<status value="draft"/> <date value="2018-04-30T20:51:52.871Z"/> <publisher value="Division of Nursing Home"/> <description value="The MDS is a powerful tool for implementing standardized assessment and for facilitating care management in nursing homes (NHs) and non-critical access hospital swing beds (SBs)."/> <approvalDate value="2018-12-28"/> <effectivePeriod> <start value="2019-10-01T00:00:00+00:00"/> </effectivePeriod> <code> <system value="http://loinc.org"/> <code value="90472-2"/> <display value="Minimum Data Set (MDS) - version 3.0 - Resident Assessment Instrument (RAI) version 1.17.1 [CMS Assessment]"/> </code> <item> <linkId value="Section-1"/> <code> <system value="http://loinc.org"/> <code value="90499-5"/> <display value="MDS v3.0 - RAI v1.17.1 - Identification information [CMS Assessment]"/> </code> <text value="Section A: Identification Information"/> <type value="group"/> <readOnly value="true"/> <item> <linkId value="Section-1/A0200"/> <code> <system value="http://loinc.org"/> <code value="85632-8"/> <display value="Facility type"/> </code> <prefix value="A0200"/> <text value="Type of Provider"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Nursing home (SNF/NF)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10882-1"/> <display value="Nursing home (SNF/NF)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Swing Bed"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10883-9"/> <display value="Swing bed"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-1/A0700"/> <code> <system value="http://loinc.org"/> <code value="45400-9"/> <display value="Medicaid #"/> </code> <prefix value="A0700"/> <text value="Medicaid Number - Enter "+" if pending, "N" if not a Medicaid recipient"/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="+"/> <display value="Enter "+" if Medicaid application is pending"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="N"/> <display value="Enter "N" if not a Medicaid recipient"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (not available or unknown)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-1/A0800"/> <code> <system value="http://loinc.org"/> <code value="46098-0"/> <display value="Sex"/> </code> <prefix value="A0800"/> <text value="Gender"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Male"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA2-8"/> <display value="Male"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Female"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA3-6"/> <display value="Female"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-1/A0900"/> <code> <system value="http://loinc.org"/> <code value="21112-8"/> <display value="Birth date"/> </code> <prefix value="A0900"/> <text value="Birth Date"/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="MMDDYYYY"/> <display value="{Patient/Resident} Birthdate"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="MMYYYY"/> <display value="{Patient/Resident} Birthdate (if day of month is unknown)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="YYYY"/> <display value="{Patient/Resident} Birthdate (if month and day unknown)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-1/A1200"/> <code> <system value="http://loinc.org"/> <code value="45404-1"/> <display value="Marital status"/> </code> <prefix value="A1200"/> <text value="Marital Status"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Never married"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA47-6"/> <display value="Never married"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Married"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA48-4"/> <display value="Married"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Widowed"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA49-2"/> <display value="Widowed"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="4"/> <display value="Separated"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA4288-2"/> <display value="Separated"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="5"/> <display value="Divorced"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA51-8"/> <display value="Divorced"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-1/A0410"/> <code> <system value="http://loinc.org"/> <code value="86526-1"/> <display value="Unit certification or licensure designation"/> </code> <prefix value="A0410"/> <text value="Unit Certification or Licensure Designation"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Unit is Medicare and/or Medicaid certified"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27985-3"/> <display value="Unit is Medicare and/or Medicaid certified"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Unit is neither Medicare nor Medicaid certified but MDS data is required by the State"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27984-6"/> <display value="Unit is neither Medicare nor Medicaid certified but MDS data is required by the State"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Unit is neither Medicare nor Medicaid certified and MDS data is not required by the State"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27983-8"/> <display value="Unit is neither Medicare nor Medicaid certified and MDS data is not required by the State"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-1/A1500"/> <code> <system value="http://loinc.org"/> <code value="54589-7"/> <display value="Preadmission Screening and Resident Review (PASRR)"/> </code> <prefix value="A1500"/> <text value="Preadmission Screening and Resident Review (PASRR). Is the resident currently considered by the state level II PASRR process to have serious mental illness and/or intellectual disability or a related condition? Complete only if {admission, annual, significant change, or significant correction}"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="9"/> <display value="Not a Medicaid-certified unit"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10921-7"/> <display value="Not a Medicaid-certified unit"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-1/A1600"/> <code> <system value="http://loinc.org"/> <code value="50786-3"/> <display value="Date of entry"/> </code> <prefix value="A1600"/> <text value="Entry Date"/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="MMDDYYYY"/> <display value="Entry date (date of this admission/entry or reentry into the facility)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-1/A1700"/> <code> <system value="http://loinc.org"/> <code value="54590-5"/> <display value="Entry type"/> </code> <prefix value="A1700"/> <text value="Type of Entry"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Admission"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10922-5"/> <display value="Admission"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Reentry"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA54-2"/> <display value="Reentry"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-1/A1800"/> <code> <system value="http://loinc.org"/> <code value="85398-6"/> <display value="Admitted from"/> </code> <prefix value="A1800"/> <text value="Entered From"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="01"/> <display value="Community (private home/apt., board/care, assisted living, group home)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10924-1"/> <display value="Community (private home/apt., board/care, assisted living, group home)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="03"/> <display value="Acute hospital"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA9928-8"/> <display value="Acute hospital"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="06"/> <display value="ID/DD facility"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10929-0"/> <display value="ID/DD facility"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="99"/> <display value="Other"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA46-8"/> <display value="Other"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="02"/> <display value="Another nursing home or swing bed"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10925-8"/> <display value="Another nursing home or swing bed"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="04"/> <display value="Psychiatric hospital"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10064-6"/> <display value="Psychiatric hospital"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="05"/> <display value="Inpatient rehabilitation facility"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10928-2"/> <display value="Inpatient rehabilitation facility"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="07"/> <display value="Hospice"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA6216-1"/> <display value="Hospice"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="09"/> <display value="Long Term Care Hospital (LTCH)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10000-0"/> <display value="Long-term care hospital (LTCH)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-1/A2000"/> <code> <system value="http://loinc.org"/> <code value="52525-3"/> <display value="Discharge date"/> </code> <prefix value="A2000"/> <text value="Discharge Date - Complete only if {discharge or death}"/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="MMDDYYYY"/> <display value="Discharge date"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-1/A2100"/> <code> <system value="http://loinc.org"/> <code value="55128-3"/> <display value="Discharge disposition"/> </code> <prefix value="A2100"/> <text value="Discharge Status - Complete only if {discharge or death}"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="01"/> <display value="Community (private home/apt., board/care, assisted living, group home)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10924-1"/> <display value="Community (private home/apt., board/care, assisted living, group home)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="03"/> <display value="Acute hospital"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA9928-8"/> <display value="Acute hospital"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="06"/> <display value="ID/DD facility"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10929-0"/> <display value="ID/DD facility"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="99"/> <display value="Other"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA46-8"/> <display value="Other"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="02"/> <display value="Another nursing home or swing bed"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10925-8"/> <display value="Another nursing home or swing bed"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="04"/> <display value="Psychiatric hospital"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10064-6"/> <display value="Psychiatric hospital"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="05"/> <display value="Inpatient rehabilitation facility"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10928-2"/> <display value="Inpatient rehabilitation facility"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="07"/> <display value="Hospice"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA6216-1"/> <display value="Hospice"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="08"/> <display value="Deceased"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10939-9"/> <display value="Deceased"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="09"/> <display value="Long Term Care Hospital (LTCH)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10000-0"/> <display value="Long-term care hospital (LTCH)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-1/A2200"/> <code> <system value="http://loinc.org"/> <code value="54592-1"/> <display value="Previous assessment reference date for significant correction"/> </code> <prefix value="A2200"/> <text value="Previous Assessment Reference Date for Significant Correction. Complete only if {significant correction}"/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="MMDDYYYY"/> <display value="Previous assessment reference date for significant correction"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-1/A2300"/> <code> <system value="http://loinc.org"/> <code value="54593-9"/> <display value="Assessment reference date - observation end date"/> </code> <prefix value="A2300"/> <text value="Assessment Reference Date. Observation end date"/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="MMDDYYYY"/> <display value="Assessment reference date"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-1/A0050"/> <code> <system value="http://loinc.org"/> <code value="58198-3"/> <display value="Type of record"/> </code> <prefix value="A0050"/> <text value="Type of Record"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Add new assessment/record"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12663-3"/> <display value="Add new record"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Modify existing record"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12664-1"/> <display value="Modify existing record"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Inactivate existing record"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12665-8"/> <display value="Inactivate existing record"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-1/A1900"/> <code> <system value="http://loinc.org"/> <code value="52455-3"/> <display value="Admission date"/> </code> <prefix value="A1900"/> <text value="Admission Date (Date this episode of care in this {facility/setting} began)"/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="MMDDYYYY"/> <display value="Admission date"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-1/A0100"/> <code> <system value="http://loinc.org"/> <code value="54581-4"/> <display value="Facility provider #s"/> </code> <prefix value="A0100"/> <text value="Facility Provider Numbers"/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> <item> <linkId value="Section-1/A0100A"/> <code> <system value="http://loinc.org"/> <code value="76468-8"/> <display value="Organization NPI"/> </code> <prefix value="A0100A"/> <text value="National Provider Identifier (NPI)"/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (not available or unknown)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-1/A0100B"/> <code> <system value="http://loinc.org"/> <code value="69417-4"/> <display value="CMS certification # Facility"/> </code> <prefix value="A0100B"/> <text value="CMS Certification Number (CCN)"/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (not available or unknown)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-1/A0100C"/> <code> <system value="http://loinc.org"/> <code value="45398-5"/> <display value="State provider # Facility"/> </code> <prefix value="A0100C"/> <text value="State {Facility/Provider} Number"/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (not available or unknown)"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="Section-1/A0310"/> <code> <system value="http://loinc.org"/> <code value="90489-6"/> <display value="MDS v3.0 - RAI v1.17.1 - Type of assessment"/> </code> <prefix value="A0310"/> <text value="Type of Assessment"/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> <item> <linkId value="Section-1/A0310A"/> <code> <system value="http://loinc.org"/> <code value="54583-0"/> <display value="Federal OBRA reason for assessment"/> </code> <prefix value="A0310A"/> <text value="Federal OBRA Reason for Assessment"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="05"/> <display value="Significant correction to prior comprehensive assessment"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10888-8"/> <display value="Significant correction to prior comprehensive assessment"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="06"/> <display value="Significant correction to prior quarterly assessment"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10889-6"/> <display value="Significant correction to prior quarterly assessment"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="01"/> <display value="Admission assessment (required by day 14)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10-4"/> <display value="Admission assessment (required by day 14)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="02"/> <display value="Quarterly review assessment"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA15-3"/> <display value="Quarterly review assessment"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="03"/> <display value="Annual assessment"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12-0"/> <display value="Annual assessment"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="04"/> <display value="Significant change in status assessment"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA13-8"/> <display value="Significant change in status assessment"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="99"/> <display value="None of the above"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA9-3"/> <display value="None of the above"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-1/A0310B"/> <code> <system value="http://loinc.org"/> <code value="54584-8"/> <display value="PPS Assessment"/> </code> <prefix value="A0310B"/> <text value="PPS Assessment"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="01"/> <display value="5-day scheduled assessment"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10894-6"/> <display value="5-day scheduled assessment"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="99"/> <display value="None of the above"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA9-3"/> <display value="None of the above"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="08"/> <display value="IPA - Interim Payment Assessment"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA29577-6"/> <display value="IPA - Interim Payment Assessment"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-1/A0310E"/> <code> <system value="http://loinc.org"/> <code value="54587-1"/> <display value="First assessment since the most recent admission &or reentry"/> </code> <prefix value="A0310E"/> <text value="Is this assessment the first assessment since the most recent {admission}?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-1/A0310F"/> <code> <system value="http://loinc.org"/> <code value="58108-2"/> <display value="Entry &or discharge reporting"/> </code> <prefix value="A0310F"/> <text value="Entry/discharge reporting"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="01"/> <display value="Entry tracking record"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12627-8"/> <display value="Entry tracking record"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="10"/> <display value="Discharge assessment - return not anticipated"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code 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<system value="http://loinc.org"/> <code value="LA9-3"/> <display value="None of the above"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-1/A0310G"/> <code> <system value="http://loinc.org"/> <code value="71440-2"/> <display value="Discharge"/> </code> <prefix value="A0310G"/> <text value="Type of discharge - Complete only if {discharge assessment}"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Planned"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA20099-0"/> <display value="Planned"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Unplanned"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28017-4"/> <display value="Unplanned"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-1/A0310H"/> <code> <system value="http://loinc.org"/> <code value="86525-3"/> <display value="SNF Part A PPS discharge assessment"/> </code> <prefix value="A0310H"/> <text value="Is this a SNF Part A PPS Discharge Assessment?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="Section-1/A0500"/> <code> <system value="http://loinc.org"/> <code value="54503-8"/> <display value="Legal name of patient"/> </code> <prefix value="A0500"/> <text value="Legal Name of {Patient/Resident}"/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> <item> <linkId value="Section-1/A0500A"/> <code> <system value="http://loinc.org"/> <code value="45392-8"/> <display value="First name"/> </code> <prefix value="A0500A"/> <text value="First name"/> <type value="text"/> <repeats value="false"/> <readOnly value="false"/> <maxLength value="12"/> </item> <item> <linkId value="Section-1/A0500B"/> <code> <system value="http://loinc.org"/> <code value="45393-6"/> <display value="Middle initial"/> </code> <prefix value="A0500B"/> <text value="Middle initial"/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (not available or unknown)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-1/A0500C"/> <code> <system value="http://loinc.org"/> <code value="45394-4"/> <display value="Last name"/> </code> <prefix value="A0500C"/> <text value="Last name"/> <type value="text"/> <repeats value="false"/> <readOnly value="false"/> <maxLength value="18"/> </item> <item> <linkId value="Section-1/A0500D"/> <code> <system value="http://loinc.org"/> <code value="45395-1"/> <display value="Name suffix"/> </code> <prefix value="A0500D"/> <text value="Suffix"/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (not available or unknown)"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="Section-1/A0600"/> <code> <system value="http://loinc.org"/> <code value="45966-9"/> <display value="Social Security & Medicare numbers"/> </code> <prefix value="A0600"/> <text value="Social Security and Medicare Numbers"/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> <item> <linkId value="Section-1/A0600A"/> <code> <system value="http://loinc.org"/> <code value="45396-9"/> <display value="Social Security #"/> </code> <prefix value="A0600A"/> <text value="Social Security Number"/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (not available or unknown)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-1/A0600B"/> <code> <system value="http://loinc.org"/> <code value="45397-7"/> <display value="Medicare or comparable #"/> </code> <prefix value="A0600B"/> <text value="Medicare number"/> <type value="open-choice"/> <repeats 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</answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="9"/> <display value="Unable to determine"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11137-9"/> <display value="Unable to determine"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-1/A1100B"/> <code> <system value="http://loinc.org"/> <code value="54899-0"/> <display value="Preferred language"/> </code> <prefix value="A1100B"/> <text value="Preferred language"/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="Section-1/A1300"/> <code> <system value="http://loinc.org"/> <code value="54506-1"/> <display value="Optional resident items"/> </code> <prefix value="A1300"/> <text value="Optional {Patient/Resident} Items"/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> <item> <linkId value="Section-1/A1300A"/> <code> <system value="http://loinc.org"/> <code value="46106-1"/> <display value="MRN"/> </code> <prefix value="A1300A"/> <text value="Medical record number"/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (not available or unknown)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-1/A1300B"/> <code> <system value="http://loinc.org"/> <code value="45403-3"/> <display value="Room #"/> </code> <prefix value="A1300B"/> <text value="Room number"/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (not available or unknown)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-1/A1300C"/> <code> <system value="http://loinc.org"/> <code value="52462-9"/> <display value="Nickname"/> </code> <prefix value="A1300C"/> <text value="Name by which 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value="Medicare Stay. Complete only if {SNF Part A Interrupted Stay}"/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> <item> <linkId value="Section-1/A2400A"/> <code> <system value="http://loinc.org"/> <code value="54594-7"/> <display value="Medicare-covered stay since the most recent entry"/> </code> <prefix value="A2400A"/> <text value="Has the {patient/resident} had a Medicare-covered stay since the most recent entry?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-1/A2400B"/> <code> <system value="http://loinc.org"/> <code value="54595-4"/> <display value="Start date of most recent Medicare stay"/> </code> <prefix value="A2400B"/> <text value="Start date of most recent Medicare stay"/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="MMDDYYYY"/> <display value="Start date of most recent Medicare stay"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-1/A2400C"/> <code> <system value="http://loinc.org"/> <code value="54596-2"/> <display value="End date of most recent Medicare stay"/> </code> <prefix value="A2400C"/> <text value="End date of most recent Medicare stay. 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Complete only if {admission, annual, significant change, or significant correction}: Check all that apply"/> <type value="choice"/> <repeats value="true"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="A"/> <display value="Serious mental illness"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA18599-3"/> <display value="Serious mental illness"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="B"/> <display value="Intellectual Disability"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA29576-8"/> <display value="Intellectual disability"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="C"/> <display value="Other related conditions"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA18601-7"/> <display value="Other related conditions"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-1/A1550"/> <code> <system value="http://loinc.org"/> <code value="86527-9"/> <display value="Conditions related to intellectual disability and developmental disability status"/> </code> <prefix value="A1550"/> <text value="Conditions Related to ID/DD Status. 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If the {patient/resident} is 21 years of age or younger, complete only if {admission, annual, significant change, or significant correction}: Check all conditions that are related to ID/DD status that were manifested before age 22, and are likely to continue indefinitely"/> <type value="choice"/> <repeats value="true"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="A"/> <display value="Down syndrome"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA20088-3"/> <display value="Down syndrome"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="B"/> <display value="Autism"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA24638-1"/> <display value="Autism"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="C"/> <display value="Epilepsy"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA16985-6"/> <display value="Epilepsy"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="D"/> <display value="Other organic condition related to ID/DD"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27792-3"/> <display value="Other organic condition related to ID/DD"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="E"/> <display value="ID/DD with no organic condition"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27793-1"/> <display value="ID/DD with no organic condition"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="Z"/> <display value="None of the above"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA9-3"/> <display value="None of the above"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="Section-2"/> <code> <system value="http://loinc.org"/> <code value="54508-7"/> <display value="Hearing, speech, and vision [CMS Assessment]"/> </code> <text value="Section B: Hearing, Speech, and Vision"/> <type value="group"/> <readOnly value="true"/> <item> <linkId value="Section-2/B0100"/> <code> <system value="http://loinc.org"/> <code value="54597-0"/> <display value="Comatose in last 7D"/> </code> <prefix value="B0100"/> <text value="Comatose. Persistent vegetative state/no discernible consciousness"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-2/B0200"/> <code> <system value="http://loinc.org"/> <code value="54598-8"/> <display value="Hearing.ability to hear in last 7D"/> </code> <prefix value="B0200"/> <text value="Hearing. Ability to hear (with hearing aid or hearing appliances if normally used)"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Adequate - no difficulty in normal conversation, social interaction, listening to TV"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10941-5"/> <display value="Adequate - no difficulty in normal conversation, social interaction, listening to TV"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Minimal difficulty - difficulty in some environments (e.g., when person speaks softly or setting is noisy)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10942-3"/> <display value="Minimal difficulty - difficulty in some environments (e.g. when person speaks softly or setting is noisy)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Moderate difficulty - speaker has to increase volume and speak distinctly"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10943-1"/> <display value="Moderate difficulty - speaker has to increase volume and speak distinctly"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Highly impaired - absence of useful hearing"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10944-9"/> <display value="Highly impaired - absence of useful hearing"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-2/B0300"/> <code> <system value="http://loinc.org"/> <code value="54599-6"/> <display value="Hearing aid used during 7D assessment period"/> </code> <prefix value="B0300"/> <text value="Hearing Aid. Hearing aid or other hearing appliance used in completing {Hearing question}"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-2/B0600"/> <code> <system value="http://loinc.org"/> <code value="54600-2"/> <display value="Speech clarity.description of speech pattern in last 7D"/> </code> <prefix value="B0600"/> <text value="Speech Clarity. Select best description of speech pattern"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Clear speech - distinct intelligible words"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10945-6"/> <display value="Clear speech - distinct intelligible words"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Unclear speech - slurred or mumbled words"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10946-4"/> <display value="Unclear speech - slurred or mumbled words"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="No speech - absence of spoken words"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10947-2"/> <display value="No speech - absence of spoken words"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-2/B0700"/> <code> <system value="http://loinc.org"/> <code value="54601-0"/> <display value="Express ideas and wants in last 7D"/> </code> <prefix value="B0700"/> <text value="Makes Self Understood. Ability to express ideas and wants, consider both verbal and non-verbal expression"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Understood"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA71-6"/> <display value="Understood"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Usually understood - difficulty communicating some words or finishing thoughts but is able if prompted or given time"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10949-8"/> <display value="Usually understood - difficulty communicating some words or finishing thoughts but is able if prompted or given time"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Sometimes understood - ability is limited to making concrete requests"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10950-6"/> <display value="Sometimes understood - ability is limited to making concrete requests"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Rarely/never understood"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA74-0"/> <display value="Rarely/never understood"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-2/B0800"/> <code> <system value="http://loinc.org"/> <code value="54602-8"/> <display value="Understanding verbal content in last 7D"/> </code> <prefix value="B0800"/> <text value="Ability To Understand Others. Understanding verbal content, however able (with hearing aid or device if used)"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Understands - clear comprehension"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10952-2"/> <display value="Understands - clear comprehension"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Usually understands - misses some part/intent of message but comprehends most conversation"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10953-0"/> <display value="Usually understands - misses some part/intent of message but comprehends most conversation"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Sometimes understands - responds adequately to simple, direct communication only"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10954-8"/> <display value="Sometimes understands - responds adequately to simple, direct communication only"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Rarely/never understands"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA81-5"/> <display value="Rarely/never understands"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-2/B1000"/> <code> <system value="http://loinc.org"/> <code value="54603-6"/> <display value="Vision.ability to see in adequate light in last 7D"/> </code> <prefix value="B1000"/> <text value="Vision. Ability to see in adequate light (with glasses or other visual appliances)"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Adequate - sees fine detail, such as regular print in newspapers/books"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10956-3"/> <display value="Adequate - sees fine detail, such as regular print in newspapers/books"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Impaired - sees large print, but not regular print in newspapers/books"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10957-1"/> <display value="Impaired - sees large print, but not regular print in newspapers/books"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Moderately impaired - limited vision; not able to see newspaper headlines but can identify objects"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10958-9"/> <display value="Moderately impaired - limited vision; not able to see newspaper headlines but can identify objects"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Highly impaired - object identification in question, but eyes appear to follow objects"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10959-7"/> <display value="Highly impaired - object identification in question, but eyes appear to follow objects"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="4"/> <display value="Severely impaired - no vision or sees only light, colors or shapes; eyes do not appear to follow objects"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10960-5"/> <display value="Severely impaired - no vision or sees only light, colors or shapes; eyes do not appear to follow objects"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-2/B1200"/> <code> <system value="http://loinc.org"/> <code value="54604-4"/> <display value="Corrective lenses used in last 7D"/> </code> <prefix value="B1200"/> <text value="Corrective lenses (contacts, glasses or magnifying glass) used in completing {Vision question}"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="Section-3"/> <code> <system value="http://loinc.org"/> <code value="86529-5"/> <display value="MDS v3.0 - RAI v1.17.1 - Cognitive patterns [CMS Assessment]"/> </code> <text value="Section C: Cognitive Patterns"/> <type value="group"/> <readOnly value="true"/> <item> <linkId value="Section-3/C0100"/> <code> <system value="http://loinc.org"/> <code value="54605-1"/> <display value="Brief interview for mental status should be conducted"/> </code> <prefix value="C0100"/> <text value="Should Brief Interview for Mental Status be Conducted? Attempt to conduct interview with all {patients/residents}"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No ({patient/resident} is rarely/never understood)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11150-2"/> <display value="No (resident is rarely/never understood)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-3/C0200"/> <code> <system value="http://loinc.org"/> <code value="52731-7"/> <display value="Repetition of three words BIMS"/> </code> <prefix value="C0200"/> <text value="Repetition of Three Words - Ask {patient/resident}: "I am going to say three words for you to remember. Please repeat the words after I have said all three. The words are: sock, blue, and bed. Now tell me the three words." Number of words repeated after first attempt"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Two"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA6404-3"/> <display value="Two"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Three"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA6395-3"/> <display value="Three"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="None"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA137-2"/> <display value="None"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="One"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA6306-0"/> <display value="One"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-3/C0500"/> <code> <system value="http://loinc.org"/> <code value="54614-3"/> <display value="Brief interview for mental status - summary score BIMS"/> </code> <prefix value="C0500"/> <text value="BIMS Summary Score. Add scores for {Brief Interview for Mental Status questions} and fill in total score (00-15). Enter 99 if the {patient/resident} was unable to complete the interview"/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="15"/> <display value="Maximum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="99"/> <display value="Unable to complete interview"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="00"/> <display value="Minimum value"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-3/C0600"/> <code> <system value="http://loinc.org"/> <code value="54615-0"/> <display value="Should staff assessment for mental status be conducted"/> </code> <prefix value="C0600"/> <text value="Should the Staff Assessment for Mental Status be Conducted?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No ({patient/resident} was able to complete Brief Interview for Mental Status)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28146-1"/> <display value="No (resident was able to complete Brief Interview for Mental Status)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes ({patient/resident} was unable to complete Brief Interview for Mental Status)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28147-9"/> <display value="Yes (resident was unable to complete Brief Interview for Mental Status)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-3/C0700"/> <code> <system value="http://loinc.org"/> <code value="54616-8"/> <display value="Short-term memory OK in last 7D"/> </code> <prefix value="C0700"/> <text value="Short-term Memory OK. Seems or appears to recall after 5 minutes"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Memory OK"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA55-9"/> <display value="Memory OK"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Memory problem"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA56-7"/> <display value="Memory problem"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-3/C0800"/> <code> <system value="http://loinc.org"/> <code value="54617-6"/> <display value="Long-term memory OK in last 7D"/> </code> <prefix value="C0800"/> <text value="Long-term Memory OK. Seems or appears to recall long past"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Memory OK"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA55-9"/> <display value="Memory OK"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Memory problem"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA56-7"/> <display value="Memory problem"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-3/C1000"/> <code> <system value="http://loinc.org"/> <code value="54624-2"/> <display value="Cognitive skills for daily decision making in last 7D"/> </code> <prefix value="C1000"/> <text value="Cognitive Skills for Daily Decision Making. Made decisions regarding tasks of daily life"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Independent - decisions consistent/reasonable"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10985-2"/> <display value="Independent - decisions consistent/reasonable"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Modified independence - some difficulty in new situations only"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10986-0"/> <display value="Modified independence - some difficulty in new situations only"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Moderately impaired - decisions poor; cues/supervision required"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10987-8"/> <display value="Moderately impaired - decisions poor; cues/supervision required"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Severely impaired - never/rarely made decisions"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10988-6"/> <display value="Severely impaired - never/rarely made decisions"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-3/C0300"/> <code> <system value="http://loinc.org"/> <code value="54510-3"/> <display value="Temporal orientation (orientation to year, month, and day) BIMS"/> </code> <prefix value="C0300"/> <text value="Temporal Orientation (orientation to year, month, and day)"/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> <item> <linkId value="Section-3/C0300A"/> <code> <system value="http://loinc.org"/> <code value="52732-5"/> <display value="Temporal orientation - current year BIMS"/> </code> <prefix value="C0300A"/> <text value="Ask {patient/resident}: "Please tell me what year it is right now." Able to report correct year"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Correct"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA9960-1"/> <display value="Correct"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Missed by 1 year"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10008-3"/> <display value="Missed by 1 year"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Missed by 2 - 5 years"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10966-2"/> <display value="Missed by 2-5 years"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Missed by > 5 years or no answer"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10965-4"/> <display value="Missed by > 5 years or no answer"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-3/C0300B"/> <code> <system value="http://loinc.org"/> <code value="52733-3"/> <display value="Temporal orientation - current month BIMS"/> </code> <prefix value="C0300B"/> <text value="Ask {patient/resident}: "What month are we in right now?" Able to report correct month"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Accurate within 5 days"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA9927-0"/> <display value="Accurate within 5 days"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Missed by 6 days to 1 month"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10010-9"/> <display value="Missed by 6 days to 1 month"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Missed by > 1 month or no answer"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10969-6"/> <display value="Missed by > 1 month or no answer"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-3/C0300C"/> <code> <system value="http://loinc.org"/> <code value="54609-3"/> <display value="Temporal orientation - current day of the week BIMS"/> </code> <prefix value="C0300C"/> <text value="Ask {patient/resident}: "What day of the week is today?" Able to report correct day of the week"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Correct"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA9960-1"/> <display value="Correct"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Incorrect or no answer"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA9981-7"/> <display value="Incorrect or no answer"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="Section-3/C0400"/> <code> <system value="http://loinc.org"/> <code value="52493-4"/> <display value="Recall BIMS"/> </code> <prefix value="C0400"/> <text value="Recall. Ask {patient/resident}: "Let's go back to an earlier question. What were those three words that I asked you to repeat?" If unable to remember a word, give cue (something to wear; a color; a piece of furniture) for that word."