESNAOA                      M2250 POC Synop; Parameter Phys Notif    
                          3,285                          Missing                                 
                             38        00                No                                      
                          1,056        01                Yes                                     
                          1,068        NA                Not applicable                          
 
M2310_CR $INDICOA                      M2310 EmergCare;Cardiac Dysrhythmia      
                          4,960                          Missing                                 
                            469        0                 Not indicated                           
                             18        1                 Indicated                               
 
M2310_IV $INDICOA                      M2310 EmergCare;IV Catheter Infection    
                          4,960                          Missing                                 
                            486        0                 Not indicated                           
                              1        1                 Indicated                               
 
M2310_DE $INDICOA                      M2310 EmergCare;Dehydration/Malnutrition 
                          4,960                          Missing                                 
                            472        0                 Not indicated                           
                             15        1                 Indicated                               
 
M2310_PL $INDICOA                      M2310 EmergCare;DVT, Pulmonary Embolus   
                          4,960                          Missing                                 
                            486        0                 Not indicated                           
                              1        1                 Indicated                               
 
M2310_GI $INDICOA                      M2310 EmergCare;GI Issues                
                          4,960                          Missing                                 
                            472        0                 Not indicated                           
                             15        1                 Indicated                               
 
M2310_HR $INDICOA                      M2310 EmergCare;Heart Failure            
                          4,960                          Missing                                 
                            444        0                 Not indicated                           
                             43        1                 Indicated                               
 
M2310_DB $INDICOA                      M2310 EmergCare;Hypo/Hyperglycemia/Diabet
                          4,960                          Missing                                 
                            485        0                 Not indicated                           
                              2        1                 Indicated                               
 
M2310_FA $INDICOA                      M2310 EmergCare;Injury From Fall         
                          4,960                          Missing                                 
                            436        0                 Not indicated                           
                             51        1                 Indicated                               
 
M2310_MD $INDICOA                      M2310 EmergCare;Improper Medication Admin
                          4,960                          Missing                                 
                            481        0                 Not indicated                           
                              6        1                 Indicated                               
 
M2310_MN $INDICOA                      M2310 EmergCare;Acute Mental/Behavioral  
                          4,960                          Missing                                 
                            475        0                 Not indicated                           
                             12        1                 Indicated                               
 
M2310_CH $INDICOA                      M2310 EmergCare;Myocardial Infarc/Chest P
                          4,960                          Missing                                 
                            464        0                 Not indicated                           
                             23        1                 Indicated                               
 
M2310_OT $INDICOA                      M2310 EmergCare;Other                    
                          4,960                          Missing                                 
                            311        0                 Not indicated                           
                            176        1                 Indicated                               
 
M2310_OH $INDICOA                      M2310 EmergCare;Other Heart Disease      
                          4,960                          Missing                                 
                            480        0                 Not indicated                           
                              7        1                 Indicated                               
 
M2310_RS $INDICOA                      M2310 EmergCare;Respir Infection         
                          4,960                          Missing                                 
                            456        0                 Not indicated                           
                             31        1                 Indicated                               
 
M2310_OR $INDICOA                      M2310 EmergCare;Other Respir Problem     
                          4,960                          Missing                                 
                            444        0                 Not indicated                           
                             43        1                 Indicated                               
 
M2310_ST $INDICOA                      M2310 EmergCare;Stroke (CVA) or TIA      
                          4,960                          Missing                                 
                            480        0                 Not indicated                           
                              7        1                 Indicated                               
 
M2310_UN $INDICOA                      M2310 EmergCare;Unknown                  
                          4,960                          Missing                                 
                            446        0                 Not indicated                           
                             41        1                 Indicated                               
 
M2310_PA $INDICOA                      M2310 EmergCare;Uncontrolled Pain        
                          4,960                          Missing                                 
                            465        0                 Not indicated                           
                             22        1                 Indicated                               
 
M2310_UT $INDICOA                      M2310 EmergCare;Urinary Tract Infection  
                          4,960                          Missing                                 
                            460        0                 Not indicated                           
                             27        1                 Indicated                               
 
M2310_WN $INDICOA                      M2310 EmergCare;Wound Infection/Deteriora
                          4,960                          Missing                                 
                            473        0                 Not indicated                           
                             14        1                 Indicated                               
 
M2410_AD $INFACOA                      M2410 Admit Inpatient Facility Type      
                          3,373                          Missing                                 
                            505        01                Hospital                                
                             11        02                Rehabilitation facility                 
                             13        03                Nursing home                            
                              2        04                Hospice                                 
                          1,543        NA                No inpatient facility admission         
 