/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> <item> <linkId value="Section-3/C0400A"/> <code> <system value="http://loinc.org"/> <code value="52735-8"/> <display value="Recall - sock BIMS"/> </code> <prefix value="C0400A"/> <text value="Able to recall "sock""/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes, after cueing ("something to wear")"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10126-3"/> <display value="Yes, after cueing ("something to wear")"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Yes, no cue required"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10134-7"/> <display value="Yes, no cue required"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No - could not recall"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10974-6"/> <display value="No - could not recall"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-3/C0400B"/> <code> <system value="http://loinc.org"/> <code value="52736-6"/> <display value="Recall - blue BIMS"/> </code> <prefix value="C0400B"/> <text value="Able to recall "blue""/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Yes, no cue required"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10134-7"/> <display value="Yes, no cue required"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes, after cueing ("a color")"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10978-7"/> <display value="Yes, after cueing ("a color")"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No - could not recall"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10974-6"/> <display value="No - could not recall"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-3/C0400C"/> <code> <system value="http://loinc.org"/> <code value="52737-4"/> <display value="Recall - bed BIMS"/> </code> <prefix value="C0400C"/> <text value="Able to recall "bed""/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes, after cueing ("a piece of furniture")"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10125-5"/> <display value="Yes, after cueing ("a piece of furniture")"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Yes, no cue required"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10134-7"/> <display value="Yes, no cue required"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No - could not recall"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10974-6"/> <display value="No - could not recall"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="Section-3/C1310"/> <code> <system value="http://loinc.org"/> <code value="86585-7"/> <display value="MDS v3.0 - RAI v1.17.1 - Signs and symptoms of delirium (from CAM)"/> </code> <prefix value="C1310"/> <text value="Signs and Symptoms of Delirium (from CAM©). Code after completing Brief Interview for Mental Status or Staff Assessment, and reviewing medical record"/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> <item> <linkId value="Section-3/C1310A"/> <code> <system value="http://loinc.org"/> <code value="54632-5"/> <display value="Acute onset mental status change"/> </code> <prefix value="C1310A"/> <text value="Acute Onset Mental Status Change. Is there evidence of an acute change in mental status from the {patient's/resident's} baseline?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-3/C1310B"/> <code> <system value="http://loinc.org"/> <code value="54628-3"/> <display value="Inattention in last 7D"/> </code> <prefix value="C1310B"/> <text value="Inattention - Did the {patient/resident} have difficulty focusing attention, for example, being easily distractible or having difficulty keeping track of what was being said?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Behavior not present"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA61-7"/> <display value="Behavior not present"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Behavior present, fluctuates (comes and goes, changes in severity)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10993-6"/> <display value="Behavior present, fluctuates (comes and goes, changes in severity)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Behavior continuously present, does not fluctuate"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10992-8"/> <display value="Behavior continuously present, does not fluctuate"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-3/C1310C"/> <code> <system value="http://loinc.org"/> <code value="54629-1"/> <display value="Disorganized thinking in last 7D"/> </code> <prefix value="C1310C"/> <text value="Disorganized Thinking - Was the {patient's/resident's} thinking disorganized or incoherent (rambling or irrelevant conversation, unclear or illogical flow of ideas, or unpredictable switching from subject to subject)?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Behavior not present"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA61-7"/> <display value="Behavior not present"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Behavior present, fluctuates (comes and goes, changes in severity)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10993-6"/> <display value="Behavior present, fluctuates (comes and goes, changes in severity)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Behavior continuously present, does not fluctuate"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10992-8"/> <display value="Behavior continuously present, does not fluctuate"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-3/C1310D"/> <code> <system value="http://loinc.org"/> <code value="54630-9"/> <display value="Altered level of consciousness in last 7D"/> </code> <prefix value="C1310D"/> <text value="Altered Level of Consciousness - Did the {patient/resident} have altered level of consciousness, as indicated by any of the following criteria? vigilant - startled easily to any sound or touch, lethargic - repeatedly dozed off when being asked questions, but responded to voice or touch, stuporous - very difficult to arouse and keep aroused for the interview, comatose - could not be aroused"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Behavior not present"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA61-7"/> <display value="Behavior not present"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Behavior present, fluctuates (comes and goes, changes in severity)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10993-6"/> <display value="Behavior present, fluctuates (comes and goes, changes in severity)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Behavior continuously present, does not fluctuate"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10992-8"/> <display value="Behavior continuously present, does not fluctuate"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="Section-3/C0900"/> <code> <system value="http://loinc.org"/> <code value="86583-2"/> <display value="Memory &or recall ability in the last 7D"/> </code> <prefix value="C0900"/> <text value="Memory/Recall Ability: Check all that the {patient/resident} was normally able to recall"/> <type value="choice"/> <repeats value="true"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="A"/> <display value="Current season"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA9962-7"/> <display value="Current season"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="B"/> <display value="Location of own room"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA9998-1"/> <display value="Location of own room"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="C"/> <display value="Staff names and faces"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10085-1"/> <display value="Staff names and faces"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="D"/> <display value="That he or she is in a nursing home/hospital swing bed"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27794-9"/> <display value="That he or she is in a nursing home/hospital swing bed"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="Z"/> <display value="None of the above were recalled"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA26729-6"/> <display value="None of the above were recalled"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="Section-4"/> <code> <system value="http://loinc.org"/> <code value="90482-1"/> <display value="MDS v3.0 - RAI v1.17.1 - Mood [CMS Assessment]"/> </code> <text value="Section D: Mood"/> <type value="group"/> <readOnly value="true"/> <item> <linkId value="Section-4/D0100"/> <code> <system value="http://loinc.org"/> <code value="54634-1"/> <display value="Should resident mood interview be conducted"/> </code> <prefix value="D0100"/> <text value="Should {Patient/Resident} Mood Interview be Conducted? - Attempt to conduct interview with all {patients/residents}"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No ({patient/resident} is rarely/never understood)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11150-2"/> <display value="No (resident is rarely/never understood)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-4/D0300"/> <code> <system value="http://loinc.org"/> <code value="54654-9"/> <display value="Mood interview total severity scoreReported.PHQ-9"/> </code> <prefix value="D0300"/> <text value="Total Severity Score. Add scores for all frequency responses in Column 2, Symptom Frequency. Total score must be between 00 and 27. Enter 99 if unable to complete interview (i.e., Symptom Frequency is blank for 3 or more items)."/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="99"/> <display value="Unable to complete interview"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="27"/> <display value="Maximum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="00"/> <display value="Minimum value"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-4/D0600"/> <code> <system value="http://loinc.org"/> <code value="54677-0"/> <display value="Staff assessment of resident mood total severity scoreObserved.PHQ-9"/> </code> <prefix value="D0600"/> <text value="Total Severity Score. Add scores for all frequency responses in Column 2, Symptom Frequency. Total score must be between 00 and 30."/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="30"/> <display value="Maximum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="00"/> <display value="Minimum value"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-4/D0200"/> <code> <system value="http://loinc.org"/> <code value="54635-8"/> <display value="Resident mood interview (PHQ-9)"/> </code> <prefix value="D0200"/> <text value="{Patient/Resident} Mood Interview (PHQ-9). Say to {patient/resident}: "Over the last 2 weeks, have you been bothered by any of the following problems?""/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> <item> <linkId value="Section-4/D0200A1"/> <code> <system value="http://loinc.org"/> <code value="54636-6"/> <display value="Little interest or pleasure in doing things in last 2W.presence"/> </code> <prefix value="D0200A1"/> <text value="Little interest or pleasure in doing things - Symptom Presence"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="9"/> <display value="No response (leave column 2 blank)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10996-9"/> <display value="No response"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No (enter 0 in column 2)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes (enter 0-3 in column 2)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-4/D0200A2"/> <code> <system value="http://loinc.org"/> <code value="54637-4"/> <display value="Little interest or pleasure in doing things in last 2W.frequency"/> </code> <prefix value="D0200A2"/> <text value="Little interest or pleasure in doing things - Symptom Frequency"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="2-6 days (several days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10998-5"/> <display value="2-6 days (several days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="12-14 days (nearly every day)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11000-9"/> <display value="12-14 days (nearly every day)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Never or 1 day"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10997-7"/> <display value="Never or 1 day"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="7-11 days (half or more of the days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10999-3"/> <display value="7-11 days (half or more of the days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-4/D0200B1"/> <code> <system value="http://loinc.org"/> <code value="54638-2"/> <display value="Feeling down, depressed or hopeless in last 2W.presence"/> </code> <prefix value="D0200B1"/> <text value="Feeling down, depressed, or hopeless - Symptom Presence"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="9"/> <display value="No response (leave column 2 blank)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10996-9"/> <display value="No response"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No (enter 0 in column 2)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes (enter 0-3 in column 2)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-4/D0200B2"/> <code> <system value="http://loinc.org"/> <code value="54639-0"/> <display value="Feeling down, depressed or hopeless in last 2W.frequency"/> </code> <prefix value="D0200B2"/> <text value="Feeling down, depressed, or hopeless - Symptom Frequency"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="2-6 days (several days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10998-5"/> <display value="2-6 days (several days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="12-14 days (nearly every day)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11000-9"/> <display value="12-14 days (nearly every day)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Never or 1 day"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10997-7"/> <display value="Never or 1 day"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="7-11 days (half or more of the days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10999-3"/> <display value="7-11 days (half or more of the days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-4/D0200C1"/> <code> <system value="http://loinc.org"/> <code value="54640-8"/> <display value="Trouble falling or staying asleep, or sleeping too much in last 2W.presence"/> </code> <prefix value="D0200C1"/> <text value="Trouble falling or staying asleep, or sleeping too much - Symptom Presence"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="9"/> <display value="No response (leave column 2 blank)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10996-9"/> <display value="No response"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No (enter 0 in column 2)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes (enter 0-3 in column 2)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-4/D0200C2"/> <code> <system value="http://loinc.org"/> <code value="54641-6"/> <display value="Trouble falling or staying asleep, or sleeping too much in last 2W.frequency"/> </code> <prefix value="D0200C2"/> <text value="Trouble falling or staying asleep, or sleeping too much - Symptom Frequency"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="2-6 days (several days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10998-5"/> <display value="2-6 days (several days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="12-14 days (nearly every day)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11000-9"/> <display value="12-14 days (nearly every day)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Never or 1 day"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10997-7"/> <display value="Never or 1 day"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="7-11 days (half or more of the days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10999-3"/> <display value="7-11 days (half or more of the days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-4/D0200D1"/> <code> <system value="http://loinc.org"/> <code value="54642-4"/> <display value="Feeling tired or having little energy in last 2W.presence"/> </code> <prefix value="D0200D1"/> <text value="Feeling tired or having little energy - Symptom Presence"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="9"/> <display value="No response (leave column 2 blank)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10996-9"/> <display value="No response"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No (enter 0 in column 2)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes (enter 0-3 in column 2)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-4/D0200D2"/> <code> <system value="http://loinc.org"/> <code value="54643-2"/> <display value="Feeling tired or having little energy in last 2W.frequency"/> </code> <prefix value="D0200D2"/> <text value="Feeling tired or having little energy - Symptom Frequency"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="2-6 days (several days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10998-5"/> <display value="2-6 days (several days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="12-14 days (nearly every day)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11000-9"/> <display value="12-14 days (nearly every day)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Never or 1 day"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10997-7"/> <display value="Never or 1 day"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="7-11 days (half or more of the days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10999-3"/> <display value="7-11 days (half or more of the days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-4/D0200E1"/> <code> <system value="http://loinc.org"/> <code value="54644-0"/> <display value="Poor appetite or overeating in last 2W.presence"/> </code> <prefix value="D0200E1"/> <text value="Poor appetite or overeating - Symptom Presence"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="9"/> <display value="No response (leave column 2 blank)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10996-9"/> <display value="No response"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No (enter 0 in column 2)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes (enter 0-3 in column 2)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-4/D0200E2"/> <code> <system value="http://loinc.org"/> <code value="54645-7"/> <display value="Poor appetite or overeating in last 2W.frequency"/> </code> <prefix value="D0200E2"/> <text value="Poor appetite or overeating - Symptom Frequency"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="2-6 days (several days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10998-5"/> <display value="2-6 days (several days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="12-14 days (nearly every day)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11000-9"/> <display value="12-14 days (nearly every day)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Never or 1 day"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10997-7"/> <display value="Never or 1 day"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="7-11 days (half or more of the days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10999-3"/> <display value="7-11 days (half or more of the days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-4/D0200F1"/> <code> <system value="http://loinc.org"/> <code value="54646-5"/> <display value="Feeling bad about yourself - or that you are a failure or have let yourself or your family down in last 2W.presence"/> </code> <prefix value="D0200F1"/> <text value="Feeling bad about yourself - or that you are a failure or have let yourself or your family down - Symptom Presence"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="9"/> <display value="No response (leave column 2 blank)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10996-9"/> <display value="No response"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No (enter 0 in column 2)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes (enter 0-3 in column 2)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-4/D0200F2"/> <code> <system value="http://loinc.org"/> <code value="54647-3"/> <display value="Feeling bad about yourself - or that you are a failure or have let yourself or your family down in last 2W.frequency"/> </code> <prefix value="D0200F2"/> <text value="Feeling bad about yourself - or that you are a failure or have let yourself or your family down - Symptom Frequency"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="2-6 days (several days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10998-5"/> <display value="2-6 days (several days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="12-14 days (nearly every day)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11000-9"/> <display value="12-14 days (nearly every day)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Never or 1 day"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10997-7"/> <display value="Never or 1 day"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="7-11 days (half or more of the days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10999-3"/> <display value="7-11 days (half or more of the days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-4/D0200G1"/> <code> <system value="http://loinc.org"/> <code value="54648-1"/> <display value="Trouble concentrating on things, such as reading the newspaper or watching television in last 2W.presence"/> </code> <prefix value="D0200G1"/> <text value="Trouble concentrating on things, such as reading the newspaper or watching television - Symptom Presence"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="9"/> <display value="No response (leave column 2 blank)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10996-9"/> <display value="No response"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No (enter 0 in column 2)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes (enter 0-3 in column 2)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-4/D0200G2"/> <code> <system value="http://loinc.org"/> <code value="54649-9"/> <display value="Trouble concentrating on things, such as reading the newspaper or watching television in last 2W.frequency"/> </code> <prefix value="D0200G2"/> <text value="Trouble concentrating on things, such as reading the newspaper or watching television - Symptom Frequency"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="2-6 days (several days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10998-5"/> <display value="2-6 days (several days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="12-14 days (nearly every day)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11000-9"/> <display value="12-14 days (nearly every day)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Never or 1 day"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10997-7"/> <display value="Never or 1 day"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="7-11 days (half or more of the days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10999-3"/> <display value="7-11 days (half or more of the days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-4/D0200H1"/> <code> <system value="http://loinc.org"/> <code value="54650-7"/> <display value="Moving or speaking so slowly that other people could have noticed. Or the opposite - being so fidgety or restless that you have been moving around a lot more than usual in last 2W.presence"/> </code> <prefix value="D0200H1"/> <text value="Moving or speaking so slowly that other people could have noticed. Or the opposite - being so fidgety or restless that you have been moving around a lot more than usual - Symptom Presence"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="9"/> <display value="No response (leave column 2 blank)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10996-9"/> <display value="No response"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No (enter 0 in column 2)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes (enter 0-3 in column 2)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-4/D0200H2"/> <code> <system value="http://loinc.org"/> <code value="54651-5"/> <display value="Moving or speaking so slowly that other people could have noticed. Or the opposite - being so fidgety or restless that you have been moving around a lot more than usual in last 2W.frequency"/> </code> <prefix value="D0200H2"/> <text value="Moving or speaking so slowly that other people could have noticed. Or the opposite - being so fidgety or restless that you have been moving around a lot more than usual - Symptom Frequency"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="2-6 days (several days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10998-5"/> <display value="2-6 days (several days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="12-14 days (nearly every day)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11000-9"/> <display value="12-14 days (nearly every day)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Never or 1 day"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10997-7"/> <display value="Never or 1 day"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="7-11 days (half or more of the days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10999-3"/> <display value="7-11 days (half or more of the days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-4/D0200I1"/> <code> <system value="http://loinc.org"/> <code value="54652-3"/> <display value="Thoughts that you would be better off dead, or of hurting yourself in some way in last 2W.presence"/> </code> <prefix value="D0200I1"/> <text value="Thoughts that you would be better off dead, or hurting yourself in some way - Symptom Presence"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="9"/> <display value="No response (leave column 2 blank)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10996-9"/> <display value="No response"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No (enter 0 in column 2)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes (enter 0-3 in column 2)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-4/D0200I2"/> <code> <system value="http://loinc.org"/> <code value="54653-1"/> <display value="Thoughts that you would be better off dead, or of hurting yourself in some way in last 2W.frequency"/> </code> <prefix value="D0200I2"/> <text value="Thoughts that you would be better off dead, or hurting yourself in some way - Symptom Frequency"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="2-6 days (several days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10998-5"/> <display value="2-6 days (several days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="12-14 days (nearly every day)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11000-9"/> <display value="12-14 days (nearly every day)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Never or 1 day"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10997-7"/> <display value="Never or 1 day"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="7-11 days (half or more of the days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10999-3"/> <display value="7-11 days (half or more of the days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="Section-4/D0500"/> <code> <system value="http://loinc.org"/> <code value="54657-2"/> <display value="Staff assessment of resident mood (PHQ-9-OV)"/> </code> <prefix value="D0500"/> <text value="Staff Assessment of {Patient/Resident} Mood (PHQ-9-OV*). Do not conduct if {Patient/Resident} Mood Interview was completed. Over the last 2 weeks, did the {patient/resident} have any of the following problems or behaviors?"/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> <item> <linkId value="Section-4/D0500A1"/> <code> <system value="http://loinc.org"/> <code value="54658-0"/> <display value="Little interest or pleasure in doing things in last 2W.presence.PHQ-9"/> </code> <prefix value="D0500A1"/> <text value="Little interest or pleasure in doing things - Symptom Presence"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No (enter 0 in column 2)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes (enter 0-3 in column 2)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-4/D0500A2"/> <code> <system value="http://loinc.org"/> <code value="54659-8"/> <display value="Little interest or pleasure in doing things in last 2W.frequency.PHQ-9"/> </code> <prefix value="D0500A2"/> <text value="Little interest or pleasure in doing things - Symptom Frequency"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="2-6 days (several days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10998-5"/> <display value="2-6 days (several days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="12-14 days (nearly every day)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11000-9"/> <display value="12-14 days (nearly every day)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Never or 1 day"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10997-7"/> <display value="Never or 1 day"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="7-11 days (half or more of the days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10999-3"/> <display value="7-11 days (half or more of the days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-4/D0500B1"/> <code> <system value="http://loinc.org"/> <code value="54660-6"/> <display value="Feeling or appearing down, depressed or hopeless in last 2W.presence.PHQ-9"/> </code> <prefix value="D0500B1"/> <text value="Feeling or appearing down, depressed, or hopeless - Symptom Presence"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No (enter 0 in column 2)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes (enter 0-3 in column 2)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-4/D0500B2"/> <code> <system value="http://loinc.org"/> <code value="54661-4"/> <display value="Feeling or appearing down, depressed, or hopeless in last 2W.frequency.PHQ-9"/> </code> <prefix value="D0500B2"/> <text value="Feeling or appearing down, depressed, or hopeless - Symptom Frequency"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="2-6 days (several days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10998-5"/> <display value="2-6 days (several days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="12-14 days (nearly every day)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11000-9"/> <display value="12-14 days (nearly every day)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Never or 1 day"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10997-7"/> <display value="Never or 1 day"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="7-11 days (half or more of the days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10999-3"/> <display value="7-11 days (half or more of the days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-4/D0500C1"/> <code> <system value="http://loinc.org"/> <code value="54662-2"/> <display value="Trouble falling or staying asleep, or sleeping too much in last 2W.presence.PHQ-9"/> </code> <prefix value="D0500C1"/> <text value="Trouble falling or staying asleep, or sleeping too much - Symptom Presence"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No (enter 0 in column 2)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes (enter 0-3 in column 2)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-4/D0500C2"/> <code> <system value="http://loinc.org"/> <code value="54663-0"/> <display value="Trouble falling or staying asleep, or sleeping too much in last 2W.frequency.PHQ-9"/> </code> <prefix value="D0500C2"/> <text value="Trouble falling or staying asleep, or sleeping too much - Symptom Frequency"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="2-6 days (several days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10998-5"/> <display value="2-6 days (several days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="12-14 days (nearly every day)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11000-9"/> <display value="12-14 days (nearly every day)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Never or 1 day"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10997-7"/> <display value="Never or 1 day"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="7-11 days (half or more of the days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10999-3"/> <display value="7-11 days (half or more of the days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-4/D0500D1"/> <code> <system value="http://loinc.org"/> <code value="54664-8"/> <display value="Feeling tired or having little energy in last 2W.presence.PHQ-9"/> </code> <prefix value="D0500D1"/> <text value="Feeling tired or having little energy - Symptom Presence"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No (enter 0 in column 2)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes (enter 0-3 in column 2)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-4/D0500D2"/> <code> <system value="http://loinc.org"/> <code value="54665-5"/> <display value="Feeling tired or having little energy in last 2W.frequency.PHQ-9"/> </code> <prefix value="D0500D2"/> <text value="Feeling tired or having little energy - Symptom Frequency"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="2-6 days (several days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10998-5"/> <display value="2-6 days (several days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="12-14 days (nearly every day)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11000-9"/> <display value="12-14 days (nearly every day)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Never or 1 day"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10997-7"/> <display value="Never or 1 day"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="7-11 days (half or more of the days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10999-3"/> <display value="7-11 days (half or more of the days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-4/D0500E1"/> <code> <system value="http://loinc.org"/> <code value="54666-3"/> <display value="Poor appetite or overeating in last 2W.presence.PHQ-9"/> </code> <prefix value="D0500E1"/> <text value="Poor appetite or overeating - Symptom Presence"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No (enter 0 in column 2)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes (enter 0-3 in column 2)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-4/D0500E2"/> <code> <system value="http://loinc.org"/> <code value="54667-1"/> <display value="Poor appetite or overeating in last 2W.frequency.PHQ-9"/> </code> <prefix value="D0500E2"/> <text value="Poor appetite or overeating - Symptom Frequency"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="2-6 days (several days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10998-5"/> <display value="2-6 days (several days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="12-14 days (nearly every day)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11000-9"/> <display value="12-14 days (nearly every day)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Never or 1 day"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10997-7"/> <display value="Never or 1 day"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="7-11 days (half or more of the days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10999-3"/> <display value="7-11 days (half or more of the days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-4/D0500F1"/> <code> <system value="http://loinc.org"/> <code value="54668-9"/> <display value="Indicating that (s)he feels bad about self, is a failure, or has let self or family down in last 2W.presence.PHQ-9"/> </code> <prefix value="D0500F1"/> <text value="Indicating that s/he feels bad about self, is a failure, or has let self or family down - Symptom Presence"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No (enter 0 in column 2)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes (enter 0-3 in column 2)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-4/D0500F2"/> <code> <system value="http://loinc.org"/> <code value="54669-7"/> <display value="Indicating that (s)he feels bad about self, is a failure, or has let self or family down in last 2W.frequency.PHQ-9"/> </code> <prefix value="D0500F2"/> <text value="Indicating that s/he feels bad about self, is a failure, or has let self or family down - Symptom Frequency"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="2-6 days (several days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10998-5"/> <display value="2-6 days (several days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="12-14 days (nearly every day)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11000-9"/> <display value="12-14 days (nearly every day)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Never or 1 day"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10997-7"/> <display value="Never or 1 day"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="7-11 days (half or more of the days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10999-3"/> <display value="7-11 days (half or more of the days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-4/D0500G1"/> <code> <system value="http://loinc.org"/> <code value="54670-5"/> <display value="Trouble concentrating on things, such as reading the newspaper or watching television in last 2W.presence.PHQ-9"/> </code> <prefix value="D0500G1"/> <text value="Trouble concentrating on things, such as reading the newspaper or watching television - Symptom Presence"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No (enter 0 in column 2)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes (enter 0-3 in column 2)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-4/D0500G2"/> <code> <system value="http://loinc.org"/> <code value="54671-3"/> <display value="Trouble concentrating on things, such as reading the newspaper or watching television in last 2W.frequency.PHQ-9"/> </code> <prefix value="D0500G2"/> <text value="Trouble concentrating on things, such as reading the newspaper or watching television - Symptom Frequency"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="2-6 days (several days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10998-5"/> <display value="2-6 days (several days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="12-14 days (nearly every day)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11000-9"/> <display value="12-14 days (nearly every day)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Never or 1 day"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10997-7"/> <display value="Never or 1 day"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="7-11 days (half or more of the days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10999-3"/> <display value="7-11 days (half or more of the days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-4/D0500H1"/> <code> <system value="http://loinc.org"/> <code value="54672-1"/> <display value="Moving or speaking so slowly that other people have noticed. Or the opposite - being so fidgety or restless that (s)he has been moving around a lot more than usual in last 2W.presence.PHQ-9"/> </code> <prefix value="D0500H1"/> <text value="Moving or speaking so slowly that other people have noticed. Or the opposite - being so fidgety or restless that s/he has been moving around a lot more than usual - Symptom Presence"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No (enter 0 in column 2)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes (enter 0-3 in column 2)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-4/D0500H2"/> <code> <system value="http://loinc.org"/> <code value="54904-8"/> <display value="Moving or speaking so slowly that other people have noticed. Or the opposite - being so fidgety or restless that (s)he has been moving around a lot more than usual in last 2W.frequency.PHQ-9"/> </code> <prefix value="D0500H2"/> <text value="Moving or speaking so slowly that other people have noticed. Or the opposite - being so fidgety or restless that s/he has been moving around a lot more than usual - Symptom Frequency"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="2-6 days (several days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10998-5"/> <display value="2-6 days (several days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="12-14 days (nearly every day)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11000-9"/> <display value="12-14 days (nearly every day)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Never or 1 day"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10997-7"/> <display value="Never or 1 day"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="7-11 days (half or more of the days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10999-3"/> <display value="7-11 days (half or more of the days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-4/D0500I1"/> <code> <system value="http://loinc.org"/> <code value="54673-9"/> <display value="States that life isn't worth living, wishes for death, or attempts to harm self in last 2W.presence.PHQ-9"/> </code> <prefix value="D0500I1"/> <text value="States that life isn't worth living, wishes for death, or attempts to harm self - Symptom Presence"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No (enter 0 in column 2)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes (enter 0-3 in column 2)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-4/D0500I2"/> <code> <system value="http://loinc.org"/> <code value="54674-7"/> <display value="States that life isn't worth living, wishes for death, or attempts to harm self in last 2W.frequency.PHQ-9"/> </code> <prefix value="D0500I2"/> <text value="States that life isn't worth living, wishes for death, or attempts to harm self - Symptom Frequency"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="2-6 days (several days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10998-5"/> <display value="2-6 days (several days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="12-14 days (nearly every day)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11000-9"/> <display value="12-14 days (nearly every day)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Never or 1 day"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10997-7"/> <display value="Never or 1 day"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="7-11 days (half or more of the days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10999-3"/> <display value="7-11 days (half or more of the days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-4/D0500J1"/> <code> <system value="http://loinc.org"/> <code value="54675-4"/> <display value="Being short-tempered, easily annoyed in last 2W.presence.PHQ-9"/> </code> <prefix value="D0500J1"/> <text value="Being short tempered, easily annoyed - Symptom Presence"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No (enter 0 in column 2)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes (enter 0-3 in column 2)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-4/D0500J2"/> <code> <system value="http://loinc.org"/> <code value="54676-2"/> <display value="Being short-tempered, easily annoyed in last 2W.frequency.PHQ-9"/> </code> <prefix value="D0500J2"/> <text value="Being short tempered, easily annoyed - Symptom Frequency"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="2-6 days (several days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10998-5"/> <display value="2-6 days (several days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="12-14 days (nearly every day)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11000-9"/> <display value="12-14 days (nearly every day)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Never or 1 day"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10997-7"/> <display value="Never or 1 day"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="7-11 days (half or more of the days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10999-3"/> <display value="7-11 days (half or more of the days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> </item> </item> <item> <linkId value="Section-5"/> <code> <system value="http://loinc.org"/> <code value="86815-8"/> <display value="MDS v3.0 - RAI v1.17.1 - Behavior - NP, NQ, ND, SD, SP, IPA, OSA [CMS Assessment]"/> </code> <text value="Section E: Behavior"/> <type value="group"/> <readOnly value="true"/> <item> <linkId value="Section-5/E0300"/> <code> <system value="http://loinc.org"/> <code value="54685-3"/> <display value="Overall presence of behavioral symptoms in last 7D"/> </code> <prefix value="E0300"/> <text value="Overall Presence of Behavioral Symptoms. Were any behavioral symptoms in {Behavioral Symptom question} coded 1, 2, or 3?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-5/E0800"/> <code> <system value="http://loinc.org"/> <code value="54692-9"/> <display value="Rejection of care - presence and frequency in last 7D"/> </code> <prefix value="E0800"/> <text value="Rejection of Care - Presence & Frequency. Did the {patient/resident} reject evaluation or care (e.g., bloodwork, taking medications, ADL assistance) that is necessary to achieve the {patient's/resident's} goals for health and well-being? Do not include behaviors that have already been addressed (e.g., by discussion or care planning with the {patient/resident} or family), and determined to be consistent with {patient/resident} values, preferences, or goals."/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Behavior not exhibited"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11005-8"/> <display value="Behavior not exhibited"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Behavior of this type occurred 1 to 3 days"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11006-6"/> <display value="Behavior of this type occurred 1 to 3 days"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Behavior of this type occurred 4 to 6 days, but less than daily"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA94-8"/> <display value="Behavior of this type occurred 4 to 6 days, but less than daily"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Behavior of this type occurred daily"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA95-5"/> <display value="Behavior of this type occurred daily"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-5/E0900"/> <code> <system value="http://loinc.org"/> <code value="54693-7"/> <display value="Wandering - presence and frequency in last 7D"/> </code> <prefix value="E0900"/> <text value="Wandering - Presence & Frequency. Has the {patient/resident} wandered?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Behavior not exhibited"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11005-8"/> <display value="Behavior not exhibited"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Behavior of this type occurred 1 to 3 days"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11006-6"/> <display value="Behavior of this type occurred 1 to 3 days"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Behavior of this type occurred 4 to 6 days, but less than daily"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA94-8"/> <display value="Behavior of this type occurred 4 to 6 days, but less than daily"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Behavior of this type occurred daily"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA95-5"/> <display value="Behavior of this type occurred daily"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-5/E1100"/> <code> <system value="http://loinc.org"/> <code value="54696-0"/> <display value="Change in behavioral or other symptoms in last 7D"/> </code> <prefix value="E1100"/> <text value="Change in Behavior or Other Symptoms. Consider all of the symptoms assessed in {Behavior section}. How does {patient's/resident's} current behavior status, care rejection, or wandering compare to prior assessment?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Same"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11009-0"/> <display value="Same"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Improved"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA65-8"/> <display value="Improved"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Worse"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11011-6"/> <display value="Worse"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="N/A because no prior MDS assessment"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11012-4"/> <display value="N/A because no prior MDS assessment"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-5/E0200"/> <code> <system value="http://loinc.org"/> <code value="54514-5"/> <display value="Behavioral symptom - presence & frequency"/> </code> <prefix value="E0200"/> <text value="Behavioral Symptom - Presence & Frequency. Note presence of symptoms and their frequency"/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> <item> <linkId value="Section-5/E0200A"/> <code> <system value="http://loinc.org"/> <code value="54682-0"/> <display value="Physical behavioral symptoms directed toward others in last 7D"/> </code> <prefix value="E0200A"/> <text value="Physical behavioral symptoms directed towards others (e. g., hitting, kicking, pushing, scratching, grabbing, abusing others sexually)"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Behavior not exhibited"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11005-8"/> <display value="Behavior not exhibited"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Behavior of this type occurred 1 to 3 days"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11006-6"/> <display value="Behavior of this type occurred 1 to 3 days"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Behavior of this type occurred 4 to 6 days, but less than daily"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA94-8"/> <display value="Behavior of this type occurred 4 to 6 days, but less than daily"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Behavior of this type occurred daily"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA95-5"/> <display value="Behavior of this type occurred daily"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-5/E0200B"/> <code> <system value="http://loinc.org"/> <code value="54683-8"/> <display value="Verbal behavioral symptoms directed toward others in last 7D"/> </code> <prefix value="E0200B"/> <text value="Verbal behavioral symptoms directed toward others (e.g., threatening others, screaming at others, cursing at others)"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Behavior not exhibited"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11005-8"/> <display value="Behavior not exhibited"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Behavior of this type occurred 1 to 3 days"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11006-6"/> <display value="Behavior of this type occurred 1 to 3 days"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Behavior of this type occurred 4 to 6 days, but less than daily"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA94-8"/> <display value="Behavior of this type occurred 4 to 6 days, but less than daily"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Behavior of this type occurred daily"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA95-5"/> <display value="Behavior of this type occurred daily"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-5/E0200C"/> <code> <system value="http://loinc.org"/> <code value="54684-6"/> <display value="Other behavioral symptoms not directed toward others in last 7D"/> </code> <prefix value="E0200C"/> <text value="Other behavioral symptoms not directed at others (e.g., physical symptoms such as hitting or scratching self, pacing, rummaging, public sexual acts, disrobing in public, throwing or smearing food or bodily wastes, or verbal/vocal symptoms like screaming, disruptive sounds)"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Behavior not exhibited"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11005-8"/> <display value="Behavior not exhibited"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Behavior of this type occurred 1 to 3 days"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11006-6"/> <display value="Behavior of this type occurred 1 to 3 days"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Behavior of this type occurred 4 to 6 days, but less than daily"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA94-8"/> <display value="Behavior of this type occurred 4 to 6 days, but less than daily"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Behavior of this type occurred daily"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA95-5"/> <display value="Behavior of this type occurred daily"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="Section-5/E0500"/> <code> <system value="http://loinc.org"/> <code value="54515-2"/> <display value="Impact on resident"/> </code> <prefix value="E0500"/> <text value="Impact on {Patient/Resident}. Did any of the identified symptom(s):"/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> <item> <linkId value="Section-5/E0500A"/> <code> <system value="http://loinc.org"/> <code value="54686-1"/> <display value="Put the resident at significant risk for physical illness or injury in last 7D"/> </code> <prefix value="E0500A"/> <text value="Put the {patient/resident} at significant risk for physical illness or injury?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-5/E0500B"/> <code> <system value="http://loinc.org"/> <code value="54687-9"/> <display value="Significantly interfere with the resident's care in last 7D"/> </code> <prefix value="E0500B"/> <text value="Significantly interfere with the {patient's/resident's} care?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-5/E0500C"/> <code> <system value="http://loinc.org"/> <code value="54688-7"/> <display value="Significantly interfere with the resident's participation in activities or social interactions in last 7D"/> </code> <prefix value="E0500C"/> <text value="Significantly interfere with the {patient's/resident's} participation in activities or social interactions?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="Section-5/E0600"/> <code> <system value="http://loinc.org"/> <code value="54516-0"/> <display value="Impact on others"/> </code> <prefix value="E0600"/> <text value="Impact on Others. Did any of the identified symptom(s):"/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> <item> <linkId value="Section-5/E0600A"/> <code> <system value="http://loinc.org"/> <code value="54689-5"/> <display value="Put others at significant risk for physical injury in last 7D"/> </code> <prefix value="E0600A"/> <text value="Put others at significant risk for physical injury?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-5/E0600B"/> <code> <system value="http://loinc.org"/> <code value="54690-3"/> <display value="Significantly intrude on the privacy or activity of others in last 7D"/> </code> <prefix value="E0600B"/> <text value="Significantly intrude on the privacy or activity of others?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-5/E0600C"/> <code> <system value="http://loinc.org"/> <code value="54691-1"/> <display value="Significantly disrupt care or living environment in last 7D"/> </code> <prefix value="E0600C"/> <text value="Significantly disrupt care or living environment?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="Section-5/E1000"/> <code> <system value="http://loinc.org"/> <code value="54517-8"/> <display value="Wandering - impact"/> </code> <prefix value="E1000"/> <text value="Wandering - Impact"/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> <item> <linkId value="Section-5/E1000A"/> <code> <system value="http://loinc.org"/> <code value="54694-5"/> <display value="Wandering places resident at significant risk of getting to a potentially dangerous place in last 7D"/> </code> <prefix value="E1000A"/> <text value="Does the wandering place the {patient/resident} at significant risk of getting to a potentially dangerous place (e.g., stairs, outside of the facility)?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-5/E1000B"/> <code> <system value="http://loinc.org"/> <code value="54695-2"/> <display value="Wandering significantly intrudes on the privacy or activities of others in last 7D"/> </code> <prefix value="E1000B"/> <text value="Does the wandering significantly intrude on the privacy or activities of others?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="Section-5/E0100"/> <code> <system value="http://loinc.org"/> <code value="86597-2"/> <display value="Potential indicators of psychosis in last 7D"/> </code> <prefix value="E0100"/> <text value="Potential Indicators of Psychosis: Check all that apply"/> <type value="choice"/> <repeats value="true"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="A"/> <display value="Hallucinations (perceptual experiences in the absence of real external sensory stimuli)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27795-6"/> <display value="Hallucinations (perceptual experiences in the absence of real external sensory stimuli)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="B"/> <display value="Delusions (misconceptions or beliefs that are firmly held, contrary to reality)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27796-4"/> <display value="Delusions (misconceptions or beliefs that are firmly held, contrary to reality)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="Z"/> <display value="None of the above"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA9-3"/> <display value="None of the above"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="Section-6"/> <code> <system value="http://loinc.org"/> <code value="86600-4"/> <display value="Preferences for customary routine and activities [CMS Assessment]"/> </code> <text value="Section F: Preferences for Customary Routine and Activities"/> <type value="group"/> <readOnly value="true"/> <item> <linkId value="Section-6/F0300"/> <code> <system value="http://loinc.org"/> <code value="54697-8"/> <display value="Interview for daily and activity preferences should be conducted"/> </code> <prefix value="F0300"/> <text value="Should Interview for Daily and Activity Preferences be Conducted? Attempt to interview all {patients/residents} able to communicate. If {patient/resident} is unable to complete, attempt to complete interview with family member or significant other"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No ({patient/resident} is rarely/never understood and family/significant other not available)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA16158-0"/> <display value="No (resident is rarely/never understood and family/significant other not available)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-6/F0600"/> <code> <system value="http://loinc.org"/> <code value="54714-1"/> <display value="Primary respondent for daily and activity preferences"/> </code> <prefix value="F0600"/> <text value="Daily and Activity Preferences Primary Respondent. Indicate primary respondent for Daily and Activity Preferences"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Family or significant other (close friend or other representative)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11020-7"/> <display value="Family or significant other (close friend or other representative)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="9"/> <display value="Interview could not be completed by {patient/resident} or family/significant other ("No response" to 3 or more items)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11021-5"/> <display value="Interview could not be completed by resident or family/significant other ("No response" to 3 or more items)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="{Patient/Resident}"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11019-9"/> <display value="Resident"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-6/F0700"/> <code> <system value="http://loinc.org"/> <code value="54715-8"/> <display value="Staff assessment of daily and activity preferences should be conducted"/> </code> <prefix value="F0700"/> <text value="Should the Staff Assessment of Daily and Activity Preferences be Conducted?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No (because Interview for Daily and Activity Preferences was completed by {patient/resident} or family/significant other)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11151-0"/> <display value="No (because Interview for Daily and Activity Preferences (F0400 and F0500) was completed by resident or family/significant other)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes (because 3 or more items in Interview for Daily and Activity Preferences were not completed by {patient/resident} or family/significant other)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11152-8"/> <display value="Yes (because 3 or more items in Interview for Daily and Activity Preferences (F0400 and F0500) were not completed by resident or family/significant other)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-6/F0400"/> <code> <system value="http://loinc.org"/> <code value="54519-4"/> <display value="Interview for daily preferences"/> </code> <prefix value="F0400"/> <text value="Interview for Daily Preferences. Show {patient/resident} the response options and say: "While you are in this {facility/setting}...""/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> <item> <linkId value="Section-6/F0400A"/> <code> <system value="http://loinc.org"/> <code value="54698-6"/> <display value="How important it is to choose what clothes to wear while in this facility"/> </code> <prefix value="F0400A"/> <text value="how important is it to you to choose what clothes to wear?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="5"/> <display value="Important, but can't do or no choice"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11017-3"/> <display value="Important, but can't do or no choice"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11013-2"/> <display value="Very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="4"/> <display value="Not important at all"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11016-5"/> <display value="Not important at all"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="9"/> <display value="No response or non-responsive"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11018-1"/> <display value="No response or non-responsive"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Somewhat important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11014-0"/> <display value="Somewhat important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Not very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11015-7"/> <display value="Not very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-6/F0400B"/> <code> <system value="http://loinc.org"/> <code value="54699-4"/> <display value="How important it is to take care of your personal belongings or things while in this facility"/> </code> <prefix value="F0400B"/> <text value="how important is it to you to take care of your personal belongings or things?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="5"/> <display value="Important, but can't do or no choice"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11017-3"/> <display value="Important, but can't do or no choice"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11013-2"/> <display value="Very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="4"/> <display value="Not important at all"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11016-5"/> <display value="Not important at all"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="9"/> <display value="No response or non-responsive"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11018-1"/> <display value="No response or non-responsive"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Somewhat important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11014-0"/> <display value="Somewhat important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Not very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11015-7"/> <display value="Not very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-6/F0400C"/> <code> <system value="http://loinc.org"/> <code value="54700-0"/> <display value="How important it is to choose between a tub bath, shower, bed bath, or sponge bath while in this facility"/> </code> <prefix value="F0400C"/> <text value="how important is it to you to choose between a tub bath, shower, bed bath, or sponge bath?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="5"/> <display value="Important, but can't do or no choice"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11017-3"/> <display value="Important, but can't do or no choice"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11013-2"/> <display value="Very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="4"/> <display value="Not important at all"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11016-5"/> <display value="Not important at all"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="9"/> <display value="No response or non-responsive"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11018-1"/> <display value="No response or non-responsive"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Somewhat important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11014-0"/> <display value="Somewhat important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Not very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11015-7"/> <display value="Not very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-6/F0400D"/> <code> <system value="http://loinc.org"/> <code value="54701-8"/> <display value="How important it is to have snacks available between meals while in this facility"/> </code> <prefix value="F0400D"/> <text value="how important is it to you to have snacks available between meals?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="5"/> <display value="Important, but can't do or no choice"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11017-3"/> <display value="Important, but can't do or no choice"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11013-2"/> <display value="Very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="4"/> <display value="Not important at all"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11016-5"/> <display value="Not important at all"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="9"/> <display value="No response or non-responsive"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11018-1"/> <display value="No response or non-responsive"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Somewhat important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11014-0"/> <display value="Somewhat important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Not very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11015-7"/> <display value="Not very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-6/F0400E"/> <code> <system value="http://loinc.org"/> <code value="54702-6"/> <display value="How important it is to choose your own bedtime while in this facility"/> </code> <prefix value="F0400E"/> <text value="how important is it to you to choose your own bedtime?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="5"/> <display value="Important, but can't do or no choice"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11017-3"/> <display value="Important, but can't do or no choice"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11013-2"/> <display value="Very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="4"/> <display value="Not important at all"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11016-5"/> <display value="Not important at all"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="9"/> <display value="No response or non-responsive"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11018-1"/> <display value="No response or non-responsive"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Somewhat important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11014-0"/> <display value="Somewhat important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Not very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11015-7"/> <display value="Not very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-6/F0400F"/> <code> <system value="http://loinc.org"/> <code value="54703-4"/> <display value="How important it is to have your family or a close friend involved in discussions about your care while in this facility"/> </code> <prefix value="F0400F"/> <text value="how important is it to you to have your family or a close friend involved in discussions about your care?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="5"/> <display value="Important, but can't do or no choice"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11017-3"/> <display value="Important, but can't do or no choice"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11013-2"/> <display value="Very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="4"/> <display value="Not important at all"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11016-5"/> <display value="Not important at all"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="9"/> <display value="No response or non-responsive"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11018-1"/> <display value="No response or non-responsive"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Somewhat important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11014-0"/> <display value="Somewhat important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Not very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11015-7"/> <display value="Not very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-6/F0400G"/> <code> <system value="http://loinc.org"/> <code value="54704-2"/> <display value="How important it is to be able to use the phone in private while in this facility"/> </code> <prefix value="F0400G"/> <text value="how important is it to you to be able to use the phone in private?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="5"/> <display value="Important, but can't do or no choice"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11017-3"/> <display value="Important, but can't do or no choice"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11013-2"/> <display value="Very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="4"/> <display value="Not important at all"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11016-5"/> <display value="Not important at all"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="9"/> <display value="No response or non-responsive"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11018-1"/> <display value="No response or non-responsive"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Somewhat important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11014-0"/> <display value="Somewhat important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Not very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11015-7"/> <display value="Not very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-6/F0400H"/> <code> <system value="http://loinc.org"/> <code value="54705-9"/> <display value="How important it is to have a place to lock your things to keep them safe while in this facility"/> </code> <prefix value="F0400H"/> <text value="how important is it to you to have a place to lock your things to keep them safe?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="5"/> <display value="Important, but can't do or no choice"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11017-3"/> <display value="Important, but can't do or no choice"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11013-2"/> <display value="Very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="4"/> <display value="Not important at all"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11016-5"/> <display value="Not important at all"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="9"/> <display value="No response or non-responsive"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11018-1"/> <display value="No response or non-responsive"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Somewhat important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11014-0"/> <display value="Somewhat important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Not very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11015-7"/> <display value="Not very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="Section-6/F0500"/> <code> <system value="http://loinc.org"/> <code value="54520-2"/> <display value="Interview for activity preferences"/> </code> <prefix value="F0500"/> <text value="Interview for Activity Preferences: Show {patient/resident} the response options and say: "While you are in this {facility/setting}...""/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> <item> <linkId value="Section-6/F0500A"/> <code> <system value="http://loinc.org"/> <code value="54706-7"/> <display value="How important it is to have books, newspapers, and magazines to read while in this facility"/> </code> <prefix value="F0500A"/> <text value="how important is it to you to have books, newspapers, and magazines to read?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="5"/> <display value="Important, but can't do or no choice"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11017-3"/> <display value="Important, but can't do or no choice"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11013-2"/> <display value="Very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="4"/> <display value="Not important at all"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11016-5"/> <display value="Not important at all"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="9"/> <display value="No response or non-responsive"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11018-1"/> <display value="No response or non-responsive"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Somewhat important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11014-0"/> <display value="Somewhat important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Not very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11015-7"/> <display value="Not very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-6/F0500B"/> <code> <system value="http://loinc.org"/> <code value="54707-5"/> <display value="How important it is to listen to music you like while in this facility"/> </code> <prefix value="F0500B"/> <text value="how important is it to you to listen to music you like?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="5"/> <display value="Important, but can't do or no choice"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11017-3"/> <display value="Important, but can't do or no choice"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11013-2"/> <display value="Very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="4"/> <display value="Not important at all"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11016-5"/> <display value="Not important at all"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="9"/> <display value="No response or non-responsive"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11018-1"/> <display value="No response or non-responsive"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Somewhat important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11014-0"/> <display value="Somewhat important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Not very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11015-7"/> <display value="Not very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-6/F0500C"/> <code> <system value="http://loinc.org"/> <code value="54708-3"/> <display value="How important it is to be around animals such as pets while in this facility"/> </code> <prefix value="F0500C"/> <text value="how important is it to you to be around animals such as pets?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="5"/> <display value="Important, but can't do or no choice"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11017-3"/> <display value="Important, but can't do or no choice"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11013-2"/> <display value="Very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="4"/> <display value="Not important at all"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11016-5"/> <display value="Not important at all"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="9"/> <display value="No response or non-responsive"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11018-1"/> <display value="No response or non-responsive"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Somewhat important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11014-0"/> <display value="Somewhat important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Not very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11015-7"/> <display value="Not very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-6/F0500D"/> <code> <system value="http://loinc.org"/> <code value="54709-1"/> <display value="How important it is to keep up with the news while in this facility"/> </code> <prefix value="F0500D"/> <text value="how important is it to you to keep up with the news?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="5"/> <display value="Important, but can't do or no choice"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11017-3"/> <display value="Important, but can't do or no choice"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11013-2"/> <display value="Very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="4"/> <display value="Not important at all"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11016-5"/> <display value="Not important at all"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="9"/> <display value="No response or non-responsive"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11018-1"/> <display value="No response or non-responsive"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Somewhat important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11014-0"/> <display value="Somewhat important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Not very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11015-7"/> <display value="Not very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-6/F0500E"/> <code> <system value="http://loinc.org"/> <code value="54710-9"/> <display value="How important it is to do things with groups of people while in this facility"/> </code> <prefix value="F0500E"/> <text value="how important is it to you to do things with groups of people?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="5"/> <display value="Important, but can't do or no choice"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11017-3"/> <display value="Important, but can't do or no choice"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11013-2"/> <display value="Very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="4"/> <display value="Not important at all"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11016-5"/> <display value="Not important at all"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="9"/> <display value="No response or non-responsive"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11018-1"/> <display value="No response or non-responsive"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Somewhat important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11014-0"/> <display value="Somewhat important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Not very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11015-7"/> <display value="Not very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-6/F0500F"/> <code> <system value="http://loinc.org"/> <code value="54711-7"/> <display value="How important it is to do your favorite activities while in this facility"/> </code> <prefix value="F0500F"/> <text value="how important is it to you to do your favorite activities?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="5"/> <display value="Important, but can't do or no choice"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11017-3"/> <display value="Important, but can't do or no choice"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11013-2"/> <display value="Very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="4"/> <display value="Not important at all"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11016-5"/> <display value="Not important at all"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="9"/> <display value="No response or non-responsive"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11018-1"/> <display value="No response or non-responsive"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Somewhat important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11014-0"/> <display value="Somewhat important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Not very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11015-7"/> <display value="Not very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-6/F0500G"/> <code> <system value="http://loinc.org"/> <code value="54712-5"/> <display value="How important it is to go outside to get fresh air when the weather is good while in this facility"/> </code> <prefix value="F0500G"/> <text value="how important is it to you to go outside to get fresh air when the weather is good?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="5"/> <display value="Important, but can't do or no choice"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11017-3"/> <display value="Important, but can't do or no choice"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11013-2"/> <display value="Very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="4"/> <display value="Not important at all"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11016-5"/> <display value="Not important at all"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="9"/> <display value="No response or non-responsive"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11018-1"/> <display value="No response or non-responsive"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Somewhat important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11014-0"/> <display value="Somewhat important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Not very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11015-7"/> <display value="Not very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-6/F0500H"/> <code> <system value="http://loinc.org"/> <code value="54713-3"/> <display value="How important it is to participate in religious services or practices while in this facility"/> </code> <prefix value="F0500H"/> <text value="how important is it to you to participate in religious services or practices?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="5"/> <display value="Important, but can't do or no choice"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11017-3"/> <display value="Important, but can't do or no choice"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11013-2"/> <display value="Very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="4"/> <display value="Not important at all"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11016-5"/> <display value="Not important at all"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="9"/> <display value="No response or non-responsive"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11018-1"/> <display value="No response or non-responsive"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Somewhat important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11014-0"/> <display value="Somewhat important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Not very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11015-7"/> <display value="Not very important"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="Section-6/F0800"/> <code> <system value="http://loinc.org"/> <code value="86599-8"/> <display value="Staff assessment of daily and activity preferences"/> </code> <prefix value="F0800"/> <text value="Staff Assessment of Daily and Activity Preferences. Do not conduct if Interview for Daily and Activity Preferences was completed. {Patient/Resident} Prefers: Check all that apply"/> <type value="choice"/> <repeats value="true"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="A"/> <display value="Choosing clothes to wear"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27797-2"/> <display value="Choosing clothes to wear"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="B"/> <display value="Caring for personal belongings"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27798-0"/> <display value="Caring for personal belongings"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="C"/> <display value="Receiving tub bath"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27799-8"/> <display value="Receiving tub bath"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="D"/> <display value="Receiving shower"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27800-4"/> <display value="Receiving shower"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="E"/> <display value="Receiving bed bath"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27815-2"/> <display value="Receiving bed bath"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="F"/> <display value="Receiving sponge bath"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27801-2"/> <display value="Receiving sponge bath"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="G"/> <display value="Snacks between meals"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27802-0"/> <display value="Snacks between meals"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="H"/> <display value="Staying up past 8:00 p.m."