M2420_DS $DISPOCA                      M2420 Discharge Location                 
                          3,904                          Missing                                 
                          1,108        01                Patient remained in commun, no assistive
                            387        02                Patient remained in commun, assistive   
                             23        03                Patient transferred to a noninsti hospic
                             14        04                Unknown, location not served by agency  
                             11        UK                Unknown, other                          
 
M2430_CR $INDICOA                      M2430 Hosp Reas;Cardiac Dysrhythmia      
                          4,942                          Missing                                 
                            488        0                 Not indicated                           
                             17        1                 Indicated                               
 
M2430_IV $INDICOA                      M2430 Hosp Reas IV Catheter Infection    
                          4,942                          Missing                                 
                            504        0                 Not indicated                           
                              1        1                 Indicated                               
 
M2430_DE $INDICOA                      M2430 Hosp Reas;Dehydration/Malnutrition 
                          4,942                          Missing                                 
                            493        0                 Not indicated                           
                             12        1                 Indicated                               
 
M2430_GI $INDICOA                      M2430 Hosp Reas;GI Issues                
                          4,942                          Missing                                 
                            487        0                 Not indicated                           
                             18        1                 Indicated                               
 
M2430_HR $INDICOA                      M2430 Hosp Reas;Heart Failure            
                          4,942                          Missing                                 
                            464        0                 Not indicated                           
                             41        1                 Indicated                               
 
M2430_FA $INDICOA                      M2430 Hosp Reas;Injury Caused by Fall    
                          4,942                          Missing                                 
                            466        0                 Not indicated                           
                             39        1                 Indicated                               
 
M2430_MD $INDICOA                      M2430 Hosp Reas;Improper Medication Admin
                          4,942                          Missing                                 
                            502        0                 Not indicated                           
                              3        1                 Indicated                               
 
M2430_MN $INDICOA                      M2430 Hosp Reas;Acute Mental/Behavioral  
                          4,942                          Missing                                 
                            493        0                 Not indicated                           
                             12        1                 Indicated                               
 
M2430_CH $INDICOA                      M2430 Hosp Reas Myocardial Infarc/Chest P
                          4,942                          Missing                                 
                            485        0                 Not indicated                           
                             20        1                 Indicated                               
 
M2430_OC $INDICOA                      M2430 Hosp Reas Other                    
                          4,942                          Missing                                 
                            323        0                 Not indicated                           
                            182        1                 Indicated                               
 
M2430_OH $INDICOA                      M2430 Hosp Reas Other Heart Disease      
                          4,942                          Missing                                 
                            496        0                 Not indicated                           
                              9        1                 Indicated                               
 
M2430_PA $INDICOA                      M2430 Hosp Reas Uncontrolled Pain        
                          4,942                          Missing                                 
                            494        0                 Not indicated                           
                             11        1                 Indicated                               
 
M2430_RS $INDICOA                      M2430 Hosp Reas Respiratory Infection    
                          4,942                          Missing                                 
                            467        0                 Not indicated                           
                             38        1                 Indicated                               
 
M2430_OR $INDICOA                      M2430 Hosp Reas Other Respiratory Problem
                          4,942                          Missing                                 
                            462        0                 Not indicated                           
                             43        1                 Indicated                               
 
M2430_SC $INDICOA                      M2430 Hosp Reas Sched Treatment/Procedure
                          4,942                          Missing                                 
                            484        0                 Not indicated                           
                             21        1                 Indicated                               
 
M2430_ST $INDICOA                      M2430 Hosp Reas Stroke (CVA) Or TIA      
                          4,942                          Missing                                 
                            496        0                 Not indicated                           
                              9        1                 Indicated                               
 
M2430_UN $INDICOA                      M2430 Hosp Reas Unknown                  
                          4,942                          Missing                                 
                            458        0                 Not indicated                           
                             47        1                 Indicated                               
 
M2430_UT $INDICOA                      M2430 Hosp Reas Urinary Tract Infect     
                          4,942                          Missing                                 
                            482        0                 Not indicated                           
                             23        1                 Indicated                               
 
M2430_PL $INDICOA                      M2430 Hosp Reas;DVT, Pulmonary Embolus   
                          4,942                          Missing                                 
                            503        0                 Not indicated                           
                              2        1                 Indicated                               
 
M2430_WN $INDICOA                      M2430 Hosp Reas Wound Infection/Deteriora
                          4,942                          Missing                                 
                            479        0                 Not indicated                           
                             26        1                 Indicated                               
 
M2430_DB $INDICOA                      M2430 Hosp Reas;Hypo/Hyperglycemia/Diabet
                          4,942                          Missing                                 
                            500        0                 Not indicated                           
                              5        1                 Indicated                               
 