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27803-8"/> <display value="Staying up past 8:00 p.m."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I"/> <display value="Family or significant other involvement in care discussions"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27804-6"/> <display value="Family or significant other involvement in care discussions"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="J"/> <display value="Use of phone in private"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27805-3"/> <display value="Use of phone in private"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="K"/> <display value="Place to lock personal belongings"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27806-1"/> <display value="Place to lock personal belongings"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="L"/> <display value="Reading books, newspapers, or magazines"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27807-9"/> <display value="Reading books, newspapers, or magazines"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="M"/> <display value="Listening to music"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA17907-9"/> <display value="Listening to music"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="N"/> <display value="Being around animals such as pets"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27808-7"/> <display value="Being around animals such as pets"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="O"/> <display value="Keeping up with the news"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27809-5"/> <display value="Keeping up with the news"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="P"/> <display value="Doing things with groups of people"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27810-3"/> <display value="Doing things with groups of people"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="Q"/> <display value="Participating in favorite activities"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27811-1"/> <display value="Participating in favorite activities"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="R"/> <display value="Spending time away from the nursing home"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27812-9"/> <display value="Spending time away from the nursing home"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="S"/> <display value="Spending time outdoors"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27813-7"/> <display value="Spending time outdoors"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="T"/> <display value="Participating in religious activities or practices"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27814-5"/> <display value="Participating in religious activities or practices"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="Z"/> <display value="None of the above"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA9-3"/> <display value="None of the above"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="Section-7"/> <code> <system value="http://loinc.org"/> <code value="86601-2"/> <display value="Functional status [CMS Assessment]"/> </code> <text value="Section G: Functional Status"/> <type value="group"/> <readOnly value="true"/> <item> <linkId value="Section-7/G0110"/> <code> <system value="http://loinc.org"/> <code value="86880-2"/> <display value="MDS v3.0 - RAI v1.17.1 - Activities of daily living (ADL) assistance - self-performance"/> </code> <prefix value="G0110"/> <text value="Activities of Daily Living (ADL) Assistance. Refer to the ADL flow chart in the {manual} to facilitate accurate coding"/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> <item> <linkId value="Section-7/G0110A1"/> <code> <system value="http://loinc.org"/> <code value="45588-1"/> <display value="Bed mobility - self-performance during 7D assessment period"/> </code> <prefix value="G0110A1"/> <text value="Bed mobility - how {patient/resident} moves to and from lying position, turns side to side, and positions body while in bed or alternate sleep furniture - Self-Performance"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="8"/> <display value="Activity did not occur - activity did not occur or family and/or non-facility staff provided care 100% of the time for that activity over the entire 7-day period"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA18614-0"/> <display value="Activity did not occur - activity did not occur or family and/or non-facility staff provided care 100% of the time for that activity over the entire 7-day period"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Extensive assistance - {patient/resident} involved in activity, staff provide weight-bearing support"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12640-1"/> <display value="Extensive assistance - resident involved in activity, staff provide weight-bearing support"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Limited assistance - {patient/resident} highly involved in activity; staff provide guided maneuvering of limbs or other non-weight-bearing assistance"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12639-3"/> <display value="Limited assistance - resident highly involved in activity; staff provide guided maneuvering of limbs or other non-weight-bearing assistance"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="7"/> <display value="Activity occurred only once or twice - activity did occur but only once or twice"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12642-7"/> <display value="Activity occurred only once or twice - activity did occur but only once or twice"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Independent - no help or staff oversight at any time"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12637-7"/> <display value="Independent - no help or staff oversight at any time"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Supervision - oversight, encouragement or cueing"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12638-5"/> <display value="Supervision - oversight, encouragement or cueing"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="4"/> <display value="Total dependence - full staff performance every time during entire 7-day period"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12641-9"/> <display value="Total dependence - full staff performance every time during entire 7-day period"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-7/G0110A2"/> <code> <system value="http://loinc.org"/> <code value="45589-9"/> <display value="Bed mobility - support provided during 7D assessment period"/> </code> <prefix value="G0110A2"/> <text value="Bed mobility - how {patient/resident} moves to and from lying position, turns side to side, and positions body while in bed or alternate sleep furniture - Support"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Setup help only"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA106-7"/> <display value="Setup help only"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Two+ persons physical assist"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA108-3"/> <display value="Two+ persons physical assist"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No setup or physical help from staff"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA105-9"/> <display value="No setup or physical help from staff"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="One person physical assist"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA107-5"/> <display value="One person physical assist"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="8"/> <display value="ADL activity itself did not occur or family and/or non-facility staff provided care 100% of the time for that activity over the entire 7-day period"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA109-1"/> <display value="ADL activity itself did not occur or family and/or non-facility staff provided care 100% of the time for that activity over the entire 7-day period"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-7/G0110B1"/> <code> <system value="http://loinc.org"/> <code value="45590-7"/> <display value="Transfer - self-performance during 7D assessment period"/> </code> <prefix value="G0110B1"/> <text value="Transfer - how {patient/resident} moves between surfaces including to or from: bed, chair, wheelchair, standing position (excludes to/from bath/toilet) - Self-Performance"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="8"/> <display value="Activity did not occur - activity did not occur or family and/or non-facility staff provided care 100% of the time for that activity over the entire 7-day period"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA18614-0"/> <display value="Activity did not occur - activity did not occur or family and/or non-facility staff provided care 100% of the time for that activity over the entire 7-day period"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Extensive assistance - {patient/resident} involved in activity, staff provide weight-bearing support"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12640-1"/> <display value="Extensive assistance - resident involved in activity, staff provide weight-bearing support"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Limited assistance - {patient/resident} highly involved in activity; staff provide guided maneuvering of limbs or other non-weight-bearing assistance"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12639-3"/> <display value="Limited assistance - resident highly involved in activity; staff provide guided maneuvering of limbs or other non-weight-bearing assistance"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="7"/> <display value="Activity occurred only once or twice - activity did occur but only once or twice"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12642-7"/> <display value="Activity occurred only once or twice - activity did occur but only once or twice"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Independent - no help or staff oversight at any time"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12637-7"/> <display value="Independent - no help or staff oversight at any time"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Supervision - oversight, encouragement or cueing"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12638-5"/> <display value="Supervision - oversight, encouragement or cueing"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="4"/> <display value="Total dependence - full staff performance every time during entire 7-day period"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12641-9"/> <display value="Total dependence - full staff performance every time during entire 7-day period"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-7/G0110B2"/> <code> <system value="http://loinc.org"/> <code value="45591-5"/> <display value="Transfer - support provided during 7D assessment period"/> </code> <prefix value="G0110B2"/> <text value="Transfer - how {patient/resident} moves between surfaces including to or from: bed, chair, wheelchair, standing position (excludes to/from bath/toilet) - Support"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Setup help only"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA106-7"/> <display value="Setup help only"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Two+ persons physical assist"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA108-3"/> <display value="Two+ persons physical assist"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No setup or physical help from staff"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA105-9"/> <display value="No setup or physical help from staff"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="One person physical assist"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA107-5"/> <display value="One person physical assist"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="8"/> <display value="ADL activity itself did not occur or family and/or non-facility staff provided care 100% of the time for that activity over the entire 7-day period"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA109-1"/> <display value="ADL activity itself did not occur or family and/or non-facility staff provided care 100% of the time for that activity over the entire 7-day period"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-7/G0110C1"/> <code> <system value="http://loinc.org"/> <code value="45592-3"/> <display value="Walk in room - self-performance during 7D assessment period"/> </code> <prefix value="G0110C1"/> <text value="Walk in room - how {patient/resident} walks between locations in his/her room - Self-Performance"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="8"/> <display value="Activity did not occur - activity did not occur or family and/or non-facility staff provided care 100% of the time for that activity over the entire 7-day period"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA18614-0"/> <display value="Activity did not occur - activity did not occur or family and/or non-facility staff provided care 100% of the time for that activity over the entire 7-day period"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Extensive assistance - {patient/resident} involved in activity, staff provide weight-bearing support"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12640-1"/> <display value="Extensive assistance - resident involved in activity, staff provide weight-bearing support"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Limited assistance - {patient/resident} highly involved in activity; staff provide guided maneuvering of limbs or other non-weight-bearing assistance"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12639-3"/> <display value="Limited assistance - resident highly involved in activity; staff provide guided maneuvering of limbs or other non-weight-bearing assistance"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="7"/> <display value="Activity occurred only once or twice - activity did occur but only once or twice"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12642-7"/> <display value="Activity occurred only once or twice - activity did occur but only once or twice"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Independent - no help or staff oversight at any time"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12637-7"/> <display value="Independent - no help or staff oversight at any time"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Supervision - oversight, encouragement or cueing"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12638-5"/> <display value="Supervision - oversight, encouragement or cueing"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="4"/> <display value="Total dependence - full staff performance every time during entire 7-day period"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12641-9"/> <display value="Total dependence - full staff performance every time during entire 7-day period"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-7/G0110C2"/> <code> <system value="http://loinc.org"/> <code value="45593-1"/> <display value="Walk in room - support provided during 7D assessment period"/> </code> <prefix value="G0110C2"/> <text value="Walk in room - how {patient/resident} walks between locations in his/her room - Support"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Setup help only"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA106-7"/> <display value="Setup help only"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Two+ persons physical assist"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA108-3"/> <display value="Two+ persons physical assist"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No setup or physical help from staff"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA105-9"/> <display value="No setup or physical help from staff"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="One person physical assist"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA107-5"/> <display value="One person physical assist"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="8"/> <display value="ADL activity itself did not occur or family and/or non-facility staff provided care 100% of the time for that activity over the entire 7-day period"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA109-1"/> <display value="ADL activity itself did not occur or family and/or non-facility staff provided care 100% of the time for that activity over the entire 7-day period"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-7/G0110D1"/> <code> <system value="http://loinc.org"/> <code value="45594-9"/> <display value="Walk in corridor - self-performance during 7D assessment period"/> </code> <prefix value="G0110D1"/> <text value="Walk in corridor - how {patient/resident} walks in corridor on unit - Self-Performance"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="8"/> <display value="Activity did not occur - activity did not occur or family and/or non-facility staff provided care 100% of the time for that activity over the entire 7-day period"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA18614-0"/> <display value="Activity did not occur - activity did not occur or family and/or non-facility staff provided care 100% of the time for that activity over the entire 7-day period"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Extensive assistance - {patient/resident} involved in activity, staff provide weight-bearing support"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12640-1"/> <display value="Extensive assistance - resident involved in activity, staff provide weight-bearing support"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Limited assistance - {patient/resident} highly involved in activity; staff provide guided maneuvering of limbs or other non-weight-bearing assistance"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12639-3"/> <display value="Limited assistance - resident highly involved in activity; staff provide guided maneuvering of limbs or other non-weight-bearing assistance"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="7"/> <display value="Activity occurred only once or twice - activity did occur but only once or twice"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12642-7"/> <display value="Activity occurred only once or twice - activity did occur but only once or twice"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Independent - no help or staff oversight at any time"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12637-7"/> <display value="Independent - no help or staff oversight at any time"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Supervision - oversight, encouragement or cueing"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12638-5"/> <display value="Supervision - oversight, encouragement or cueing"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="4"/> <display value="Total dependence - full staff performance every time during entire 7-day period"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12641-9"/> <display value="Total dependence - full staff performance every time during entire 7-day period"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-7/G0110D2"/> <code> <system value="http://loinc.org"/> <code value="45595-6"/> <display value="Walk in corridor - support provided during 7D assessment period"/> </code> <prefix value="G0110D2"/> <text value="Walk in corridor - how {patient/resident} walks in corridor on unit - Support"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Setup help only"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA106-7"/> <display value="Setup help only"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Two+ persons physical assist"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA108-3"/> <display value="Two+ persons physical assist"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No setup or physical help from staff"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA105-9"/> <display value="No setup or physical help from staff"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="One person physical assist"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA107-5"/> <display value="One person physical assist"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="8"/> <display value="ADL activity itself did not occur or family and/or non-facility staff provided care 100% of the time for that activity over the entire 7-day period"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA109-1"/> <display value="ADL activity itself did not occur or family and/or non-facility staff provided care 100% of the time for that activity over the entire 7-day period"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-7/G0110E1"/> <code> <system value="http://loinc.org"/> <code value="45596-4"/> <display value="Locomotion on unit - self-performance during 7D assessment period"/> </code> <prefix value="G0110E1"/> <text value="Locomotion on unit - how {patient/resident} moves between locations in his/her room and adjacent corridor on same floor. If in wheelchair, self-sufficiency once in chair - Self-Performance"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="8"/> <display value="Activity did not occur - activity did not occur or family and/or non-facility staff provided care 100% of the time for that activity over the entire 7-day period"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA18614-0"/> <display value="Activity did not occur - activity did not occur or family and/or non-facility staff provided care 100% of the time for that activity over the entire 7-day period"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Extensive assistance - {patient/resident} involved in activity, staff provide weight-bearing support"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12640-1"/> <display value="Extensive assistance - resident involved in activity, staff provide weight-bearing support"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Limited assistance - {patient/resident} highly involved in activity; staff provide guided maneuvering of limbs or other non-weight-bearing assistance"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12639-3"/> <display value="Limited assistance - resident highly involved in activity; staff provide guided maneuvering of limbs or other non-weight-bearing assistance"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="7"/> <display value="Activity occurred only once or twice - activity did occur but only once or twice"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12642-7"/> <display value="Activity occurred only once or twice - activity did occur but only once or twice"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Independent - no help or staff oversight at any time"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12637-7"/> <display value="Independent - no help or staff oversight at any time"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Supervision - oversight, encouragement or cueing"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12638-5"/> <display value="Supervision - oversight, encouragement or cueing"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="4"/> <display value="Total dependence - full staff performance every time during entire 7-day period"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12641-9"/> <display value="Total dependence - full staff performance every time during entire 7-day period"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-7/G0110E2"/> <code> <system value="http://loinc.org"/> <code value="45597-2"/> <display value="Locomotion on unit - support provided during 7D assessment period"/> </code> <prefix value="G0110E2"/> <text value="Locomotion on unit - how {patient/resident} moves between locations in his/her room and adjacent corridor on same floor. If in wheelchair, self-sufficiency once in chair - Support"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Setup help only"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA106-7"/> <display value="Setup help only"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Two+ persons physical assist"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA108-3"/> <display value="Two+ persons physical assist"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No setup or physical help from staff"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA105-9"/> <display value="No setup or physical help from staff"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="One person physical assist"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA107-5"/> <display value="One person physical assist"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="8"/> <display value="ADL activity itself did not occur or family and/or non-facility staff provided care 100% of the time for that activity over the entire 7-day period"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA109-1"/> <display value="ADL activity itself did not occur or family and/or non-facility staff provided care 100% of the time for that activity over the entire 7-day period"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-7/G0110F1"/> <code> <system value="http://loinc.org"/> <code value="45598-0"/> <display value="Locomotion off unit - self-performance during 7D assessment period"/> </code> <prefix value="G0110F1"/> <text value="Locomotion off unit - how {patient/resident} moves to and returns from off-unit locations (e.g., areas set aside for dining, activities or treatments). If {facility/setting} has only one floor, how {patient/resident} moves to and from distant areas on the floor. If in a wheelchair, self-sufficiency once in chair - Self-Performance"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="8"/> <display value="Activity did not occur - activity did not occur or family and/or non-facility staff provided care 100% of the time for that activity over the entire 7-day period"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA18614-0"/> <display value="Activity did not occur - activity did not occur or family and/or non-facility staff provided care 100% of the time for that activity over the entire 7-day period"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Extensive assistance - {patient/resident} involved in activity, staff provide weight-bearing support"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12640-1"/> <display value="Extensive assistance - resident involved in activity, staff provide weight-bearing support"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Limited assistance - {patient/resident} highly involved in activity; staff provide guided maneuvering of limbs or other non-weight-bearing assistance"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12639-3"/> <display value="Limited assistance - resident highly involved in activity; staff provide guided maneuvering of limbs or other non-weight-bearing assistance"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="7"/> <display value="Activity occurred only once or twice - activity did occur but only once or twice"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12642-7"/> <display value="Activity occurred only once or twice - activity did occur but only once or twice"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Independent - no help or staff oversight at any time"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12637-7"/> <display value="Independent - no help or staff oversight at any time"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Supervision - oversight, encouragement or cueing"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12638-5"/> <display value="Supervision - oversight, encouragement or cueing"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="4"/> <display value="Total dependence - full staff performance every time during entire 7-day period"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12641-9"/> <display value="Total dependence - full staff performance every time during entire 7-day period"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-7/G0110F2"/> <code> <system value="http://loinc.org"/> <code value="45599-8"/> <display value="Locomotion off unit - support provided during 7D assessment period"/> </code> <prefix value="G0110F2"/> <text value="Locomotion off unit - how {patient/resident} moves to and returns from off-unit locations (e.g., areas set aside for dining, activities or treatments). If {facility/setting} has only one floor, how {patient/resident} moves to and from distant areas on the floor. If in a wheelchair, self-sufficiency once in chair - Support"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Setup help only"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA106-7"/> <display value="Setup help only"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Two+ persons physical assist"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA108-3"/> <display value="Two+ persons physical assist"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No setup or physical help from staff"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA105-9"/> <display value="No setup or physical help from staff"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="One person physical assist"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA107-5"/> <display value="One person physical assist"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="8"/> <display value="ADL activity itself did not occur or family and/or non-facility staff provided care 100% of the time for that activity over the entire 7-day period"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA109-1"/> <display value="ADL activity itself did not occur or family and/or non-facility staff provided care 100% of the time for that activity over the entire 7-day period"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-7/G0110G1"/> <code> <system value="http://loinc.org"/> <code value="45600-4"/> <display value="Dressing - self-performance during 7D assessment period"/> </code> <prefix value="G0110G1"/> <text value="Dressing - how {patient/resident} puts on, fastens and takes off all items of clothing, including donning/removing a prosthesis or TED hose. Dressing includes putting on and changing pajamas and housedresses - Self-Performance"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="8"/> <display value="Activity did not occur - activity did not occur or family and/or non-facility staff provided care 100% of the time for that activity over the entire 7-day period"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA18614-0"/> <display value="Activity did not occur - activity did not occur or family and/or non-facility staff provided care 100% of the time for that activity over the entire 7-day period"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Extensive assistance - {patient/resident} involved in activity, staff provide weight-bearing support"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12640-1"/> <display value="Extensive assistance - resident involved in activity, staff provide weight-bearing support"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Limited assistance - {patient/resident} highly involved in activity; staff provide guided maneuvering of limbs or other non-weight-bearing assistance"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12639-3"/> <display value="Limited assistance - resident highly involved in activity; staff provide guided maneuvering of limbs or other non-weight-bearing assistance"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="7"/> <display value="Activity occurred only once or twice - activity did occur but only once or twice"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12642-7"/> <display value="Activity occurred only once or twice - activity did occur but only once or twice"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Independent - no help or staff oversight at any time"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12637-7"/> <display value="Independent - no help or staff oversight at any time"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Supervision - oversight, encouragement or cueing"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12638-5"/> <display value="Supervision - oversight, encouragement or cueing"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="4"/> <display value="Total dependence - full staff performance every time during entire 7-day period"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12641-9"/> <display value="Total dependence - full staff performance every time during entire 7-day period"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-7/G0110G2"/> <code> <system value="http://loinc.org"/> <code value="45601-2"/> <display value="Dressing - support provided during 7D assessment period"/> </code> <prefix value="G0110G2"/> <text value="Dressing - how {patient/resident} puts on, fastens and takes off all items of clothing, including donning/removing a prosthesis or TED hose. 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Do not include eating/drinking during medication pass. 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staff provide guided maneuvering of limbs or other non-weight-bearing assistance"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12639-3"/> <display value="Limited assistance - resident highly involved in activity; staff provide guided maneuvering of limbs or other non-weight-bearing assistance"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="7"/> <display value="Activity occurred only once or twice - activity did occur but only once or twice"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12642-7"/> <display value="Activity occurred only once or twice - activity did occur but only once or twice"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Independent - no help or staff oversight at any time"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12637-7"/> <display value="Independent - no help or staff oversight at any time"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Supervision - oversight, encouragement or cueing"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12638-5"/> <display value="Supervision - oversight, encouragement or cueing"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="4"/> <display value="Total dependence - full staff performance every time during entire 7-day period"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12641-9"/> <display value="Total dependence - full staff performance every time during entire 7-day period"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-7/G0110J2"/> <code> <system value="http://loinc.org"/> <code value="45607-9"/> <display value="Personal hygiene - support provided during 7D assessment period"/> </code> <prefix value="G0110J2"/> <text value="Personal hygiene - how {patient/resident} maintains personal hygiene, including combing hair, brushing teeth, shaving, applying makeup, washing/drying face and hands (excludes baths and showers) - Support"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Setup help only"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA106-7"/> <display value="Setup help only"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Two+ persons physical assist"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA108-3"/> <display value="Two+ persons physical assist"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No setup or physical help from staff"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA105-9"/> <display value="No setup or physical help from staff"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="One person physical assist"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA107-5"/> <display value="One person physical assist"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="8"/> <display value="ADL activity itself did not occur or family and/or non-facility staff provided care 100% of the time for that activity over the entire 7-day period"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA109-1"/> <display value="ADL activity itself did not occur or family and/or non-facility staff provided care 100% of the time for that activity over the entire 7-day period"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="Section-7/G0120"/> <code> <system value="http://loinc.org"/> <code value="46008-9"/> <display value="Bathing"/> </code> <prefix value="G0120"/> <text value="Bathing. How {patient/resident} takes full-body bath/shower, sponge bath, and transfers in/out of tub/shower (excludes washing of back and hair). Code for most dependent in self-performance and support"/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> <item> <linkId value="Section-7/G0120A"/> <code> <system value="http://loinc.org"/> <code value="45608-7"/> <display value="Bathing - self-performance during 7D assessment period"/> </code> <prefix value="G0120A"/> <text value="Bathing - Self performance"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Independent - no help provided"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA110-9"/> <display value="Independent - no help provided"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Supervision - oversight help only"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA111-7"/> <display value="Supervision - oversight help only"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Physical help limited to transfer only"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA112-5"/> <display value="Physical help limited to transfer only"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Physical help in part of bathing activity"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA113-3"/> <display value="Physical help in part of bathing activity"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="4"/> <display value="Total dependence"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA114-1"/> <display value="Total dependence"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="8"/> <display value="Activity itself did not occur or family and/or non-facility staff provided care 100% of the time for that activity over the entire 7-day period"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA115-8"/> <display value="Activity itself did not occur or family and/or non-facility staff provided care 100% of the time for that activity over the entire 7-day period"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-7/G0120B"/> <code> <system value="http://loinc.org"/> <code value="45609-5"/> <display value="Bathing - support provided during 7D assessment period"/> </code> <prefix value="G0120B"/> <text value="Bathing - Support provided. (Bathing support codes are as defined in {ADL question, column 2, ADL Support Provided})"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Setup help only"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA106-7"/> <display value="Setup help only"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Two+ persons physical assist"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA108-3"/> <display value="Two+ persons physical assist"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No setup or physical help from staff"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA105-9"/> <display value="No setup or physical help from staff"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="One person physical assist"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA107-5"/> <display value="One person physical assist"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="8"/> <display value="ADL activity itself did not occur or family and/or non-facility staff provided care 100% of the time for that activity over the entire 7-day period"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA109-1"/> <display value="ADL activity itself did not occur or family and/or non-facility staff provided care 100% of the time for that activity over the entire 7-day period"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="Section-7/G0300"/> <code> <system value="http://loinc.org"/> <code value="54524-4"/> <display value="Balance during transitions and walking"/> </code> <prefix value="G0300"/> <text value="Balance During Transitions and Walking. After observing the {patient/resident}, code the following walking and transition items for most dependent."/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> <item> <linkId value="Section-7/G0300A"/> <code> <system value="http://loinc.org"/> <code value="54749-7"/> <display value="Moving from seated to standing position in last 7D"/> </code> <prefix value="G0300A"/> <text value="Moving from seated to standing position"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="8"/> <display value="Activity did not occur"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11034-8"/> <display value="Activity did not occur"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Steady at all times"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11031-4"/> <display value="Steady at all times"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Not steady, but able to stabilize without staff assistance"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11032-2"/> <display value="Not steady, but able to stabilize without staff assistance"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Not steady, only able to stabilize with staff assistance"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11033-0"/> <display value="Not steady, only able to stabilize with staff assistance"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-7/G0300B"/> <code> <system value="http://loinc.org"/> <code value="54750-5"/> <display value="Walking (with assistive device if used) in last 7D"/> </code> <prefix value="G0300B"/> <text value="Walking (with assistive device if used)"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="8"/> <display value="Activity did not occur"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11034-8"/> <display value="Activity did not occur"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Steady at all times"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11031-4"/> <display value="Steady at all times"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Not steady, but able to stabilize without staff assistance"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11032-2"/> <display value="Not steady, but able to stabilize without staff assistance"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Not steady, only able to stabilize with staff assistance"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11033-0"/> <display value="Not steady, only able to stabilize with staff assistance"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-7/G0300C"/> <code> <system value="http://loinc.org"/> <code value="54751-3"/> <display value="Turning around and facing the opposite direction while walking in last 7D"/> </code> <prefix value="G0300C"/> <text value="Turning around and facing the opposite direction while walking"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="8"/> <display value="Activity did not occur"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11034-8"/> <display value="Activity did not occur"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Steady at all times"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11031-4"/> <display value="Steady at all times"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Not steady, but able to stabilize without staff assistance"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11032-2"/> <display value="Not steady, but able to stabilize without staff assistance"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Not steady, only able to stabilize with staff assistance"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11033-0"/> <display value="Not steady, only able to stabilize with staff assistance"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-7/G0300D"/> <code> <system value="http://loinc.org"/> <code value="54752-1"/> <display value="Moving on and off toilet in last 7D"/> </code> <prefix value="G0300D"/> <text value="Moving on and off toilet"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="8"/> <display value="Activity did not occur"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11034-8"/> <display value="Activity did not occur"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Steady at all times"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11031-4"/> <display value="Steady at all times"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Not steady, but able to stabilize without staff assistance"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11032-2"/> <display value="Not steady, but able to stabilize without staff assistance"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Not steady, only able to stabilize with staff assistance"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11033-0"/> <display value="Not steady, only able to stabilize with staff assistance"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-7/G0300E"/> <code> <system value="http://loinc.org"/> <code value="54753-9"/> <display value="Surface-to-surface transfer in last 7D"/> </code> <prefix value="G0300E"/> <text value="Surface-to-surface transfer (transfer between bed and chair or wheelchair)"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="8"/> <display value="Activity did not occur"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11034-8"/> <display value="Activity did not occur"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Steady at all times"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11031-4"/> <display value="Steady at all times"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Not steady, but able to stabilize without staff assistance"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11032-2"/> <display value="Not steady, but able to stabilize without staff assistance"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Not steady, only able to stabilize with staff assistance"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11033-0"/> <display value="Not steady, only able to stabilize with staff assistance"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="Section-7/G0400"/> <code> <system value="http://loinc.org"/> <code value="92908-3"/> <display value="Functional limitation in range of motion in the last 7D"/> </code> <prefix value="G0400"/> <text value="Functional Limitation in Range of Motion. Code for limitation that interfered with daily functions or placed {patient/resident} at risk of injury"/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> <item> <linkId value="Section-7/G0400A"/> <code> <system value="http://loinc.org"/> <code value="92850-7"/> <display value="Range of motion in the last 7D Upper extremity"/> </code> <prefix value="G0400A"/> <text value="Upper extremity (shoulder, elbow, wrist, hand)"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No impairment"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA9606-0"/> <display value="No impairment"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Impairment on one side"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11036-3"/> <display value="Impairment on one side"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Impairment on both sides"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11037-1"/> <display value="Impairment on both sides"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-7/G0400B"/> <code> <system value="http://loinc.org"/> <code value="92851-5"/> <display value="Range of motion in the last 7D Lower extremity"/> </code> <prefix value="G0400B"/> <text value="Lower extremity (hip, knee, ankle, foot)"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No impairment"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA9606-0"/> <display value="No impairment"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Impairment on one side"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11036-3"/> <display value="Impairment on one side"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Impairment on both sides"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11037-1"/> <display value="Impairment on both sides"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="Section-7/G0900"/> <code> <system value="http://loinc.org"/> <code value="54527-7"/> <display value="Functional rehabilitation potential"/> </code> <prefix value="G0900"/> <text value="Functional Rehabilitation Potential. Complete only if {admission}"/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> <item> <linkId value="Section-7/G0900A"/> <code> <system value="http://loinc.org"/> <code value="55123-4"/> <display value="Resident believes he or she is capable of increased independence in at least some ADLs"/> </code> <prefix value="G0900A"/> <text value="{Patient/Resident} believes he or she is capable of increased independence in at least some ADL's"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="9"/> <display value="Unable to determine"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11137-9"/> <display value="Unable to determine"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-7/G0900B"/> <code> <system value="http://loinc.org"/> <code value="45613-7"/> <display value="Direct care staff believe resident is capable of increased independence in at least some ADLs"/> </code> <prefix value="G0900B"/> <text value="Direct care staff believe {patient/resident} is capable of increased independence in at least some ADL's"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="Section-7/G0600"/> <code> <system value="http://loinc.org"/> <code value="86602-0"/> <display value="Mobility devices normally used during 7D assessment period"/> </code> <prefix value="G0600"/> <text value="Mobility Devices: Check all that were normally used"/> <type value="choice"/> <repeats value="true"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="A"/> <display value="Cane/crutch"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA9941-1"/> <display value="Cane/crutch"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="B"/> <display 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<answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28019-0"/> <display value="None of the above were used"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="Section-8"/> <code> <system value="http://loinc.org"/> <code value="89048-3"/> <display value="MDS v3.0 - RAI v1.17.1 - Bladder and bowel [CMS Assessment]"/> </code> <text value="Section H: Bladder and Bowel"/> <type value="group"/> <readOnly value="true"/> <item> <linkId value="Section-8/H0300"/> <code> <system value="http://loinc.org"/> <code value="54770-3"/> <display value="Urinary continence in last 7D"/> </code> <prefix value="H0300"/> <text value="Urinary continence - Select the one category that best describes the {patient/resident}"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Occasionally incontinent (less than 7 episodes of incontinence)"/> 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<code value="LA11045-4"/> <display value="Always incontinent (no episodes of continent voiding)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="9"/> <display value="Not rated, {patient/resident} had a catheter (indwelling, condom), urinary ostomy, or no urine output for the entire 7 days"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11046-2"/> <display value="Not rated, resident had a catheter (indwelling, condom), urinary ostomy, or no urine output for the entire 7 days"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Always continent"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11042-1"/> <display value="Always continent"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system 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<answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11048-8"/> <display value="Occasionally incontinent (one episode of bowel incontinence)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Frequently incontinent (2 or more episodes of bowel incontinence, but at least one continent bowel movement)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11049-6"/> <display value="Frequently incontinent (2 or more episodes of bowel incontinence, but at least one continent bowel movement)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Always incontinent (no episodes of continent bowel movements)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11050-4"/> <display 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Is a toileting program currently being used to manage the {patient's/resident's} bowel continence?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-8/H0600"/> <code> <system value="http://loinc.org"/> <code value="54773-7"/> <display value="Constipation present in last 7D"/> </code> <prefix value="H0600"/> <text value="Bowel Patterns. Constipation present?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-8/H0200"/> <code> <system value="http://loinc.org"/> <code value="54530-1"/> <display value="Urinary toileting program"/> </code> <prefix value="H0200"/> <text value="Urinary Toileting Program"/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> <item> <linkId value="Section-8/H0200A"/> <code> <system value="http://loinc.org"/> <code value="54767-9"/> <display value="Trial of toileting program has been attempted on admission or reentry or since urinary incontinence was noted in this facility"/> </code> <prefix value="H0200A"/> <text value="Has a trial of a toileting program (e.g., scheduled toileting, prompted voiding, or bladder training) been attempted on {admission} or since urinary incontinence was noted in this {facility/setting}?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="9"/> <display value="Unable to determine"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11137-9"/> <display value="Unable to determine"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-8/H0200B"/> <code> <system value="http://loinc.org"/> <code value="54768-7"/> <display value="Response to toileting program"/> </code> <prefix value="H0200B"/> <text value="Response - 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Enter diagnosis on line and ICD code in boxes. 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<display value="Anemia (e.g. aplastic, iron deficiency, pernicious, and sickle cell)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I0300"/> <display value="Atrial Fibrillation or Other Dysrhythmias (e.g., bradycardias and tachycardias)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27837-6"/> <display value="Atrial fibrillation or other dysrhythmias (e.g. bradycardias and tachycardias)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I0400"/> <display value="Coronary Artery Disease (CAD) (e.g., angina, myocardial infarction, and atherosclerotic heart disease (ASHD))"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27838-4"/> <display value="Coronary artery disease (CAD) (e.g., angina, myocardial infarction, and atherosclerotic heart disease (ASHD))"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I0500"/> <display value="Deep Venous Thrombosis (DVT), Pulmonary Embolus (PE), or Pulmonary Thrombo-Embolism (PTE)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27839-2"/> <display value="Deep venous thrombosis (DVT), pulmonary embolus (PE), or Pulmonary thrombo-embolism (PTE)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I0600"/> <display value="Heart Failure (e.g., congestive heart failure (CHF) and pulmonary edema)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27840-0"/> <display value="Heart failure (e.g., congestive heart failure (CHF) and pulmonary edema)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I0700"/> <display value="Hypertension"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA7444-8"/> <display value="Hypertension"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I0800"/> <display value="Orthostatic Hypotension"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27841-8"/> <display value="Orthostatic hypotension"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I0900"/> <display value="Peripheral Vascular Disease (PVD) or Peripheral Arterial Disease (PAD)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA18399-8"/> <display value="Peripheral vascular disease (PVD) or peripheral arterial disease (PAD)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I1100"/> <display value="Cirrhosis"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA9639-1"/> <display value="Cirrhosis"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I1200"/> <display value="Gastroesophageal Reflux Disease (GERD) or Ulcer (e.g., esophageal, gastric, and peptic ulcers)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27842-6"/> <display value="Gastroesophageal reflux disease (GERD) or ulcer (e.g., esophageal, gastric, and peptic ulcers)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I1300"/> <display value="Ulcerative Colitis, Crohn's Disease, or Inflammatory Bowel Disease"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27843-4"/> <display value="Ulcerative colitis, Crohn's disease, or inflammatory bowel disease"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I1400"/> <display value="Benign Prostatic Hyperplasia (BPH)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27844-2"/> <display value="Benign prostatic hyperplasia (BPH)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I1500"/> <display value="Renal Insufficiency, Renal Failure, or End-Stage Renal Disease (ESRD)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27845-9"/> <display value="Renal insufficiency, renal failure, or end-stage renal disease (ESRD)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I1550"/> <display value="Neurogenic Bladder"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27846-7"/> <display value="Neurogenic bladder"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I1650"/> <display value="Obstructive Uropathy"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27847-5"/> <display value="Obstructive uropathy"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I1700"/> <display value="Multidrug-Resistant Organism (MDRO)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27848-3"/> <display value="Multidrug-resistant organism (MDRO)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I2000"/> <display value="Pneumonia"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA7465-3"/> <display value="Pneumonia"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I2100"/> <display value="Septicemia"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10591-8"/> <display value="Septicemia"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I2200"/> <display value="Tuberculosis"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10513-2"/> <display value="Tuberculosis"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I2300"/> <display value="Urinary Tract Infection (UTI) (LAST 30 DAYS)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27849-1"/> <display value="Urinary tract infection (UTI) (last 30 days)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I2400"/> <display value="Viral Hepatitis (e.g., Hepatitis A, B, C, D, and E)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27850-9"/> <display value="Viral hepatitis (e.g., Hepatitis A, B, C, D, and E)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I2500"/> <display value="Wound Infection (other than foot)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27851-7"/> <display value="Wound infection (other than foot)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I2900"/> <display value="Diabetes Mellitus (DM) (e.g., diabetic retinopathy, nephropathy, and neuropathy)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA26741-1"/> <display value="Diabetes mellitus (DM) (e.g., diabetic retinopathy, nephropathy, and neuropathy)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I3100"/> <display value="Hyponatremia"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27852-5"/> <display value="Hyponatremia"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I3200"/> <display value="Hyperkalemia"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA19699-0"/> <display value="Hyperkalemia"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I3300"/> <display value="Hyperlipidemia (e.g., hypercholesterolemia)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27853-3"/> <display value="Hyperlipidemia (e.g., hypercholesterolemia)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I3400"/> <display value="Thyroid Disorder (e.g., hypothyroidism, hyperthyroidism, and Hashimoto's thyroiditis)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27854-1"/> <display value="Thyroid disorder (e.g., hypothyroidism, hyperthyroidism, and Hashimoto's thyroiditis)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I3700"/> <display value="Arthritis (e.g., degenerative joint disease (DJD), 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value="http://loinc.org"/> <code value="LA27856-6"/> <display value="Hip fracture - any hip fracture that has a relationship to current status, treatments, monitoring (e.g., sub-capital fractures, and fractures of the trochanter and femoral neck)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I4000"/> <display value="Other Fracture"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27857-4"/> <display value="Other fracture"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I4200"/> <display value="Alzheimer's Disease"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA22313-3"/> <display value="Alzheimer's disease"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I4300"/> <display value="Aphasia"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA18262-8"/> <display value="Aphasia"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I4400"/> <display value="Cerebral Palsy"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27858-2"/> <display value="Cerebral palsy"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I4500"/> <display value="Cerebrovascular Accident (CVA), Transient Ischemic Attack (TIA), or Stroke"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27859-0"/> <display value="Cerebrovascular accident (CVA), transient ischemic attack (TIA), or stroke"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I4800"/> <display value="Non-Alzheimer's Dementia (e.g. Lewy body dementia, vascular or multi-infarct dementia; mixed dementia; frontotemporal dementia such as Pick's disease; and dementia related to stroke, Parkinson's or Creutzfeldt-Jakob diseases)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27860-8"/> <display value="Non-Alzheimer's dementia (e.g., Lewy body dementia, vascular or multi-infarct dementia; mixed dementia; frontotemporal dementia such as Pick's disease; and dementia related to stroke, Parkinson's or Creutzfeldt-Jakob diseases)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I4900"/> <display value="Hemiplegia or Hemiparesis"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27523-2"/> <display value="Hemiplegia or hemiparesis"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I5000"/> <display value="Paraplegia"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA25276-9"/> <display value="Paraplegia"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I5100"/> <display value="Quadriplegia"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27861-6"/> <display value="Quadriplegia"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I5200"/> <display value="Multiple Sclerosis (MS)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27531-5"/> <display value="Multiple sclerosis (MS)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I5250"/> <display value="Huntington's Disease"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27532-3"/> <display value="Huntington's disease"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I5300"/> <display value="Parkinson's Disease"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27533-1"/> <display value="Parkinson's disease"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I5350"/> <display value="Tourette's Syndrome"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27862-4"/> <display value="Tourette's syndrome"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I5400"/> <display value="Seizure Disorder or Epilepsy"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27863-2"/> <display value="Seizure disorder or epilepsy"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I5500"/> <display value="Traumatic Brain Injury (TBI)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27864-0"/> <display value="Traumatic brain injury (TBI)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I5600"/> <display value="Malnutrition (protein or calorie) or at risk for malnutrition"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27865-7"/> <display value="Malnutrition (protein or calorie) or at risk for malnutrition"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I5700"/> <display value="Anxiety Disorder"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27866-5"/> <display value="Anxiety disorder"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I5800"/> <display value="Depression (other than bipolar)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27867-3"/> <display value="Depression (other than bipolar)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I5900"/> <display value="Bipolar Disorder"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA29615-4"/> <display value="Bipolar Disorder"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I5950"/> <display value="Psychotic Disorder (other than schizophrenia)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27869-9"/> <display value="Psychotic disorder (other than schizophrenia)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I6000"/> <display value="Schizophrenia (e.g., schizoaffective and schizophreniform disorders)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27870-7"/> <display value="Schizophrenia (e.g., schizoaffective and schizophreniform disorders)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I6100"/> <display value="Post Traumatic Stress Disorder (PTSD)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27871-5"/> <display value="Post traumatic stress disorder (PTSD)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I6200"/> <display value="Asthma, Chronic Obstructive Pulmonary Disease (COPD), or Chronic Lung Disease (e.g., chronic bronchitis and restrictive lung diseases such as asbestosis)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27872-3"/> <display value="Asthma, chronic obstructive pulmonary disease (COPD), or chronic lung disease (e.g., chronic bronchitis and restrictive lung diseases such as asbestosis)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I6300"/> <display value="Respiratory Failure"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27873-1"/> <display value="Respiratory failure"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I6500"/> <display value="Cataracts, Glaucoma, or Macular Degeneration"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27874-9"/> <display value="Cataracts, glaucoma, or macular degeneration"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I7900"/> <display value="None of the above active diagnoses"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27875-6"/> <display value="None of the above active diagnoses within the last 7 days"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-9/I0020"/> <code> <system value="http://loinc.org"/> <code value="89045-9"/> <display value="Indicate the patient's primary medical condition category"/> </code> <prefix value="I0020"/> <text value="Indicate the {patient's/resident's} primary medical condition category that best describes the primary reason for admission"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="01"/> <display value="Stroke"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA22099-8"/> <display value="Stroke"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="02"/> <display value="Non-Traumatic Brain Dysfunction"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28875-5"/> <display value="Non-traumatic brain dysfunction"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="03"/> <display value="Traumatic Brain Dysfunction"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28876-3"/> <display value="Traumatic brain dysfunction"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="04"/> <display value="Non-Traumatic Spinal Cord Dysfunction"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28877-1"/> <display value="Non-traumatic spinal cord dysfunction"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="05"/> <display value="Traumatic Spinal Cord Dysfunction"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28878-9"/> <display value="Traumatic spinal cord dysfunction"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="06"/> <display value="Progressive Neurological Conditions"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28879-7"/> <display value="Progressive neurological conditions"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="07"/> <display value="Other Neurological Conditions"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28880-5"/> <display value="Other neurological conditions"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="08"/> <display value="Amputation"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28881-3"/> <display value="Amputation"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="09"/> <display value="Hip and Knee Replacement"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28882-1"/> <display value="Hip and knee replacement"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="10"/> <display value="Fractures and Other Multiple Trauma"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28883-9"/> <display value="Fractures and other multiple trauma"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="11"/> <display value="Other Orthopedic Conditions"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28884-7"/> <display value="Other orthopedic conditions"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="12"/> <display value="Debility, Cardiorespiratory Conditions"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28885-4"/> <display value="Debility, cardiorespiratory conditions"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="13"/> <display value="Medically Complex Conditions"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28886-2"/> <display value="Medically complex conditions"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="Section-10"/> <code> <system value="http://loinc.org"/> <code value="90486-2"/> <display value="MDS v3.0 - RAI v1.17.1 - Health conditions [CMS Assessment]"/> </code> <text value="Section J: Health Conditions"/> <type value="group"/> <readOnly value="true"/> <item> <linkId value="Section-10/J0200"/> <code> <system value="http://loinc.org"/> <code value="54828-9"/> <display value="Pain assessment interview should be conducted"/> </code> <prefix value="J0200"/> <text value="Should Pain Assessment Interview be Conducted? Attempt to conduct interview with all {patients/residents}."/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No ({patient/resident} is rarely/never understood)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11150-2"/> <display value="No (resident is rarely/never understood)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-10/J0300"/> <code> <system value="http://loinc.org"/> <code value="54829-7"/> <display value="Pain presence in last 5D"/> </code> <prefix value="J0300"/> <text value="Pain Presence. Ask {patient/resident} "Have you had pain or hurting at any time in the last 5 days?""/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="9"/> <display value="Unable to answer"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11054-6"/> <display value="Unable to answer"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-10/J0400"/> <code> <system value="http://loinc.org"/> <code value="54830-5"/> <display value="Pain frequency in last 5D"/> </code> <prefix value="J0400"/> <text value="Pain Frequency. Ask {patient/resident} "How much of the time have you experienced pain or hurting over the last 5 days?""/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Almost constantly"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11055-3"/> <display value="Almost constantly"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Frequently"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA6482-9"/> <display value="Frequently"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Occasionally"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA6483-7"/> <display value="Occasionally"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="4"/> <display value="Rarely"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10066-1"/> <display value="Rarely"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="9"/> <display value="Unable to answer"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11054-6"/> <display value="Unable to answer"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-10/J1300"/> <code> <system value="http://loinc.org"/> <code value="54845-3"/> <display value="Tobacco use in last 7D"/> </code> <prefix value="J1300"/> <text value="Current Tobacco Use"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-10/J1400"/> <code> <system value="http://loinc.org"/> <code value="54846-1"/> <display value="Life expectancy of less than 6M"/> </code> <prefix value="J1400"/> <text value="Prognosis. Does the {patient/resident} have a condition or chronic disease that may result in a life expectancy of less than 6 months? (Requires physician documentation)"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-10/J1800"/> <code> <system value="http://loinc.org"/> <code value="54853-7"/> <display value="Has the patient had any falls since admission or prior assessment"/> </code> <prefix value="J1800"/> <text value="Has the {patient/resident} had any falls since {admission} or the prior assessment whichever is more recent?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-10/J0850"/> <code> <system value="http://loinc.org"/> <code value="58118-1"/> <display value="Frequency of indicator of pain or possible pain in last 5D"/> </code> <prefix value="J0850"/> <text value="Frequency of Indicator of Pain or Possible Pain in the last 5 days. Frequency with which {patient/resident} complains or shows evidence of pain or possible pain."/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Indicators of pain or possible pain observed 1 to 2 days"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12645-0"/> <display value="Indicators of pain or possible pain observed 1 to 2 days"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Indicators of pain or possible pain observed 3 to 4 days"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12646-8"/> <display value="Indicators of pain or possible pain observed 3 to 4 days"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Indicators of pain or possible pain observed daily"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12647-6"/> <display value="Indicators of pain or possible pain observed daily"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-10/J0700"/> <code> <system value="http://loinc.org"/> <code value="58117-3"/> <display value="Staff pain assessment interview should be conducted"/> </code> <prefix value="J0700"/> <text value="Should the Staff Assessment for Pain be Conducted?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No (Pain frequency answered)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes (Pain Assessment interview not conducted or Unable to answer pain presence or unable to answer pain frequency)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-10/J2000"/> <code> <system value="http://loinc.org"/> <code value="83274-1"/> <display value="Did the patient have major surgery during the 100D prior to admission"/> </code> <prefix value="J2000"/> <text value="Prior Surgery. Did the {patient/resident} have major surgery during the 100 days prior to admission?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="8"/> <display value="Unknown"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA4489-6"/> <display value="Unknown"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-10/J0100"/> <code> <system value="http://loinc.org"/> <code value="54557-4"/> <display value="Pain management"/> </code> <prefix value="J0100"/> <text value="Pain Management - Complete for all {patients/residents}, regardless of current pain level. At any time in the last 5 days, has the {patient/resident}:"/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> <item> <linkId value="Section-10/J0100A"/> <code> <system value="http://loinc.org"/> <code value="71447-7"/> <display value="Received scheduled pain medication regimen in last 5D"/> </code> <prefix value="J0100A"/> <text value="Received scheduled pain medication regimen?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-10/J0100B"/> <code> <system value="http://loinc.org"/> <code value="71448-5"/> <display value="Received PRN pain medications or was offered and declined in the last 5D"/> </code> <prefix value="J0100B"/> <text value="Received PRN pain medications OR was offered and declined?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-10/J0100C"/> <code> <system value="http://loinc.org"/> <code value="71449-3"/> <display value="Received non-medication intervention for pain in last 5D"/> </code> <prefix value="J0100C"/> <text value="Received non-medication intervention for pain?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="Section-10/J0500"/> <code> <system value="http://loinc.org"/> <code value="54559-0"/> <display value="Pain effect on function"/> </code> <prefix value="J0500"/> <text value="Pain Effect on Function"/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> <item> <linkId value="Section-10/J0500A"/> <code> <system value="http://loinc.org"/> <code value="54831-3"/> <display value="Pain has made it hard to sleep in last 5D"/> </code> <prefix value="J0500A"/> <text value="Ask {patient/resident} "Over the past 5 days, has pain made it hard for you to sleep at night?""/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="9"/> <display value="Unable to answer"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11054-6"/> <display value="Unable to answer"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-10/J0500B"/> <code> <system value="http://loinc.org"/> <code value="54832-1"/> <display value="Limited activities because of pain in last 5D"/> </code> <prefix value="J0500B"/> <text value="Ask {patient/resident} "Over the past 5 days, have you limited your day-to-day activities because of pain?""/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="9"/> <display value="Unable to answer"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11054-6"/> <display value="Unable to answer"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="Section-10/J0600"/> <code> <system value="http://loinc.org"/> <code value="54560-8"/> <display value="Pain intensity"/> </code> <prefix value="J0600"/> <text value="Pain Intensity - Administer ONLY ONE of the following pain intensity questions (A or B)"/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> <item> <linkId value="Section-10/J0600A"/> <code> <system value="http://loinc.org"/> <code value="54833-9"/> <display value="Pain severity in last 5D"/> </code> <prefix value="J0600A"/> <text value="Numeric Rating Scale (00-10). Ask {patient/resident} "Please rate your worst pain over the last 5 days on a zero to ten scale, with zero being no pain and ten as the worst pain you can imagine." (Show {patient/resident} 00-10 pain scale) Enter two-digit response. Enter 99 if unable to answer."/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="10"/> <display value="Maximum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="99"/> <display value="Unable to answer"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="00"/> <display value="Minimum value"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-10/J0600B"/> <code> <system value="http://loinc.org"/> <code value="54834-7"/> <display value="Rate pain severity in last 5D using verbal descriptor scale"/> </code> <prefix value="J0600B"/> <text value="Verbal Descriptor Scale. Ask {patient/resident} "Please rate the intensity of your worst pain over the last 5 days." (Show {patient/resident} verbal scale)"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="9"/> <display value="Unable to answer"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11054-6"/> <display value="Unable to answer"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="4"/> <display value="Very severe, horrible"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11063-7"/> <display value="Very severe, horrible"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Mild"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA6752-5"/> <display value="Mild"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Moderate"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA6751-7"/> <display value="Moderate"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Severe"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA6750-9"/> <display value="Severe"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="Section-10/J1700"/> <code> <system value="http://loinc.org"/> <code value="54849-5"/> <display value="Fall history on admission"/> </code> <prefix value="J1700"/> <text value="Fall History on {Admission}. Complete only if {admission}"/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> <item> <linkId value="Section-10/J1700A"/> <code> <system value="http://loinc.org"/> <code value="54850-3"/> <display value="Fall one or more times in the last Mo prior to admission"/> </code> <prefix value="J1700A"/> <text value="Did the {patient/resident} have a fall any time in the last month prior to {admission}?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="9"/> <display value="Unable to determine"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11137-9"/> <display value="Unable to determine"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-10/J1700B"/> <code> <system value="http://loinc.org"/> <code value="54851-1"/> <display value="Fall one or more times in the last 2 to 6Mo prior to admission"/> </code> <prefix value="J1700B"/> <text value="Did the {patient/resident} have a fall any time in the last 2-6 months prior to {admission}?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="9"/> <display value="Unable to determine"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11137-9"/> <display value="Unable to determine"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-10/J1700C"/> <code> <system value="http://loinc.org"/> <code value="54852-9"/> <display value="Any fracture related to a fall in the 6Mo prior to admission"/> </code> <prefix value="J1700C"/> <text value="Did the {patient/resident} have any fracture related to a fall in the 6 months prior to {admission}?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="9"/> <display value="Unable to determine"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11137-9"/> <display value="Unable to determine"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="Section-10/J1900"/> <code> <system value="http://loinc.org"/> <code value="54854-5"/> <display value="Number of falls since admission or prior assessmen"/> </code> <prefix value="J1900"/> <text value="Number of Falls Since {Admission} or Prior Assessment whichever is most recent"/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> <item> <linkId value="Section-10/J1900A"/> <code> <system value="http://loinc.org"/> <code value="54855-2"/> <display value="Number of falls since admission or prior assessment - no injury"/> </code> <prefix value="J1900A"/> <text value="No injury - no evidence of any injury is noted on physical assessment by the nurse or primary care clinician; no complaints of pain or injury by the {patient/resident}; no change in the {patient's/resident's} behavior is noted after the fall."/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="None"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA137-2"/> <display value="None"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="One"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA6306-0"/> <display value="One"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Two or more"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11073-6"/> <display value="Two or more"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-10/J1900B"/> <code> <system value="http://loinc.org"/> <code value="54856-0"/> <display value="Number of falls since admission or prior assessment - injury except major"/> </code> <prefix value="J1900B"/> <text value="Injury (except major) - skin tears, abrasions, lacerations, superficial bruises, hematomas and sprains; or any fall-related injury that causes the {patient/resident} to complain of pain"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="None"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA137-2"/> <display value="None"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="One"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA6306-0"/> <display value="One"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Two or more"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11073-6"/> <display value="Two or more"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-10/J1900C"/> <code> <system value="http://loinc.org"/> <code value="54857-8"/> <display value="Number of falls since admission or prior assessment - major injury"/> </code> <prefix value="J1900C"/> <text value="Major injury - bone fractures, joint dislocations, closed head injuries with altered consciousness, subdural hematoma"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="None"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA137-2"/> <display value="None"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="One"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA6306-0"/> <display value="One"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Two or more"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11073-6"/> <display value="Two or more"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="Section-10/J0800"/> <code> <system value="http://loinc.org"/> <code value="86673-1"/> <display value="Indicators of pain or possible pain in the last 5D"/> </code> <prefix value="J0800"/> <text value="Staff Assessment for Pain. Indicators of Pain or Possible Pain in the last 5 days: Check all that apply"/> <type value="choice"/> <repeats value="true"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="A"/> <display value="Non-verbal sounds (e.g., crying, whining, gasping, moaning, or groaning)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10034-9"/> <display value="Non-verbal sounds (e.g., crying, whining, gasping, moaning, or groaning)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="B"/> <display value="Vocal complaints of pain (e.g., that hurts, ouch, stop)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10116-4"/> <display value="Vocal complaints of pain (e.g., that hurts, ouch, stop)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="C"/> <display value="Facial expressions (e.g., grimaces, winces, wrinkled forehead, furrowed brow, clenched teeth or jaw)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA9968-4"/> <display value="Facial Expressions (e.g., grimaces, winces, wrinkled forehead, furrowed brow, clenched teeth or jaw)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="D"/> <display value="Protective body movements or postures (e.g., bracing, guarding, rubbing or massaging a body part/area, clutching or holding a body part during movement)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10063-8"/> <display value="Protective body movements or postures (e.g., bracing, guarding, rubbing or massaging a body part/area, clutching or holding a body part during movement)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="Z"/> <display value="None of these signs observed or documented"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10032-3"/> <display value="None of these signs observed or documented"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-10/J1100"/> <code> <system value="http://loinc.org"/> <code value="86675-6"/> <display value="Shortness of breath in last 7D"/> </code> <prefix value="J1100"/> <text value="Shortness of Breath (dyspnea): Check all that apply"/> <type value="choice"/> <repeats value="true"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="A"/> <display value="Shortness of breath or trouble breathing with exertion (e.g., walking, bathing, transferring)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27988-7"/> <display value="Shortness of breath or trouble breathing with exertion (e.g., walking, bathing, transferring)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="B"/> <display value="Shortness of breath or trouble breathing when sitting at rest"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27989-5"/> <display value="Shortness of breath or trouble breathing when sitting at rest"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="C"/> <display value="Shortness of breath or trouble breathing when lying flat"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27990-3"/> <display value="Shortness of breath or trouble breathing when lying flat"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="Z"/> <display value="None of the above"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA9-3"/> <display value="None of the above"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-10/J1550"/> <code> <system value="http://loinc.org"/> <code value="86676-4"/> <display value="Problem conditions in last 7D"/> </code> <prefix value="J1550"/> <text value="Problem Conditions: Check all that apply"/> <type value="choice"/> <repeats value="true"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="A"/> <display value="Fever"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA7435-6"/> <display value="Fever"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="B"/> <display value="Vomiting"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA15099-7"/> <display value="Vomiting"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="C"/> <display value="Dehydrated"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27897-0"/> <display value="Dehydrated"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="D"/> <display value="Internal bleeding"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27898-8"/> <display value="Internal bleeding"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="Z"/> <display value="None of the above"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA9-3"/> <display value="None of the above"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="Section-11"/> <code> <system value="http://loinc.org"/> <code value="90483-9"/> <display value="MDS v3.0 - RAI v1.17.1 - Swallowing &or nutritional status [CMS Assessment]"/> </code> <text value="Section K: Swallowing/Nutritional Status"/> <type value="group"/> <readOnly value="true"/> <item> <linkId value="Section-11/K0300"/> <code> <system value="http://loinc.org"/> <code value="54863-6"/> <display value="Weight loss of 5% or more in the last Mo or loss of 10% or more in last 6Mo"/> </code> <prefix value="K0300"/> <text value="Weight Loss. Loss of 5% or more in the last month or loss of 10% or more in last 6 months"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes, on physician-prescribed weight-loss regimen"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11075-1"/> <display value="Yes, on physician-prescribed weight-loss regimen"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Yes, not on physician-prescribed weight-loss regimen"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11076-9"/> <display value="Yes, not on physician-prescribed weight-loss regimen"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No or unknown"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11074-4"/> <display value="No or unknown"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-11/K0310"/> <code> <system value="http://loinc.org"/> <code value="86678-0"/> <display value="Weight gain of 5% or more in the last month or gain of 10% or more in last 6Mo"/> </code> <prefix value="K0310"/> <text value="Weight Gain. Gain of 5% or more in the last month or gain of 10% or more in last 6 months"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No or unknown"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11074-4"/> <display value="No or unknown"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes, on physician-prescribed weight-gain regimen"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA18602-5"/> <display value="Yes, on physician-prescribed weight-gain regimen"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Yes, not on physician-prescribed weight-gain regimen"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA18603-3"/> <display value="Yes, not on physician-prescribed weight-gain regimen"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-11/K0200"/> <code> <system value="http://loinc.org"/> <code value="54567-3"/> <display value="Height and weight"/> </code> <prefix value="K0200"/> <text value="Height and Weight - While measuring, if the number is X.1 - X.4 round down; X.5 or greater round up"/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> <item> <linkId value="Section-11/K0200A"/> <code> <system value="http://loinc.org"/> <code value="3137-7"/> <display value="Body height Measured"/> </code> <prefix value="K0200A"/> <text value="Height (in inches). Record most recent height measure since {admission}"/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="99"/> <display value="Maximum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="00"/> <display value="Minimum value"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-11/K0200B"/> <code> <system value="http://loinc.org"/> <code value="3141-9"/> <display value="Weight Measured"/> </code> <prefix value="K0200B"/> <text value="Weight (in pounds). Base weight on most recent measure in last {specify time period in days}; measure weight consistently, according to standard {facility/setting} practice (e.g., in a.m. after voiding, before meal, with shoes off, etc.)"/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="999"/> <display value="Maximum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="000"/> <display value="Minimum value"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="Section-11/K0710"/> <code> <system value="http://loinc.org"/> <code value="90543-0"/> <display value="Percent intake by artificial route while a resident and during the last 7D"/> </code> <prefix value="K0710"/> <text value="Percent Intake by Artificial Route - Complete only if {nutritional approach - parenteral/IV feeding or feeding tube = yes}"/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> <item> <linkId value="Section-11/K0710A2"/> <code> <system value="http://loinc.org"/> <code value="86681-4"/> <display value="Proportion of total calories the resident received through parenteral or tube feeding in last 7D - while a resident"/> </code> <prefix value="K0710A2"/> <text value="Proportion of total calories the {patient/resident} received through parenteral or tube feeding - While a {Patient/Resident}"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="26-50%"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11078-5"/> <display value="26-50%"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="51% or more"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11079-3"/> <display value="51% or more"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="25% or less"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11077-7"/> <display value="25% or less"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-11/K0710A3"/> <code> <system value="http://loinc.org"/> <code value="86687-1"/> <display value="Proportion of total calories the resident received through parenteral or tube feeding during entire 7D"/> </code> <prefix value="K0710A3"/> <text value="Proportion of total calories the {patient/resident} received through parenteral or tube feeding - During Entire 7 Days"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="26-50%"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11078-5"/> <display value="26-50%"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="51% or more"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11079-3"/> <display value="51% or more"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="25% or less"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11077-7"/> <display value="25% or less"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-11/K0710B2"/> <code> <system value="http://loinc.org"/> <code value="86683-0"/> <display value="Mean fluid intake per day by IV or tube feeding in last 7D - while a resident"/> </code> <prefix value="K0710B2"/> <text value="Average fluid intake per day by IV or tube feeding - While a {Patient/Resident}"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="501 cc/day or more"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11081-9"/> <display value="501 cc/day or more"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="500 cc/day or less"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11080-1"/> <display value="500 cc/day or less"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-11/K0710B3"/> <code> <system value="http://loinc.org"/> <code value="86684-8"/> <display value="Mean fluid intake per day by IV or tube feeding during entire 7D"/> </code> <prefix value="K0710B3"/> <text value="Average fluid intake per day by IV or tube feeding - During Entire 7 Days"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="501 cc/day or more"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11081-9"/> <display value="501 cc/day or more"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="500 cc/day or less"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11080-1"/> <display value="500 cc/day or less"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="Section-11/K0100"/> <code> <system value="http://loinc.org"/> <code value="86677-2"/> <display value="Signs and symptoms of swallowing disorder in last 7D"/> </code> <prefix value="K0100"/> <text value="Swallowing Disorder. Signs and symptoms of possible swallowing disorder: Check all that apply"/> <type value="choice"/> <repeats value="true"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="A"/> <display value="Loss of liquids/solids from mouth when eating or drinking"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10001-8"/> <display value="Loss of liquids/solids from mouth when eating or drinking"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="B"/> <display value="Holding food in mouth/cheeks or residual food in mouth after meals"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA9977-5"/> <display value="Holding food in mouth/cheeks or residual food in mouth after meals"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="C"/> <display value="Coughing or choking during meals or when swallowing medications"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA9961-9"/> <display value="Coughing or choking during meals or when swallowing medications"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="D"/> <display value="Complaints of difficulty or pain with swallowing"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA9952-8"/> <display value="Complaints of difficulty or pain with swallowing"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="Z"/> <display value="None of the above"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA9-3"/> <display value="None of the above"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-11/K0510"/> <code> <system value="http://loinc.org"/> <code value="54568-1"/> <display value="Nutritional approaches"/> </code> <prefix value="K0510"/> <text value="Nutritional Approaches: Check all of the following nutritional approaches that were performed during the last 7 days"/> <type value="choice"/> <repeats value="true"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="A1"/> <display value="Parenteral/IV feeding - While NOT a {Patient/Resident}"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA18604-1"/> <display value="Parenteral/IV feeding"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="A2"/> <display value="Parenteral/IV feeding - While a {Patient/Resident}"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA18604-1"/> <display value="Parenteral/IV feeding"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="B1"/> <display value="Feeding tube - nasogastric or abdominal (PEG) - While NOT a {Patient/Resident}"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA18605-8"/> <display value="Feeding tube - nasogastric or abdominal (PEG)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="B2"/> <display value="Feeding tube - nasogastric or abdominal (PEG) - While a {Patient/Resident}"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA18605-8"/> <display value="Feeding tube - nasogastric or abdominal (PEG)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="C2"/> <display value="Mechanically altered diet - require change in texture of food or liquids (e.g., pureed food, thickened liquids) - While a {Patient/Resident}"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA18606-6"/> <display value="Mechanically altered diet - require change in texture of food or liquids (e.g., pureed food, thickened liquids)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="D2"/> <display value="Therapeutic diet (e.g., low salt, diabetic, low cholesterol) - While a {Patient/Resident}"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA18607-4"/> <display value="Therapeutic diet (e.g. low salt, diabetic, low cholesterol)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="Z2"/> <display value="None of the above - While a {Patient/Resident}"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA9-3"/> <display value="None of the above"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="Z1"/> <display value="None of the above - While NOT a {Patient/Resident}"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA9-3"/> <display value="None of the above"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="Section-12"/> <code> <system value="http://loinc.org"/> <code value="86685-5"/> <display value="Oral &or dental status [CMS Assessment]"/> </code> <text value="Section L: Oral/Dental Status"/> <type value="group"/> <readOnly value="true"/> <item> <linkId value="Section-12/L0200"/> <code> <system value="http://loinc.org"/> <code value="86706-9"/> <display value="Dental problems during 7D assessment period"/> </code> <prefix value="L0200"/> <text value="Dental: Check all that apply"/> <type value="choice"/> <repeats value="true"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="A"/> <display value="Broken or loosely fitting full or partial denture (chipped, cracked, uncleanable, or loose)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27932-5"/> <display value="Broken or loosely fitting full or partial denture (chipped, cracked, uncleanable, or loose)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="B"/> <display value="No natural teeth or tooth fragment(s) (edentulous)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27933-3"/> <display value="No natural teeth or tooth fragment(s) (edentulous)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="C"/> <display value="Abnormal mouth tissue (ulcers, masses, oral lesions, including under denture or partial if one is worn)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27934-1"/> <display value="Abnormal mouth tissue (ulcers, masses, oral lesions, including under denture or partial if one is worn)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="D"/> <display value="Obvious or likely cavity or broken natural teeth"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27935-8"/> <display value="Obvious or likely cavity or broken natural teeth"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="E"/> <display value="Inflamed or bleeding gums or loose natural teeth"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27936-6"/> <display value="Inflamed or bleeding gums or loose natural teeth"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="F"/> <display value="Mouth or facial pain, discomfort or difficulty with chewing"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27937-4"/> <display value="Mouth or facial pain, discomfort or difficulty with chewing"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="G"/> <display value="Unable to examine"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27938-2"/> <display value="Unable to examine"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="Z"/> <display value="None of the above were present"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27939-0"/> <display value="None of the above were present"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="Section-13"/> <code> <system value="http://loinc.org"/> <code value="88960-0"/> <display value="MDS v3.00 - RAI v1.17.1 - Skin conditions [CMS Assessment]"/> </code> <text value="Section M: Skin Conditions"/> <type value="group"/> <readOnly value="true"/> <item> <linkId value="Section-13/M0150"/> <code> <system value="http://loinc.org"/> <code value="57280-0"/> <display value="Risk of developing pressure injuries"/> </code> <prefix value="M0150"/> <text value="Risk of Pressure Ulcers/Injuries. Is this {patient/resident} at risk of developing pressure ulcers/injuries?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-13/M0210"/> <code> <system value="http://loinc.org"/> <code value="58214-8"/> <display value="One or more unhealed pressure injuries stage 1 or higher"/> </code> <prefix value="M0210"/> <text value="Unhealed Pressure Ulcers/Injuries. Does this {patient/resident} have one or more unhealed pressure ulcers/injuries?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-13/M1030"/> <code> <system value="http://loinc.org"/> <code value="54970-9"/> <display value="Number of venous and arterial ulcers in last 7D"/> </code> <prefix value="M1030"/> <text value="Number of Venous and Arterial Ulcers. Enter the total number of venous and arterial ulcers present"/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Minimum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="9"/> <display value="Maximum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-13/M0300"/> <code> <system value="http://loinc.org"/> <code value="88961-8"/> <display value="MDS v3.0 - RAI v1.17.1 - Current number of unhealed pressure injuries at each stage"/> </code> <prefix value="M0300"/> <text value="Current Number of Unhealed Pressure Ulcers/Injuries at Each Stage"/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> <item> <linkId value="Section-13/M0300A"/> <prefix value="M0300A"/> <text value="Stage 1: Intact skin with non-blanchable redness of a localized area usually over a bony prominence. Darkly pigmented skin may not have a visible blanching; in dark skin tones only it may appear with persistent blue or purple hues"/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> </item> <item> <linkId value="Section-13/M0300B"/> <prefix value="M0300B"/> <text value="Stage 2: Partial thickness loss of dermis presenting as a shallow open ulcer with a red or pink wound bed, without slough. May also present as an intact or open/ruptured blister."/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> </item> <item> <linkId value="Section-13/M0300C"/> <prefix value="M0300C"/> <text value="Stage 3: Full thickness tissue loss. Subcutaneous fat may be visible but bone, tendon or muscle is not exposed. Slough may be present but does not obscure the depth of tissue loss. May include undermining and tunneling"/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> </item> <item> <linkId value="Section-13/M0300D"/> <prefix value="M0300D"/> <text value="Stage 4: Full thickness tissue loss with exposed bone, tendon or muscle. Slough or eschar may be present on some parts of the wound bed. Often includes undermining and tunneling"/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> </item> <item> <linkId value="Section-13/M0300E"/> <prefix value="M0300E"/> <text value="Unstageable - Non-removable dressing/device: Known but not stageable due to non-removable dressing/device"/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> </item> <item> <linkId value="Section-13/M0300F"/> <prefix value="M0300F"/> <text value="Unstageable - Slough and/or eschar: Known but not stageable due to coverage of wound bed by slough and/or eschar"/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> </item> <item> <linkId value="Section-13/M0300G"/> <prefix value="M0300G"/> <text value="Unstageable - Deep tissue injury"/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> </item> </item> <item> <linkId value="Section-13/M0100"/> <code> <system value="http://loinc.org"/> <code value="86708-5"/> <display value="Determination of pressure injury risk in last 7D"/> </code> <prefix value="M0100"/> <text value="Determination of Pressure Ulcer/Injury Risk: Check all that apply"/> <type value="choice"/> <repeats value="true"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="Z"/> <display value="None of the above"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA9-3"/> <display value="None of the above"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="A"/> <display value="{Patient/Resident} has a pressure ulcer/injury, a scar over bony prominence, or a non-removable dressing/device"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28887-0"/> <display value="Resident has a pressure ulcer/injury, a scar over bony prominence, or a non-removable dressing/device"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="B"/> <display value="Formal assessment instrument/tool (e.g., Braden, Norton, or other)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27941-6"/> <display value="Formal assessment instrument/tool (e.g., Braden, Norton, or other)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="C"/> <display value="Clinical assessment"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27942-4"/> <display value="Clinical assessment"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-13/M1040"/> <code> <system value="http://loinc.org"/> <code value="88696-0"/> <display value="Ulcers, wounds and skin problems in the last 7D"/> </code> <prefix value="M1040"/> <text value="Other Ulcers, Wounds and Skin Problems: Check all that apply"/> <type value="choice"/> <repeats value="true"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="A"/> <display value="Infection of the foot (e.g., cellulitis, purulent drainage)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27943-2"/> <display value="Infection of the foot (e.g., cellulitis, purulent drainage)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="B"/> <display value="Diabetic foot ulcer(s)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27944-0"/> <display value="Diabetic foot ulcer(s)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="C"/> <display value="Other open lesion(s) on the foot"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27945-7"/> <display value="Other open lesion(s) on the foot"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="D"/> <display value="Open lesion(s) other than ulcers, rashes, cuts (e.g., cancer lesion)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27946-5"/> <display value="Open lesion(s) other than ulcers, rashes, cuts (e.g., cancer lesion)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="E"/> <display value="Surgical wound(s)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27947-3"/> <display value="Surgical wound(s)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="F"/> <display value="Burn(s) (second or third degree)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27948-1"/> <display value="Burn(s) (second or third degree)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="G"/> <display value="Skin tear(s)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA18608-2"/> <display value="Skin tear(s)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="H"/> <display value="Moisture Associated Skin Damage (MASD) (e.g., incontinence-associated dermatitis [IAD], perspiration, drainage)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27950-7"/> <display value="Moisture associated skin damage (MASD) (e.g., incontinence-associated dermatitis [IAD], perspiration, drainage)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="Z"/> <display value="None of the above were present"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27939-0"/> <display value="None of the above were present"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-13/M1200"/> <code> <system value="http://loinc.org"/> <code value="86748-1"/> <display value="Skin and ulcer &or injury treatments during 7D assessment period"/> </code> <prefix value="M1200"/> <text value="Skin and Ulcer/Injury Treatments: Check all that apply"/> <type value="choice"/> <repeats value="true"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="A"/> <display value="Pressure reducing device for chair"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27951-5"/> <display value="Pressure reducing device for chair"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="B"/> <display value="Pressure reducing device for bed"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27952-3"/> <display value="Pressure reducing device for bed"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="C"/> <display value="Turning/repositioning program"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27953-1"/> <display value="Turning/repositioning program"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="D"/> <display value="Nutrition or hydration intervention to manage skin problems"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27954-9"/> <display value="Nutrition or hydration intervention to manage skin problems"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="E"/> <display value="Pressure ulcer/injury care"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28888-8"/> <display value="Pressure ulcer/injury care"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="F"/> <display value="Surgical wound care"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27956-4"/> <display value="Surgical wound care"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="G"/> <display value="Application of nonsurgical dressings (with or without topical medications) other than to feet"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27957-2"/> <display value="Application of nonsurgical dressings (with or without topical medications) other than to feet"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="H"/> <display value="Applications of ointments/medications other than to feet"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27958-0"/> <display value="Applications of ointments/medications other than to feet"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="I"/> <display value="Application of dressings to feet (with or without topical medications)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27959-8"/> <display value="Application of dressings to feet (with or without topical medications)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="Z"/> <display value="None of the above were provided"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27960-6"/> <display value="None of the above were provided"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="Section-14"/> <code> <system value="http://loinc.org"/> <code value="88962-6"/> <display value="MDS v3.0 - RAI v1.17.1 - Medications [CMS Assessment]"/> </code> <text value="Section N: Medications"/> <type value="group"/> <readOnly value="true"/> <item> <linkId value="Section-14/N0300"/> <code> <system value="http://loinc.org"/> <code value="54982-4"/> <display value="Number of D injectable substances received in last 7D or since admission &or reentry if less than 7D"/> </code> <prefix value="N0300"/> <text value="Injections. Record the number of days that injections of any type were received during the last 7 days or since {admission} if less than 7 days."/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Minimum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="7"/> <display value="Maximum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-14/N2001"/> <code> <system value="http://loinc.org"/> <code value="57255-2"/> <display value="Drug regimen review identified potential medication issues"/> </code> <prefix value="N2001"/> <text value="Drug Regimen Review: Did a complete drug regimen review identify potential clinically significant medication issues?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No - No issues found during review"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27634-7"/> <display value="No - No issues found during review"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes - Issues found during review"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27635-4"/> <display value="Yes - Issues found during review"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="9"/> <display value="NA - {Patient/Resident} is not taking any medications"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27636-2"/> <display value="NA - Patient is not taking any medications"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-14/N2003"/> <code> <system value="http://loinc.org"/> <code value="57281-8"/> <display value="Medication follow-up"/> </code> <prefix value="N2003"/> <text value="Medication Follow-up. Did the {facility/setting} contact a physician (or physician-designee) by midnight of the next calendar day and complete prescribed/recommended actions in response to the identified potential clinically significant medication issues?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-14/N2005"/> <code> <system value="http://loinc.org"/> <code value="57256-0"/> <display value="Medication intervention since admission &or reentry"/> </code> <prefix value="N2005"/> <text value="Medication Intervention. Did the {facility/setting} contact and complete physician (or physician-designee) prescribed/recommended actions by midnight of the next calendar day each time potential clinically significant medication issues were identified since the {admission}?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="9"/> <display value="NA - There were no potential clinically significant medication issues identified since {admission} or {patient/resident} is not taking any medications"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28935-7"/> <display value="NA - There were no potential clinically significant medication issues identified since admission or resident is not taking any medications"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-14/N0350"/> <code> <system value="http://loinc.org"/> <code value="58217-1"/> <display value="Insulin"/> </code> <prefix value="N0350"/> <text value="Insulin"/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> <item> <linkId value="Section-14/N0350A"/> <code> <system value="http://loinc.org"/> <code value="58127-2"/> <display value="Number of D insulin injections were received in last 7D or since admission &or reentry if less than 7D"/> </code> <prefix value="N0350A"/> <text value="Insulin injections - Record the number of days that insulin injections were received during the last 7 days or since {admission} if less than 7 days."/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Minimum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="7"/> <display value="Maximum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-14/N0350B"/> <code> <system value="http://loinc.org"/> <code value="58128-0"/> <display value="Number of D the physician changed the resident's insulin orders in last 7D or since admission &or reentry if less than 7D"/> </code> <prefix value="N0350B"/> <text value="Orders for insulin - Record the number of days the physician (or authorized assistant or practitioner) changed the {patient's/resident's} insulin orders during the last 7 days or since {admission} if less than 7 days."/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Minimum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="7"/> <display value="Maximum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="Section-14/N0410"/> <code> <system value="http://loinc.org"/> <code value="88290-2"/> <display value="MDS v3.0 - RAI v1.17.1 - Medications received"/> </code> <prefix value="N0410"/> <text value="Medications Received. Indicate the number of DAYS the {patient/resident} received the following medications by pharmacological classification, not how it is used, during the last 7 days or since {admission} if less than 7 days. Enter "0" if medication was not received by the {patient/resident} during the last 7 days."/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> <item> <linkId value="Section-14/N0410A"/> <code> <system value="http://loinc.org"/> <code value="86751-5"/> <display value="Number of D antipsychotic received in last 7D or since admission &or reentry if less than 7D"/> </code> <prefix value="N0410A"/> <text value="Antipsychotic"/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Minimum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="7"/> <display value="Maximum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-14/N0410B"/> <code> <system value="http://loinc.org"/> <code value="86752-3"/> <display value="Number of D antianxiety received in last 7D or since admission &or reentry if less than 7D"/> </code> <prefix value="N0410B"/> <text value="Antianxiety"/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Minimum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="7"/> <display value="Maximum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-14/N0410C"/> <code> <system value="http://loinc.org"/> <code value="86753-1"/> <display value="Number of D antidepressant received in last 7D or since admission &or reentry if less than 7D"/> </code> <prefix value="N0410C"/> <text value="Antidepressant"/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Minimum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="7"/> <display value="Maximum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-14/N0410D"/> <code> <system value="http://loinc.org"/> <code value="86754-9"/> <display value="Number of D hypnotic received in last 7D or since admission &or reentry if less than 7D"/> </code> <prefix value="N0410D"/> <text value="Hypnotic"/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Minimum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="7"/> <display value="Maximum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-14/N0410E"/> <code> <system value="http://loinc.org"/> <code value="86755-6"/> <display value="Number of D anticoagulant received in last 7D or since admission &or reentry if less than 7D"/> </code> <prefix value="N0410E"/> <text value="Anticoagulant (e.g., warfarin, heparin, or low-molecular weight heparin)"/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Minimum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="7"/> <display value="Maximum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-14/N0410F"/> <code> <system value="http://loinc.org"/> <code value="86756-4"/> <display value="Number of D antibiotic received in last 7D or since admission &or reentry if less than 7D"/> </code> <prefix value="N0410F"/> <text value="Antibiotic"/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Minimum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="7"/> <display value="Maximum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-14/N0410G"/> <code> <system value="http://loinc.org"/> <code value="86757-2"/> <display value="Number of D diuretic received in last 7D or since admission &or reentry if less than 7D"/> </code> <prefix value="N0410G"/> <text value="Diuretic"/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Minimum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="7"/> <display value="Maximum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-14/N0410H"/> <code> <system value="http://loinc.org"/> <code value="88291-0"/> <display value="Number of D opiod received in last 7D or since admission &or reentry if less than 7D"/> </code> <prefix value="N0410H"/> <text value="Opioid"/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Minimum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="7"/> <display value="Maximum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="Section-14/N0450"/> <code> <system value="http://loinc.org"/> <code value="88295-1"/> <display value="Antipsychotic medication review"/> </code> <prefix value="N0450"/> <text value="Antipsychotic Medication Review"/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> <item> <linkId value="Section-14/N0450A"/> <code> <system value="http://loinc.org"/> <code value="88296-9"/> <display value="Antipsychotic medications since admission or entry or reentry or the prior OBRA assessment, whichever is more recent"/> </code> <prefix value="N0450A"/> <text value="Did the {patient/resident} receive antipsychotic medications since {admission}, whichever is more recent?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No - Antipsychotics were not received"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28462-2"/> <display value="No - Antipsychotics were not received"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes - Antipsychotics were received on a routine basis only"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28463-0"/> <display value="Yes - Antipsychotics were received on a routine basis only"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Yes - Antipsychotics were received on a PRN basis only"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28464-8"/> <display value="Yes - Antipsychotics were received on a PRN basis only"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Yes - Antipsychotics were received on a routine and PRN basis"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28465-5"/> <display value="Yes - Antipsychotics were received on a routine and PRN basis"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-14/N0450B"/> <code> <system value="http://loinc.org"/> <code value="88297-7"/> <display value="Gradual dose reduction (GDR) attempted"/> </code> <prefix value="N0450B"/> <text value="Has a gradual dose reduction (GDR) been attempted?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-14/N0450C"/> <code> <system value="http://loinc.org"/> <code value="88298-5"/> <display value="Date of last attempted GDR"/> </code> <prefix value="N0450C"/> <text value="Date of last attempted GDR:"/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="MMDDYYYY"/> <display value="Date of last attempted GDR"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-14/N0450D"/> <code> <system value="http://loinc.org"/> <code value="88299-3"/> <display value="Physician documented GDR as clinically contraindicated"/> </code> <prefix value="N0450D"/> <text value="Physician documented GDR as clinically contraindicated"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No - GDR has not been documented by a physician as clinically contraindicated"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28466-3"/> <display value="No - GDR has not been documented by a physician as clinically contraindicated"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes - GDR has been documented by a physician as clinically contraindicated"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28467-1"/> <display value="Yes - GDR has been documented by a physician as clinically contraindicated"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-14/N0450E"/> <code> <system value="http://loinc.org"/> <code value="88300-9"/> <display value="Date physician documented GDR as clinically contraindicated"/> </code> <prefix value="N0450E"/> <text value="Date physician documented GDR as clinically contraindicated"/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="MMDDYYYY"/> <display value="Date physician documented GDR contraindicated"/> </valueCoding> </answerOption> </item> </item> </item> <item> <linkId value="Section-15"/> <code> <system value="http://loinc.org"/> <code value="90514-1"/> <display value="MDS v3.0 - RAI v1.17.1 - Special treatments, procedures, and programs [CMS Assessment]"/> </code> <text value="Section O: Special Treatments, Procedures, and Programs"/> <type value="group"/> <readOnly value="true"/> <item> <linkId value="Section-15/O0600"/> <code> <system value="http://loinc.org"/> <code value="55040-0"/> <display value="Number of D physician examined the patient in last 14D"/> </code> <prefix value="O0600"/> <text value="Physician Examinations. Over the last 14 days, on how many days did the physician (or authorized assistant or practitioner) examine the {patient/resident}?"/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="14"/> <display value="Maximum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="00"/> <display value="Minimum value"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-15/O0700"/> <code> <system value="http://loinc.org"/> <code value="55041-8"/> <display value="Number of D physician orders changed in last 14D"/> </code> <prefix value="O0700"/> <text value="Physician Orders. Over the last 14 days, on how many days did the physician (or authorized assistant or practitioner) change the {patient's/resident's} orders?"/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="14"/> <display value="Maximum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="00"/> <display value="Minimum value"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-15/O0420"/> <code> <system value="http://loinc.org"/> <code value="86769-7"/> <display value="Distinct calendar days of therapy in last 7D"/> </code> <prefix value="O0420"/> <text value="Distinct Calendar Days of Therapy. Record the number of calendar days that the {patient/resident} received Speech-Language Pathology and Audiology Services, Occupational Therapy, or Physical Therapy for at least 15 minutes in the past 7 days."/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Minimum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="7"/> <display value="Maximum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-15/O0250"/> <code> <system value="http://loinc.org"/> <code value="69339-0"/> <display value="Influenza vaccine"/> </code> <prefix value="O0250"/> <text value="Influenza Vaccine - Refer to the current version of 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<answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-15/O0250C"/> <code> <system value="http://loinc.org"/> <code value="55020-2"/> <display value="Reason influenza virus vaccine not received"/> </code> <prefix value="O0250C"/> <text value="If influenza vaccine not received, state reason"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Received outside of this facility"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA184-4"/> <display value="Received outside of this facility"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Not eligible - medical contraindication"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11091-8"/> <display value="Not eligible - medical contraindication"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="4"/> <display value="Offered and declined"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA186-9"/> <display value="Offered and declined"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="5"/> <display value="Not offered"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA187-7"/> <display value="Not offered"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="6"/> <display value="Inability to obtain influenza vaccine due to a declared shortage"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA26746-0"/> <display value="Inability to obtain influenza vaccine due to a declared shortage"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="9"/> <display value="None of the above"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA9-3"/> <display value="None of the above"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="{Patient/resident} not in facility during this year's influenza vaccination season"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28194-1"/> <display value="Resident not in facility during this year's influenza vaccination season"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-15/O0250B"/> <code> <system value="http://loinc.org"/> <code value="58131-4"/> <display value="Flu vaccine date"/> </code> <prefix value="O0250B"/> <text value="Date influenza vaccine received"/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="MMDDYYYY"/> <display value="Date influenza vaccine received"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="Section-15/O0300"/> <code> <system value="http://loinc.org"/> <code value="55021-0"/> <display value="Pneumococcal vaccine"/> </code> <prefix value="O0300"/> <text value="Pneumococcal Vaccine"/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> <item> <linkId value="Section-15/O0300A"/> <code> <system value="http://loinc.org"/> <code value="55022-8"/> <display value="Pneumococcal vaccination up to date"/> </code> <prefix value="O0300A"/> <text value="Is the {patient's/resident's} Pneumococcal vaccination up to date?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-15/O0300B"/> <code> <system value="http://loinc.org"/> <code value="45956-0"/> <display value="Reason pneumococcal vaccine not received"/> </code> <prefix value="O0300B"/> <text value="If Pneumococcal vaccine not received, state reason"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Not eligible - medical contraindication"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11091-8"/> <display value="Not eligible - medical contraindication"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Offered and declined"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA186-9"/> <display value="Offered and declined"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Not offered"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA187-7"/> <display value="Not offered"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="Section-15/O0400"/> <code> <system value="http://loinc.org"/> <code value="86762-2"/> <display value="Therapies"/> </code> <prefix value="O0400"/> <text value="Therapies"/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> <item> <linkId value="Section-15/O0400A"/> <code> <system value="http://loinc.org"/> <code value="58132-2"/> <display value="Speech-language pathology and audiology services"/> </code> <prefix value="O0400A"/> <text value="Speech-Language Pathology and Audiology Services"/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> </item> <item> <linkId value="Section-15/O0400B"/> <code> <system value="http://loinc.org"/> <code value="58135-5"/> <display value="Occupational therapy"/> </code> <prefix value="O0400B"/> <text value="Occupational Therapy"/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> </item> <item> <linkId value="Section-15/O0400C"/> <code> <system value="http://loinc.org"/> <code value="58138-9"/> <display value="Physical therapy"/> </code> <prefix value="O0400C"/> <text value="Physical Therapy"/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> </item> <item> <linkId value="Section-15/O0400D"/> <code> <system value="http://loinc.org"/> <code value="58141-3"/> <display value="Respiratory therapy"/> </code> <prefix value="O0400D"/> <text value="Respiratory Therapy"/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> </item> <item> <linkId value="Section-15/O0400E"/> <code> <system value="http://loinc.org"/> <code value="58142-1"/> <display value="Psychological therapy"/> </code> <prefix value="O0400E"/> <text value="Psychological Therapy (by any licensed mental health professional)"/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> </item> <item> <linkId value="Section-15/O0400F"/> <code> <system value="http://loinc.org"/> <code value="58143-9"/> <display value="Recreational therapy"/> </code> <prefix value="O0400F"/> <text value="Recreational Therapy (includes recreational and music therapy)"/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> </item> </item> <item> <linkId value="Section-15/O0450"/> <prefix value="O0450"/> <text value="Resumption of Therapy"/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> <item> <linkId value="Section-15/O0450A"/> <code> <system value="http://loinc.org"/> <code value="86772-1"/> <display value="Previous rehabilitation therapy regimen (speech, occupational, &or physical therapy) ended, & regimen now resumed at exactly the same level for each discipline"/> </code> <prefix value="O0450A"/> <text value="Has a previous rehabilitation therapy regimen (speech, occupational, and/or physical therapy) ended, as reported on this {End of Therapy}, and has this regimen now resumed at exactly the same level for each discipline?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="Section-15/O0500"/> <code> <system value="http://loinc.org"/> <code value="86773-9"/> <display value="Restorative nursing programs"/> </code> <prefix value="O0500"/> <text value="Restorative Nursing Programs. Record the number of days each of the following restorative programs was performed (for at least 15 minutes a day) in the last 7 calendar days (enter 0 if none or less than 15 minutes daily)"/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> <item> <linkId value="Section-15/O0500A"/> <code> <system value="http://loinc.org"/> <code value="86774-7"/> <display value="Number of D of passive range of motion in last 7 calendar D"/> </code> <prefix value="O0500A"/> <text value="Technique. Range of motion (passive)"/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Minimum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="7"/> <display value="Maximum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-15/O0500B"/> <code> <system value="http://loinc.org"/> <code value="86775-4"/> <display value="Number of D of active range of motion in last 7 calendar D"/> </code> <prefix value="O0500B"/> <text value="Technique. Range of motion (active)"/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Minimum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="7"/> <display value="Maximum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-15/O0500C"/> <code> <system value="http://loinc.org"/> <code value="86776-2"/> <display value="Number of D of splint or brace assistance in last 7 calendar D"/> </code> <prefix value="O0500C"/> <text value="Technique. Splint or brace assistance"/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Minimum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="7"/> <display value="Maximum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-15/O0500D"/> <code> <system value="http://loinc.org"/> <code value="86777-0"/> <display value="Number of D of training & skill practice in bed mobility in last 7 calendar D"/> </code> <prefix value="O0500D"/> <text value="Training and Skill Practice in. Bed mobility"/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Minimum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="7"/> <display value="Maximum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-15/O0500E"/> <code> <system value="http://loinc.org"/> <code value="86778-8"/> <display value="Number of D of training & skill practice in transfer in last 7 calendar D"/> </code> <prefix value="O0500E"/> <text value="Training and Skill Practice in. Transfer"/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Minimum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="7"/> <display value="Maximum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-15/O0500F"/> <code> <system value="http://loinc.org"/> <code value="86779-6"/> <display value="Number of D of training & skill practice in walking in last 7 calendar D"/> </code> <prefix value="O0500F"/> <text value="Training and Skill Practice in. Walking"/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Minimum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="7"/> <display value="Maximum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-15/O0500G"/> <code> <system value="http://loinc.org"/> <code value="86780-4"/> <display value="Number of D of training & skill practice in dressing or grooming in last 7 calendar D"/> </code> <prefix value="O0500G"/> <text value="Training and Skill Practice in. Dressing and/or grooming"/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Minimum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="7"/> <display value="Maximum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-15/O0500H"/> <code> <system value="http://loinc.org"/> <code value="86781-2"/> <display value="Number of D of training & skill practice in eating or swallowing in last 7 calendar D"/> </code> <prefix value="O0500H"/> <text value="Training and Skill Practice in. Eating and/or swallowing"/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Minimum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="7"/> <display value="Maximum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-15/O0500I"/> <code> <system value="http://loinc.org"/> <code value="86782-0"/> <display value="Number of D of training & skill practice in amputation or prosthesis care in last 7 calendar D"/> </code> <prefix value="O0500I"/> <text value="Training and Skill Practice in. 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Does the {patient's/resident's} clinical record document a request that this question be asked only on comprehensive assessments?"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-17/Q0100"/> <code> <system value="http://loinc.org"/> <code value="55053-3"/> <display value="Participation in assessment"/> </code> <prefix value="Q0100"/> <text value="Participation in Assessment"/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> <item> <linkId value="Section-17/Q0100A"/> <code> <system value="http://loinc.org"/> <code value="55054-1"/> <display value="Participation in assessment"/> </code> <prefix value="Q0100A"/> <text value="{Patient/Resident} participated in assessment"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-17/Q0100B"/> <code> <system value="http://loinc.org"/> <code value="55074-9"/> <display value="Participation in assessment Family or significant other"/> </code> <prefix value="Q0100B"/> <text value="Family or significant other participated in assessment"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system 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</valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12649-2"/> <display value="Expects to remain in this facility"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Expects to be discharged to another facility/institution"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12650-0"/> <display value="Expects to be discharged to another facility/institution"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="9"/> <display value="Unknown or uncertain"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11107-2"/> <display value="Unknown or uncertain"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-17/Q0300B"/> <code> <system value="http://loinc.org"/> <code value="55058-2"/> <display value="Information source for resident's overall goal"/> </code> <prefix value="Q0300B"/> <text value="Indicate information source for {patient/resident overall goal}"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="9"/> <display value="Unknown or uncertain"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11107-2"/> <display value="Unknown or uncertain"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code 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<readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="Section-17/Q0500"/> <prefix value="Q0500"/> <text value="Return to Community"/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> <item> <linkId value="Section-17/Q0500B"/> <code> <system value="http://loinc.org"/> <code value="58149-6"/> <display value="Wants to talk to someone about the possibility of returning to the community"/> </code> <prefix value="Q0500B"/> <text value="Ask the {patient/resident} (or family or significant other or guardian or legally authorized representative if {patient/resident} is unable to understand or respond): "Do you want to talk to someone about the possibility of leaving this {facility/setting} and returning to live and receive services in the community?""/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="9"/> <display value="Unknown or uncertain"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11107-2"/> <display value="Unknown or uncertain"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="Section-17/Q0550"/> <code> <system value="http://loinc.org"/> <code value="86796-0"/> <display value="Resident's preference to avoid being asked about returning to the community"/> </code> <prefix value="Q0550"/> <text value="{Patient's/Resident's} Preference to Avoid Being Asked {Return to Community question} Again"/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> <item> <linkId value="Section-17/Q0550A"/> <code> <system value="http://loinc.org"/> <code value="86797-8"/> <display value="Resident (or legally authorized representative) wants to be asked about returning to the community on all assessments"/> </code> <prefix value="Q0550A"/> <text value="Does the {patient/resident} (or family or significant other or guardian or legally authorized representative if {patient/resident} is unable to understand or respond) want to be asked about returning to the community on all assessments? (Rather than only on comprehensive assessments.)"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA32-8"/> <display value="No"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA33-6"/> <display value="Yes"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="8"/> <display value="Information not available"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA21297-9"/> <display value="Information not available"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-17/Q0550B"/> <code> <system value="http://loinc.org"/> <code value="86798-6"/> <display value="Information source for preference on return to community queries"/> </code> <prefix value="Q0550B"/> <text value="Indicate information source for {preference on asking return to community question}"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="{Patient/Resident}"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11019-9"/> <display value="Resident"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="If not {patient/resident}, then family or significant other"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11116-3"/> <display value="If not resident, then family or significant other"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="If not {patient/resident}, family, or significant other, then guardian or legally authorized representative"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12652-6"/> <display value="If not resident, family, or significant other, then guardian or legally authorized representative"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="9"/> <display value="None of the above"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA9-3"/> <display value="None of the above"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> </item> </item> <item> <linkId value="Section-18"/> <code> <system value="http://loinc.org"/> <code value="87207-7"/> <display value="Care Area Assessment (CAA) Summary [CMS Assessment]"/> </code> <text value="Section V: Care Area Assessment (CAA) Summary"/> <type value="group"/> <readOnly value="true"/> <item> <linkId value="Section-18/V0100"/> <code> <system value="http://loinc.org"/> <code value="87208-5"/> <display value="Items from the most recent prior OBRA or scheduled PPS Assessment"/> </code> <prefix value="V0100"/> <text value="Items From the Most Recent Prior OBRA or Scheduled PPS Assessment"/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> <item> <linkId value="Section-18/V0100A"/> <code> <system value="http://loinc.org"/> <code value="54583-0"/> <display value="Federal OBRA reason for assessment"/> </code> <prefix value="V0100A"/> <text value="Prior Assessment Federal OBRA Reason for Assessment (A0310A value from prior assessment)"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="05"/> <display value="Significant correction to prior comprehensive assessment"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10888-8"/> <display value="Significant correction to prior comprehensive assessment"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="06"/> <display value="Significant correction to prior quarterly assessment"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10889-6"/> <display value="Significant correction to prior quarterly assessment"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="01"/> <display value="Admission assessment (required by day 14)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10-4"/> <display value="Admission assessment (required by day 14)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="02"/> <display value="Quarterly review assessment"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA15-3"/> <display value="Quarterly review assessment"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="03"/> <display value="Annual assessment"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA12-0"/> <display value="Annual assessment"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="04"/> <display value="Significant change in status assessment"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA13-8"/> <display value="Significant change in status assessment"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="99"/> <display value="None of the above"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA9-3"/> <display value="None of the above"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-18/V0100B"/> <code> <system value="http://loinc.org"/> <code value="54584-8"/> <display value="PPS Assessment"/> </code> <prefix value="V0100B"/> <text value="Prior Assessment PPS Reason for Assessment (A0310B value from prior assessment"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="01"/> <display value="5-day scheduled assessment"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA10894-6"/> <display value="5-day scheduled assessment"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="99"/> <display value="None of the above"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA9-3"/> <display value="None of the above"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="08"/> <display value="IPA - Interim Payment Assessment"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA29577-6"/> <display value="IPA - Interim Payment Assessment"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-18/V0100C"/> <code> <system value="http://loinc.org"/> <code value="54593-9"/> <display value="Assessment reference date - observation end date"/> </code> <prefix value="V0100C"/> <text value="Prior Assessment Reference Date (A2300 value from prior assessment)"/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="MMDDYYYY"/> <display value="Prior assessment reference date (Assessment reference date value from prior assessment)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-18/V0100D"/> <code> <system value="http://loinc.org"/> <code value="54614-3"/> <display value="Brief interview for mental status - summary score BIMS"/> </code> <prefix value="V0100D"/> <text value="Prior Assessment Brief Interview for Mental Status (BIMS) Summary Score (C0500 value from prior assessment)"/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="15"/> <display value="Maximum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="99"/> <display value="Unable to complete interview"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="00"/> <display value="Minimum value"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-18/V0100E"/> <code> <system value="http://loinc.org"/> <code value="54654-9"/> <display value="Mood interview total severity scoreReported.PHQ-9"/> </code> <prefix value="V0100E"/> <text value="Prior Assessment Resident Mood Interview (PHQ-9) Total Severity Score (D0300 value from prior assessment)"/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="99"/> <display value="Unable to complete interview"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="27"/> <display value="Maximum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="00"/> <display value="Minimum value"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-18/V0100F"/> <code> <system value="http://loinc.org"/> <code value="54677-0"/> <display value="Staff assessment of resident mood total severity scoreObserved.PHQ-9"/> </code> <prefix value="V0100F"/> <text value="Prior Assessment Staff Assessment of Resident Mood (PHQ-9-OV) Total Severity Score (D0600 value from prior assessment)"/> <type value="open-choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="30"/> <display value="Maximum value"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="00"/> <display value="Minimum value"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="Section-18/V0200"/> <code> <system value="http://loinc.org"/> <code value="87210-1"/> <display value="Care Area Assessment (CAA) and Care Planning"/> </code> <prefix value="V0200"/> <text value="CAAs and Care Planning. 1. Check column A if Care Area is triggered. 2. For each triggered Care Area, indicate whether a new care plan, care plan revision, or continuation of current plan is necessary to address the problem(s) identified in your assessment of the care area. The Care Planning Decision column must be completed within 7 days of completing the RAI (MDS and CAA(s)). Check column B is the triggered care area is addressed in the care plan. 3. Indicate in the Location and Date of CAA Documentation column where information related to the CAA can be found. CAA documentation should include information on the complicating factors, risks, and any referrals for this resident for this care area."/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> <item> <linkId value="Section-18/V0200B"/> <prefix value="V0200B"/> <text value="Signature of RN coordinator for CAA Process and Date Signed"/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> </item> <item> <linkId value="Section-18/V0200C"/> <prefix value="V0200C"/> <text value="Signature of Person Completing Care Plan Decision and Date Signed"/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> </item> <item> <linkId value="Section-18/V0200A"/> <code> <system value="http://loinc.org"/> <code value="87211-9"/> <display value="Care Area Assessment (CAA) results"/> </code> <prefix value="V0200A"/> <text value="CAA Results"/> <type value="choice"/> <repeats value="true"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="01A"/> <display value="Delirium - Care Area Triggered"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA7426-5"/> <display value="Delirium"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="01B"/> <display value="Delirium - Care Planning Decision"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA7426-5"/> <display value="Delirium"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="02A"/> <display value="Cognitive Loss/Dementia - Care Area Triggered"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28159-4"/> <display value="Cognitive loss/dementia"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="02B"/> <display value="Cognitive Loss/Dementia - Care Planning Decision"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28159-4"/> <display value="Cognitive loss/dementia"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="03A"/> <display value="Visual Function - Care Area Triggered"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28160-2"/> <display value="Visual function"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="03B"/> <display value="Visual Function - Care Planning Decision"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28160-2"/> <display value="Visual function"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="04A"/> <display value="Communication - Care Area Triggered"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28161-0"/> <display value="Communication"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="04B"/> <display value="Communication - Care Planning Decision"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28161-0"/> <display value="Communication"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="05A"/> <display value="ADL Functional/Rehabilitation Potential - Care Area Triggered"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28162-8"/> <display value="ADL functional/rehabilitation potential"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="05B"/> <display value="ADL Functional/Rehabilitation Potential - Care Planning Decision"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28162-8"/> <display value="ADL functional/rehabilitation potential"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="06A"/> <display value="Urinary Incontinence and Indwelling Catheter - Care Area Triggered"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28163-6"/> <display value="Urinary incontinence and indwelling catheter"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="06B"/> <display value="Urinary Incontinence and Indwelling Catheter - Care Planning Decision"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28163-6"/> <display value="Urinary incontinence and indwelling catheter"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="07A"/> <display value="Psychosocial Well-Being - Care Area Triggered"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28165-1"/> <display value="Psychosocial well-being"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="07B"/> <display value="Psychosocial Well-Being - Care Planning Decision"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28165-1"/> <display value="Psychosocial well-being"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="08A"/> <display value="Mood State - Care Area Triggered"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28166-9"/> <display value="Mood state"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="08B"/> <display value="Mood State - Care Planning Decision"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28166-9"/> <display value="Mood state"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="09A"/> <display value="Behavioral Symptoms - Care Area Triggered"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28167-7"/> <display value="Behavioral symptoms"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="09B"/> <display value="Behavioral Symptoms - Care Planning Decision"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28167-7"/> <display value="Behavioral symptoms"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="10A"/> <display value="Activities - 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A helper completed the activities for the {patient/resident}."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28864-9"/> <display value="Dependent - A helper completed the activities for the resident."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-37/GG0100D"/> <code> <system value="http://loinc.org"/> <code value="85073-5"/> <display value="Prior functioning.functional cognition"/> </code> <prefix value="GG0100D"/> <text value="Functional Cognition: Code the {patient's/resident's} need for assistance with planning regular tasks, such as shopping or remembering to take medication prior to the current illness, exacerbation, or injury."/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="3"/> <display value="Independent - 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A helper completed the activities for the {patient/resident}."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28864-9"/> <display value="Dependent - A helper completed the activities for the resident."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="Section-37/GG0130"/> <prefix value="GG0130"/> <text value="Self-Care. Code the {patient's/resident's} usual performance at {admission} for each activity using the 6-point scale. If activity was not attempted at {admission}, code the reason. Code the {patient's/resident's} {discharge} goal(s) using the 6 point scale. Use of codes 07, 09, 10, or 88 is permissible to code {discharge} goal(s)."/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> <item> <linkId value="Section-37/GG0130A1"/> <code> <system value="http://loinc.org"/> <code value="83232-9"/> <display value="Eating - functional ability during 3D assessment period"/> </code> <prefix value="GG0130A1"/> <text value="Eating: The ability to use suitable utensils to bring food and/or liquid to the mouth and swallow food and/or liquid once the meal is placed before the {patient/resident}. - Admission Performance"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="09"/> <display value="Not applicable - Not attempted and the {patient/resident} did not perform this activity prior to the current illness, exacerbation, or injury."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28871-4"/> <display value="Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="02"/> <display value="Substantial/maximal assistance - Helper does MORE THAN HALF the effort. Helper lifts or holds trunk or limbs and provides more than half the effort."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11759-0"/> <display value="Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="01"/> <display value="Dependent - Helper does ALL of the effort. {Patient/Resident} does none of the effort to complete the activity. Or, the assistance of 2 or more helpers is required for the {patient/resident} to complete the activity."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27998-6"/> <display value="Dependent - Helper does all of the effort. Resident does none of the effort to complete the activity. Or, the assistance of 2 or more helpers is required for the resident to complete the activity."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="03"/> <display value="Partial/moderate assistance - Helper does LESS THAN HALF the effort. Helper lifts, holds, or supports trunk or limbs, but provides less than half the effort."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27996-0"/> <display value="Partial/moderate assistance - Helper does less than half the effort. Helper lifts, holds, or supports trunk or limbs, but provides less than half the effort."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="07"/> <display value="{Patient/Resident} refused"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27999-4"/> <display value="Resident refused"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="06"/> <display value="Independent - {Patient/Resident} completes the activity by him/herself with no assistance from a helper."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27993-7"/> <display value="Independent - Resident completes the activity by him/herself with no assistance from a helper."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="04"/> <display value="Supervision or touching assistance - Helper provides verbal cues and/or touching/steadying and/or contact guard assistance as {patient/resident} completes activity. Assistance may be provided throughout the activity or intermittently."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28870-6"/> <display value="Supervision or touching assistance - Helper provides verbal cues and/or touching/steadying and/or contact guard assistance as resident completes activity. Assistance may be provided throughout the activity or intermittently."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="05"/> <display value="Setup or clean-up assistance - Helper sets up or cleans up; {patient/resident} completes activity. Helper assists only prior to or following the activity."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27994-5"/> <display value="Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="10"/> <display value="Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28227-9"/> <display value="Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="88"/> <display value="Not attempted due to medical condition or safety concerns"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA26735-3"/> <display value="Not attempted due to medical condition or safety concerns"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-37/GG0130B1"/> <code> <system value="http://loinc.org"/> <code value="83230-3"/> <display value="Oral hygiene - functional ability during 3D assessment period"/> </code> <prefix value="GG0130B1"/> <text value="Oral hygiene: The ability to use suitable items to clean teeth. Dentures (if applicable): The ability to insert and remove dentures into and from the mouth, and manage denture soaking and rinsing with use of equipment. - Admission Performance"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="09"/> <display value="Not applicable - Not attempted and the {patient/resident} did not perform this activity prior to the current illness, exacerbation, or injury."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28871-4"/> <display value="Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="02"/> <display value="Substantial/maximal assistance - Helper does MORE THAN HALF the effort. Helper lifts or holds trunk or limbs and provides more than half the effort."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11759-0"/> <display value="Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="01"/> <display value="Dependent - Helper does ALL of the effort. {Patient/Resident} does none of the effort to complete the activity. Or, the assistance of 2 or more helpers is required for the {patient/resident} to complete the activity."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27998-6"/> <display value="Dependent - Helper does all of the effort. Resident does none of the effort to complete the activity. Or, the assistance of 2 or more helpers is required for the resident to complete the activity."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="03"/> <display value="Partial/moderate assistance - Helper does LESS THAN HALF the effort. Helper lifts, holds, or supports trunk or limbs, but provides less than half the effort."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27996-0"/> <display value="Partial/moderate assistance - Helper does less than half the effort. Helper lifts, holds, or supports trunk or limbs, but provides less than half the effort."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="07"/> <display value="{Patient/Resident} refused"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27999-4"/> <display value="Resident refused"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="06"/> <display value="Independent - {Patient/Resident} completes the activity by him/herself with no assistance from a helper."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27993-7"/> <display value="Independent - Resident completes the activity by him/herself with no assistance from a helper."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="04"/> <display value="Supervision or touching assistance - Helper provides verbal cues and/or touching/steadying and/or contact guard assistance as {patient/resident} completes activity. Assistance may be provided throughout the activity or intermittently."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28870-6"/> <display value="Supervision or touching assistance - Helper provides verbal cues and/or touching/steadying and/or contact guard assistance as resident completes activity. Assistance may be provided throughout the activity or intermittently."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="05"/> <display value="Setup or clean-up assistance - Helper sets up or cleans up; {patient/resident} completes activity. Helper assists only prior to or following the activity."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27994-5"/> <display value="Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="10"/> <display value="Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28227-9"/> <display value="Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="88"/> <display value="Not attempted due to medical condition or safety concerns"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA26735-3"/> <display value="Not attempted due to medical condition or safety concerns"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-37/GG0130C1"/> <code> <system value="http://loinc.org"/> <code value="83228-7"/> <display value="Toileting hygiene - functional ability during 3D assessment period"/> </code> <prefix value="GG0130C1"/> <text value="Toileting hygiene: The ability to maintain perineal hygiene, adjust clothes before and after voiding or having a bowel movement. If managing an ostomy, include wiping the opening but not managing equipment. - Admission Performance"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="09"/> <display value="Not applicable - Not attempted and the {patient/resident} did not perform this activity prior to the current illness, exacerbation, or injury."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28871-4"/> <display value="Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="02"/> <display value="Substantial/maximal assistance - Helper does MORE THAN HALF the effort. Helper lifts or holds trunk or limbs and provides more than half the effort."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11759-0"/> <display value="Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="01"/> <display value="Dependent - Helper does ALL of the effort. {Patient/Resident} does none of the effort to complete the activity. Or, the assistance of 2 or more helpers is required for the {patient/resident} to complete the activity."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27998-6"/> <display value="Dependent - Helper does all of the effort. Resident does none of the effort to complete the activity. Or, the assistance of 2 or more helpers is required for the resident to complete the activity."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="03"/> <display value="Partial/moderate assistance - Helper does LESS THAN HALF the effort. Helper lifts, holds, or supports trunk or limbs, but provides less than half the effort."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27996-0"/> <display value="Partial/moderate assistance - Helper does less than half the effort. Helper lifts, holds, or supports trunk or limbs, but provides less than half the effort."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="07"/> <display value="{Patient/Resident} refused"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27999-4"/> <display value="Resident refused"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="06"/> <display value="Independent - {Patient/Resident} completes the activity by him/herself with no assistance from a helper."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27993-7"/> <display value="Independent - Resident completes the activity by him/herself with no assistance from a helper."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="04"/> <display value="Supervision or touching assistance - Helper provides verbal cues and/or touching/steadying and/or contact guard assistance as {patient/resident} completes activity. Assistance may be provided throughout the activity or intermittently."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28870-6"/> <display value="Supervision or touching assistance - Helper provides verbal cues and/or touching/steadying and/or contact guard assistance as resident completes activity. Assistance may be provided throughout the activity or intermittently."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="05"/> <display value="Setup or clean-up assistance - Helper sets up or cleans up; {patient/resident} completes activity. Helper assists only prior to or following the activity."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27994-5"/> <display value="Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="10"/> <display value="Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28227-9"/> <display value="Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="88"/> <display value="Not attempted due to medical condition or safety concerns"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA26735-3"/> <display value="Not attempted due to medical condition or safety concerns"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-37/GG0130A3"/> <code> <system value="http://loinc.org"/> <code value="83232-9"/> <display value="Eating - functional ability during 3D assessment period"/> </code> <prefix value="GG0130A3"/> <text value="Eating: The ability to use suitable utensils to bring food and/or liquid to the mouth and swallow food and/or liquid once the meal is placed before the {patient/resident}. - Discharge Performance"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="09"/> <display value="Not applicable - Not attempted and the {patient/resident} did not perform this activity prior to the current illness, exacerbation, or injury."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28871-4"/> <display value="Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="02"/> <display value="Substantial/maximal assistance - Helper does MORE THAN HALF the effort. Helper lifts or holds trunk or limbs and provides more than half the effort."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11759-0"/> <display value="Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="01"/> <display value="Dependent - Helper does ALL of the effort. {Patient/Resident} does none of the effort to complete the activity. Or, the assistance of 2 or more helpers is required for the {patient/resident} to complete the activity."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27998-6"/> <display value="Dependent - Helper does all of the effort. Resident does none of the effort to complete the activity. Or, the assistance of 2 or more helpers is required for the resident to complete the activity."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="03"/> <display value="Partial/moderate assistance - Helper does LESS THAN HALF the effort. Helper lifts, holds, or supports trunk or limbs, but provides less than half the effort."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27996-0"/> <display value="Partial/moderate assistance - Helper does less than half the effort. Helper lifts, holds, or supports trunk or limbs, but provides less than half the effort."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="07"/> <display value="{Patient/Resident} refused"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27999-4"/> <display value="Resident refused"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="06"/> <display value="Independent - {Patient/Resident} completes the activity by him/herself with no assistance from a helper."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27993-7"/> <display value="Independent - Resident completes the activity by him/herself with no assistance from a helper."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="04"/> <display value="Supervision or touching assistance - Helper provides verbal cues and/or touching/steadying and/or contact guard assistance as {patient/resident} completes activity. Assistance may be provided throughout the activity or intermittently."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28870-6"/> <display value="Supervision or touching assistance - Helper provides verbal cues and/or touching/steadying and/or contact guard assistance as resident completes activity. Assistance may be provided throughout the activity or intermittently."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="05"/> <display value="Setup or clean-up assistance - Helper sets up or cleans up; {patient/resident} completes activity. Helper assists only prior to or following the activity."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27994-5"/> <display value="Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="10"/> <display value="Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28227-9"/> <display value="Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="88"/> <display value="Not attempted due to medical condition or safety concerns"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA26735-3"/> <display value="Not attempted due to medical condition or safety concerns"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-37/GG0130B3"/> <code> <system value="http://loinc.org"/> <code value="83230-3"/> <display value="Oral hygiene - functional ability during 3D assessment period"/> </code> <prefix value="GG0130B3"/> <text value="Oral hygiene: The ability to use suitable items to clean teeth. Dentures (if applicable): The ability to insert and remove dentures into and from the mouth, and manage denture soaking and rinsing with use of equipment. - Discharge Performance"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="09"/> <display value="Not applicable - Not attempted and the {patient/resident} did not perform this activity prior to the current illness, exacerbation, or injury."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28871-4"/> <display value="Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="02"/> <display value="Substantial/maximal assistance - Helper does MORE THAN HALF the effort. 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Helper assists only prior to or following the activity."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27994-5"/> <display value="Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="10"/> <display value="Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28227-9"/> <display value="Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="88"/> <display value="Not attempted due to medical condition or safety concerns"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA26735-3"/> <display value="Not attempted due to medical condition or safety concerns"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-37/GG0130G3"/> <code> <system value="http://loinc.org"/> <code value="83222-0"/> <display value="Lower body dressing - functional ability during 3D assessment period"/> </code> <prefix value="GG0130G3"/> <text value="Lower body dressing: The ability to dress and undress below the waist, including fasteners; does not include footwear. - Discharge Performance"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="09"/> <display value="Not applicable - Not attempted and the {patient/resident} did not perform this activity prior to the current illness, exacerbation, or injury."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28871-4"/> <display value="Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="02"/> <display value="Substantial/maximal assistance - Helper does MORE THAN HALF the effort. Helper lifts or holds trunk or limbs and provides more than half the effort."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11759-0"/> <display value="Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="01"/> <display value="Dependent - Helper does ALL of the effort. {Patient/Resident} does none of the effort to complete the activity. Or, the assistance of 2 or more helpers is required for the {patient/resident} to complete the activity."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27998-6"/> <display value="Dependent - Helper does all of the effort. Resident does none of the effort to complete the activity. Or, the assistance of 2 or more helpers is required for the resident to complete the activity."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="03"/> <display value="Partial/moderate assistance - Helper does LESS THAN HALF the effort. Helper lifts, holds, or supports trunk or limbs, but provides less than half the effort."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27996-0"/> <display value="Partial/moderate assistance - Helper does less than half the effort. Helper lifts, holds, or supports trunk or limbs, but provides less than half the effort."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="07"/> <display value="{Patient/Resident} refused"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27999-4"/> <display value="Resident refused"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="06"/> <display value="Independent - {Patient/Resident} completes the activity by him/herself with no assistance from a helper."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27993-7"/> <display value="Independent - Resident completes the activity by him/herself with no assistance from a helper."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="04"/> <display value="Supervision or touching assistance - Helper provides verbal cues and/or touching/steadying and/or contact guard assistance as {patient/resident} completes activity. Assistance may be provided throughout the activity or intermittently."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28870-6"/> <display value="Supervision or touching assistance - Helper provides verbal cues and/or touching/steadying and/or contact guard assistance as resident completes activity. Assistance may be provided throughout the activity or intermittently."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="05"/> <display value="Setup or clean-up assistance - Helper sets up or cleans up; {patient/resident} completes activity. Helper assists only prior to or following the activity."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27994-5"/> <display value="Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="10"/> <display value="Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28227-9"/> <display value="Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="88"/> <display value="Not attempted due to medical condition or safety concerns"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA26735-3"/> <display value="Not attempted due to medical condition or safety concerns"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-37/GG0130H2"/> <code> <system value="http://loinc.org"/> <code value="83219-6"/> <display value="Putting on and taking off footwear - functional goal recorded during 3D assessment period"/> </code> <prefix value="GG0130H2"/> <text value="Putting on/taking off footwear: The ability to put on and take off socks and shoes or other footwear that is appropriate for safe mobility; including fasteners, if applicable. - Discharge Goal"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="09"/> <display value="Not applicable - Not attempted and the {patient/resident} did not perform this activity prior to the current illness, exacerbation, or injury."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28871-4"/> <display value="Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="02"/> <display value="Substantial/maximal assistance - Helper does MORE THAN HALF the effort. Helper lifts or holds trunk or limbs and provides more than half the effort."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11759-0"/> <display value="Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="01"/> <display value="Dependent - Helper does ALL of the effort. {Patient/Resident} does none of the effort to complete the activity. Or, the assistance of 2 or more helpers is required for the {patient/resident} to complete the activity."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27998-6"/> <display value="Dependent - Helper does all of the effort. Resident does none of the effort to complete the activity. Or, the assistance of 2 or more helpers is required for the resident to complete the activity."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="03"/> <display value="Partial/moderate assistance - Helper does LESS THAN HALF the effort. Helper lifts, holds, or supports trunk or limbs, but provides less than half the effort."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27996-0"/> <display value="Partial/moderate assistance - Helper does less than half the effort. Helper lifts, holds, or supports trunk or limbs, but provides less than half the effort."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="07"/> <display value="{Patient/Resident} refused"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27999-4"/> <display value="Resident refused"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="06"/> <display value="Independent - {Patient/Resident} completes the activity by him/herself with no assistance from a helper."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27993-7"/> <display value="Independent - Resident completes the activity by him/herself with no assistance from a helper."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="04"/> <display value="Supervision or touching assistance - Helper provides verbal cues and/or touching/steadying and/or contact guard assistance as {patient/resident} completes activity. Assistance may be provided throughout the activity or intermittently."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28870-6"/> <display value="Supervision or touching assistance - Helper provides verbal cues and/or touching/steadying and/or contact guard assistance as resident completes activity. Assistance may be provided throughout the activity or intermittently."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="05"/> <display value="Setup or clean-up assistance - Helper sets up or cleans up; {patient/resident} completes activity. Helper assists only prior to or following the activity."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27994-5"/> <display value="Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="10"/> <display value="Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28227-9"/> <display value="Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="88"/> <display value="Not attempted due to medical condition or safety concerns"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA26735-3"/> <display value="Not attempted due to medical condition or safety concerns"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-37/GG0130H3"/> <code> <system value="http://loinc.org"/> <code value="83220-4"/> <display value="Putting on and taking off footwear - functional ability during 3D assessment period"/> </code> <prefix value="GG0130H3"/> <text value="Putting on/taking off footwear: The ability to put on and take off socks and shoes or other footwear that is appropriate for safe mobility; including fasteners, if applicable. - Discharge Performance"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="09"/> <display value="Not applicable - Not attempted and the {patient/resident} did not perform this activity prior to the current illness, exacerbation, or injury."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28871-4"/> <display value="Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="02"/> <display value="Substantial/maximal assistance - Helper does MORE THAN HALF the effort. Helper lifts or holds trunk or limbs and provides more than half the effort."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11759-0"/> <display value="Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="01"/> <display value="Dependent - Helper does ALL of the effort. {Patient/Resident} does none of the effort to complete the activity. Or, the assistance of 2 or more helpers is required for the {patient/resident} to complete the activity."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27998-6"/> <display value="Dependent - Helper does all of the effort. Resident does none of the effort to complete the activity. Or, the assistance of 2 or more helpers is required for the resident to complete the activity."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="03"/> <display value="Partial/moderate assistance - Helper does LESS THAN HALF the effort. Helper lifts, holds, or supports trunk or limbs, but provides less than half the effort."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27996-0"/> <display value="Partial/moderate assistance - Helper does less than half the effort. Helper lifts, holds, or supports trunk or limbs, but provides less than half the effort."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="07"/> <display value="{Patient/Resident} refused"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27999-4"/> <display value="Resident refused"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="06"/> <display value="Independent - {Patient/Resident} completes the activity by him/herself with no assistance from a helper."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27993-7"/> <display value="Independent - Resident completes the activity by him/herself with no assistance from a helper."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="04"/> <display value="Supervision or touching assistance - Helper provides verbal cues and/or touching/steadying and/or contact guard assistance as {patient/resident} completes activity. Assistance may be provided throughout the activity or intermittently."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28870-6"/> <display value="Supervision or touching assistance - Helper provides verbal cues and/or touching/steadying and/or contact guard assistance as resident completes activity. Assistance may be provided throughout the activity or intermittently."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="05"/> <display value="Setup or clean-up assistance - Helper sets up or cleans up; {patient/resident} completes activity. Helper assists only prior to or following the activity."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27994-5"/> <display value="Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="10"/> <display value="Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28227-9"/> <display value="Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="88"/> <display value="Not attempted due to medical condition or safety concerns"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA26735-3"/> <display value="Not attempted due to medical condition or safety concerns"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="Section-37/GG0170"/> <prefix value="GG0170"/> <text value="Mobility. Code the {patient's/resident's} usual performance at {admission} for each activity using the 6-point scale. If activity was not attempted at {admission}, code the reason. Code the {patient's/resident's} {discharge} goal(s) using the 6-point scale. Use of codes 07, 09, 10, or 88 is permissible to code {discharge} goal(s)."/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> <item> <linkId value="Section-37/GG0170A1"/> <code> <system value="http://loinc.org"/> <code value="83218-8"/> <display value="Roll left and right - functional ability during 3D assessment period"/> </code> <prefix value="GG0170A1"/> <text value="Roll left and right: The ability to roll from lying on back to left and right side, and return to lying on back on the bed. - Admission Performance"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="09"/> <display value="Not applicable - Not attempted and the {patient/resident} did not perform this activity prior to the current illness, exacerbation, or injury."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28871-4"/> <display value="Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="02"/> <display value="Substantial/maximal assistance - Helper does MORE THAN HALF the effort. Helper lifts or holds trunk or limbs and provides more than half the effort."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11759-0"/> <display value="Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="01"/> <display value="Dependent - Helper does ALL of the effort. {Patient/Resident} does none of the effort to complete the activity. Or, the assistance of 2 or more helpers is required for the {patient/resident} to complete the activity."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27998-6"/> <display value="Dependent - Helper does all of the effort. Resident does none of the effort to complete the activity. Or, the assistance of 2 or more helpers is required for the resident to complete the activity."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="03"/> <display value="Partial/moderate assistance - Helper does LESS THAN HALF the effort. Helper lifts, holds, or supports trunk or limbs, but provides less than half the effort."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27996-0"/> <display value="Partial/moderate assistance - Helper does less than half the effort. Helper lifts, holds, or supports trunk or limbs, but provides less than half the effort."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="07"/> <display value="{Patient/Resident} refused"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27999-4"/> <display value="Resident refused"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="06"/> <display value="Independent - {Patient/Resident} completes the activity by him/herself with no assistance from a helper."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27993-7"/> <display value="Independent - Resident completes the activity by him/herself with no assistance from a helper."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="04"/> <display value="Supervision or touching assistance - Helper provides verbal cues and/or touching/steadying and/or contact guard assistance as {patient/resident} completes activity. Assistance may be provided throughout the activity or intermittently."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28870-6"/> <display value="Supervision or touching assistance - Helper provides verbal cues and/or touching/steadying and/or contact guard assistance as resident completes activity. Assistance may be provided throughout the activity or intermittently."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="05"/> <display value="Setup or clean-up assistance - Helper sets up or cleans up; {patient/resident} completes activity. Helper assists only prior to or following the activity."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27994-5"/> <display value="Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="10"/> <display value="Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28227-9"/> <display value="Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="88"/> <display value="Not attempted due to medical condition or safety concerns"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA26735-3"/> <display value="Not attempted due to medical condition or safety concerns"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-37/GG0170B1"/> <code> <system value="http://loinc.org"/> <code value="83216-2"/> <display value="Sit to lying - functional ability during 3D assessment period"/> </code> <prefix value="GG0170B1"/> <text value="Sit to lying: The ability to move from sitting on side of bed to lying flat on the bed. - Admission Performance"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="09"/> <display value="Not applicable - Not attempted and the {patient/resident} did not perform this activity prior to the current illness, exacerbation, or injury."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28871-4"/> <display value="Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="02"/> <display value="Substantial/maximal assistance - Helper does MORE THAN HALF the effort. Helper lifts or holds trunk or limbs and provides more than half the effort."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11759-0"/> <display value="Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="01"/> <display value="Dependent - Helper does ALL of the effort. {Patient/Resident} does none of the effort to complete the activity. Or, the assistance of 2 or more helpers is required for the {patient/resident} to complete the activity."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27998-6"/> <display value="Dependent - Helper does all of the effort. Resident does none of the effort to complete the activity. Or, the assistance of 2 or more helpers is required for the resident to complete the activity."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="03"/> <display value="Partial/moderate assistance - Helper does LESS THAN HALF the effort. Helper lifts, holds, or supports trunk or limbs, but provides less than half the effort."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27996-0"/> <display value="Partial/moderate assistance - Helper does less than half the effort. Helper lifts, holds, or supports trunk or limbs, but provides less than half the effort."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="07"/> <display value="{Patient/Resident} refused"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27999-4"/> <display value="Resident refused"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="06"/> <display value="Independent - {Patient/Resident} completes the activity by him/herself with no assistance from a helper."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27993-7"/> <display value="Independent - Resident completes the activity by him/herself with no assistance from a helper."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="04"/> <display value="Supervision or touching assistance - Helper provides verbal cues and/or touching/steadying and/or contact guard assistance as {patient/resident} completes activity. 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Helper lifts, holds, or supports trunk or limbs, but provides less than half the effort."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="07"/> <display value="{Patient/Resident} refused"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27999-4"/> <display value="Resident refused"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="06"/> <display value="Independent - {Patient/Resident} completes the activity by him/herself with no assistance from a helper."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27993-7"/> <display value="Independent - Resident completes the activity by him/herself with no assistance from a helper."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="04"/> <display value="Supervision or touching assistance - Helper provides verbal cues and/or touching/steadying and/or contact guard assistance as {patient/resident} completes activity. 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Helper lifts or holds trunk or limbs and provides more than half the effort."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11759-0"/> <display value="Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="01"/> <display value="Dependent - Helper does ALL of the effort. {Patient/Resident} does none of the effort to complete the activity. Or, the assistance of 2 or more helpers is required for the {patient/resident} to complete the activity."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27998-6"/> <display value="Dependent - Helper does all of the effort. Resident does none of the effort to complete the activity. 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Helper lifts, holds, or supports trunk or limbs, but provides less than half the effort."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="07"/> <display value="{Patient/Resident} refused"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27999-4"/> <display value="Resident refused"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="06"/> <display value="Independent - {Patient/Resident} completes the activity by him/herself with no assistance from a helper."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27993-7"/> <display value="Independent - Resident completes the activity by him/herself with no assistance from a helper."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="04"/> <display value="Supervision or touching assistance - Helper provides verbal cues and/or touching/steadying and/or contact guard assistance as {patient/resident} completes activity. 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Helper assists only prior to or following the activity."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27994-5"/> <display value="Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="10"/> <display value="Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28227-9"/> <display value="Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="88"/> <display value="Not attempted due to medical condition or safety concerns"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA26735-3"/> <display value="Not attempted due to medical condition or safety concerns"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-37/GG0170E1"/> <code> <system value="http://loinc.org"/> <code value="83210-5"/> <display value="Bed-to-chair transfer - functional ability during 3D assessment period"/> </code> <prefix value="GG0170E1"/> <text value="Chair/bed-to-chair transfer: The ability to transfer to and from a bed to a chair (or wheelchair). - Admission Performance"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="09"/> <display value="Not applicable - Not attempted and the {patient/resident} did not perform this activity prior to the current illness, exacerbation, or injury."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28871-4"/> <display value="Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="02"/> <display value="Substantial/maximal assistance - Helper does MORE THAN HALF the effort. 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Helper assists only prior to or following the activity."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27994-5"/> <display value="Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="10"/> <display value="Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28227-9"/> <display value="Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="88"/> <display value="Not attempted due to medical condition or safety concerns"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA26735-3"/> <display value="Not attempted due to medical condition or safety concerns"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-37/GG0170M1"/> <code> <system value="http://loinc.org"/> <code value="83196-6"/> <display value="1 step (curb) - functional ability during 3D assessment period"/> </code> <prefix value="GG0170M1"/> <text value="1 step (curb): The ability to go up and down a curb and/or up and down one step. - Admission Performance"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="09"/> <display value="Not applicable - Not attempted and the {patient/resident} did not perform this activity prior to the current illness, exacerbation, or injury."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28871-4"/> <display value="Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="02"/> <display value="Substantial/maximal assistance - Helper does MORE THAN HALF the effort. Helper lifts or holds trunk or limbs and provides more than half the effort."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11759-0"/> <display value="Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="01"/> <display value="Dependent - Helper does ALL of the effort. {Patient/Resident} does none of the effort to complete the activity. Or, the assistance of 2 or more helpers is required for the {patient/resident} to complete the activity."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27998-6"/> <display value="Dependent - Helper does all of the effort. Resident does none of the effort to complete the activity. 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Helper lifts, holds, or supports trunk or limbs, but provides less than half the effort."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="07"/> <display value="{Patient/Resident} refused"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27999-4"/> <display value="Resident refused"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="06"/> <display value="Independent - {Patient/Resident} completes the activity by him/herself with no assistance from a helper."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27993-7"/> <display value="Independent - Resident completes the activity by him/herself with no assistance from a helper."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="04"/> <display value="Supervision or touching assistance - Helper provides verbal cues and/or touching/steadying and/or contact guard assistance as {patient/resident} completes activity. 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Helper assists only prior to or following the activity."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27994-5"/> <display value="Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. 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Helper lifts, holds, or supports trunk or limbs, but provides less than half the effort."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="07"/> <display value="{Patient/Resident} refused"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27999-4"/> <display value="Resident refused"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="06"/> <display value="Independent - {Patient/Resident} completes the activity by him/herself with no assistance from a helper."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27993-7"/> <display value="Independent - Resident completes the activity by him/herself with no assistance from a helper."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="04"/> <display value="Supervision or touching assistance - Helper provides verbal cues and/or touching/steadying and/or contact guard assistance as {patient/resident} completes activity. 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Helper lifts or holds trunk or limbs and provides more than half the effort."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA11759-0"/> <display value="Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="01"/> <display value="Dependent - Helper does ALL of the effort. {Patient/Resident} does none of the effort to complete the activity. Or, the assistance of 2 or more helpers is required for the {patient/resident} to complete the activity."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27998-6"/> <display value="Dependent - Helper does all of the effort. Resident does none of the effort to complete the activity. 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Helper lifts, holds, or supports trunk or limbs, but provides less than half the effort."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="07"/> <display value="{Patient/Resident} refused"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27999-4"/> <display value="Resident refused"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="06"/> <display value="Independent - {Patient/Resident} completes the activity by him/herself with no assistance from a helper."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27993-7"/> <display value="Independent - Resident completes the activity by him/herself with no assistance from a helper."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="04"/> <display value="Supervision or touching assistance - Helper provides verbal cues and/or touching/steadying and/or contact guard assistance as {patient/resident} completes activity. 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Helper assists only prior to or following the activity."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="^"/> <display value="Blank (skip pattern)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="10"/> <display value="Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28227-9"/> <display value="Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="88"/> <display value="Not attempted due to medical condition or safety concerns"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA26735-3"/> <display value="Not attempted due to medical condition or safety concerns"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-37/GG0170N2"/> <code> <system value="http://loinc.org"/> <code value="83193-3"/> <display value="4 steps - functional goal recorded during 3D assessment period"/> </code> <prefix value="GG0170N2"/> <text value="4 steps: The ability to go up and down four steps with or without a rail. - Discharge Goal"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="09"/> <display value="Not applicable - Not attempted and the {patient/resident} did not perform this activity prior to the current illness, exacerbation, or injury."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28871-4"/> <display value="Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="02"/> <display value="Substantial/maximal assistance - Helper does MORE THAN HALF the effort. 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Or, the assistance of 2 or more helpers is required for the resident to complete the activity."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="03"/> <display value="Partial/moderate assistance - Helper does LESS THAN HALF the effort. Helper lifts, holds, or supports trunk or limbs, but provides less than half the effort."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27996-0"/> <display value="Partial/moderate assistance - Helper does less than half the effort. Helper lifts, holds, or supports trunk or limbs, but provides less than half the effort."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="07"/> <display value="{Patient/Resident} refused"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27999-4"/> <display value="Resident refused"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="06"/> <display value="Independent - {Patient/Resident} completes the activity by him/herself with no assistance from a helper."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27993-7"/> <display value="Independent - Resident completes the activity by him/herself with no assistance from a helper."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="04"/> <display value="Supervision or touching assistance - Helper provides verbal cues and/or touching/steadying and/or contact guard assistance as {patient/resident} completes activity. Assistance may be provided throughout the activity or intermittently."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA28870-6"/> <display value="Supervision or touching assistance - Helper provides verbal cues and/or touching/steadying and/or contact guard assistance as resident completes activity. Assistance may be provided throughout the activity or intermittently."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="05"/> <display value="Setup or clean-up assistance - Helper sets up or cleans up; {patient/resident} completes activity. Helper assists only prior to or following the activity."/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA27994-5"/> <display value="Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. 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Physical restraints are any manual method or physical or mechanical device, material or equipment attached or adjacent to the {patient's/resident's} body that the individual cannot remove easily which restricts freedom of movement or normal access to one's body"/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> <item> <linkId value="Section-51/P0100A"/> <code> <system value="http://loinc.org"/> <code value="86786-1"/> <display value="Physical restraints used in bed - bed rail used during 7D assessment period"/> </code> <prefix value="P0100A"/> <text value="Used in Bed. 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Trunk restraint"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Not used"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA157-0"/> <display value="Not used"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Used less than daily"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA158-8"/> <display value="Used less than daily"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Used daily"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA159-6"/> <display value="Used daily"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-51/P0100F"/> <code> <system value="http://loinc.org"/> <code value="86791-1"/> <display value="Physical restraints used in chair or out of bed - limb restraint used during 7D assessment period"/> </code> <prefix value="P0100F"/> <text value="Used in Chair or Out of Bed. Limb restraint"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Not used"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA157-0"/> <display value="Not used"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Used less than daily"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA158-8"/> <display value="Used less than daily"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Used daily"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA159-6"/> <display value="Used daily"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-51/P0100G"/> <code> <system value="http://loinc.org"/> <code value="86792-9"/> <display value="Physical restraints used in chair or out of bed - chair prevents rising used during 7D assessment period"/> </code> <prefix value="P0100G"/> <text value="Used in Chair or Out of Bed. Chair prevents rising"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Not used"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA157-0"/> <display value="Not used"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Used less than daily"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA158-8"/> <display value="Used less than daily"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Used daily"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA159-6"/> <display value="Used daily"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-51/P0100H"/> <code> <system value="http://loinc.org"/> <code value="86793-7"/> <display value="Other physical restraints used in chair or out of bed used during 7D assessment period"/> </code> <prefix value="P0100H"/> <text value="Used in Chair or Out of Bed. Other"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Not used"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA157-0"/> <display value="Not used"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Used less than daily"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA158-8"/> <display value="Used less than daily"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Used daily"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA159-6"/> <display value="Used daily"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="Section-51/P0200"/> <code> <system value="http://loinc.org"/> <code value="88309-0"/> <display value="Alarms"/> </code> <prefix value="P0200"/> <text value="Alarms. An alarm is any physical or electronic device that monitors {patient/resident} movement and alerts the staff when movement is detected"/> <type value="group"/> <repeats value="false"/> <readOnly value="true"/> <item> <linkId value="Section-51/P0200A"/> <code> <system value="http://loinc.org"/> <code value="88310-8"/> <display value="Bed alarm used during 7D assessment period"/> </code> <prefix value="P0200A"/> <text value="Bed alarm"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Not used"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA157-0"/> <display value="Not used"/> </valueCoding> </answerOption> <answerOption> <valueCoding> 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<display value="Used less than daily"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Used daily"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA159-6"/> <display value="Used daily"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-51/P0200D"/> <code> <system value="http://loinc.org"/> <code value="88313-2"/> <display value="Motion sensor alarm used during 7D assessment period"/> </code> <prefix value="P0200D"/> <text value="Motion sensor alarm"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Not used"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA157-0"/> <display value="Not used"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Used less than daily"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA158-8"/> <display value="Used less than daily"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Used daily"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA159-6"/> <display value="Used daily"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-51/P0200E"/> <code> <system value="http://loinc.org"/> <code value="88314-0"/> <display value="Wander or elopement alarm used during 7D assessment period"/> </code> <prefix value="P0200E"/> <text value="Wander/elopement alarm"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Not used"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA157-0"/> <display value="Not used"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Used less than daily"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA158-8"/> <display value="Used less than daily"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Used daily"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA159-6"/> <display value="Used daily"/> </valueCoding> </answerOption> </item> <item> <linkId value="Section-51/P0200F"/> <code> <system value="http://loinc.org"/> <code value="88308-2"/> <display value="Other alarm used during 7D assessment period"/> </code> <prefix value="P0200F"/> <text value="Other alarm"/> <type value="choice"/> <repeats value="false"/> <readOnly value="false"/> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="-"/> <display value="Not assessed/no information"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="0"/> <display value="Not used"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA157-0"/> <display value="Not used"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="1"/> <display value="Used less than daily"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA158-8"/> <display value="Used less than daily"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://del.cms.gov"/> <code value="2"/> <display value="Used daily"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://loinc.org"/> <code value="LA159-6"/> <display value="Used daily"/> </valueCoding> </answerOption> </item> </item> </item> </Questionnaire>

MDS3_0_NC standard form version 1.17.

The MDS is a powerful tool for implementing standardized assessment and for facilitating care management in nursing homes (NHs) and non-critical access hospital swing beds (SBs).