# MDS v3.0 - RAI v1.17.1, 1.17.2 - Nursing home comprehensive (NC) item set - PACIO Sample Data Depot v0.1.0

* [**Table of Contents**](toc.md)
* [**Artifacts Summary**](artifacts.md)
* **MDS v3.0 - RAI v1.17.1, 1.17.2 - Nursing home comprehensive (NC) item set**

## Questionnaire: MDS v3.0 - RAI v1.17.1, 1.17.2 - Nursing home comprehensive (NC) item set 

| | |
| :--- | :--- |
| *Official URL*:http://loinc.org/q/90473-0 | *Version*:0.1.0 |
| Draft as of 2025-12-02 | *Computable Name*:MDS_v3_RAI_v1_Nursing_home_comprehensive_NC_item_set |
| **Copyright/Legal**: This material contains content from LOINC (http://loinc.org). LOINC is copyright © Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee. All rights reserved. LOINC is available at no cost under the license at http://loinc.org/license. LOINC® is a registered United States trademark of Regenstrief Institute, Inc. Copyright © 2003 Sharon K. Inouye, M.D., MPH. Adapted from: Inouye SK, vanDyck CH, Alessi CA, Balkin S, Siegal AP, Horwitz RI. Clarifying confusion: The Confusion Assessment Method. A new method for detection of delirium. Ann Intern Med. 1990; 113: 941-948. Confusion Assessment Method: Training Manual and Coding Guide. Used with permission. Copyright © Pfizer Inc. All rights reserved. Developed by Drs. Robert L. Spitzer, Janet B.W. Williams, Kurt Kroenke and colleagues, with an educational grant from Pfizer Inc. No permission required to reproduce, translate, display or distribute. | |

version: 14; Last updated: 2025-02-26 20:49:17+0000; 

Information Source: #e6hBXlNCA3ym4tDd

**Structure**

* [LinkID](https://hl7.org/fhir/R4/formats.html#table): MDS_v3_RAI_v1_Nursing_home_comprehensive_NC_item_set
  * [Text](https://hl7.org/fhir/R4/formats.html#table): 
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 
  * [Type](https://hl7.org/fhir/R4/formats.html#table): Questionnaire
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): http://loinc.org/q/90473-0#0.1.0
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)105334
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A. Identification Information
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102711
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A0050. Type of Record
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.102711)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)102712
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A0100. Facility Provider Numbers
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-string.png)102713
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A0100A. National Provider Identifier (NPI)
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [string](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-string.png)102714
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A0100B. CMS Certification Number (CCN)
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [string](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-string.png)102715
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A0100C. State Provider Number
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [string](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102716
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A0200. Type of Provider
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.102716)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)110660
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A0300. Optional State Assessment
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)105339
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A0300A. Is this assessment for state payment purposes only?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.105339)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)105364
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A0310. Type of Assessment
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102718
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A0310A. Federal OBRA Reason for Assessment
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[7 options](#opt-item.102718)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102719
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A0310B. PPS Assessment
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.102719)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102722
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A0310E. Is this assessment the first assessment (OBRA, Scheduled PPS, or Discharge) since the most recent admission/entry or reentry?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.102722)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102723
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A0310F. Entry/discharge reporting
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[5 options](#opt-item.102723)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102724
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A0310G. Type of discharge
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.102724)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)105365
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A0310G1. Is this a SNF Part A Interrupted Stay?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.105365)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102725
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A0310H. Is this a SNF Part A PPS Discharge Assessment?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.102725)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102726
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A0410. Unit Certification or Licensure Designation
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.102726)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)102727
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A0500. Legal Name of Resident
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-string.png)102728
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A0500A. First name
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [string](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-string.png)102729
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A0500B. Middle initial
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [string](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-string.png)102730
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A0500C. Last name
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [string](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-string.png)102731
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A0500D. Suffix
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [string](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)102732
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A0600. Social Security and Medicare Numbers
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-string.png)102733
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A0600A. Social Security Number
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [string](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-string.png)102734
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A0600B. Medicare number
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [string](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-string.png)102735
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A0700. Medicaid Number
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [string](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102736
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A0800. Gender
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.102736)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)102737
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A0900. Birth Date
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102738
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A1000. Race/Ethnicity
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..*
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[6 options](#opt-item.102738)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)102739
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A1100. Language
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102740
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A1100A. Does the resident need or want an interpreter to communicate with a doctor or health care staff?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.102740)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102741
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A1100B. Preferred language
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[6 options](#opt-item.102741)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102742
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A1200. Marital Status
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[5 options](#opt-item.102742)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)102743
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A1300. Optional Resident Items
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-string.png)102744
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A1300A. Medical record number
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [string](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-string.png)102745
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A1300B. Room number
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [string](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-string.png)102746
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A1300C. Name by which resident prefers to be addressed
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [string](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102747
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A1300D. Lifetime occupation(s)
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[1 option](#opt-item.102747)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102748
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A1500. 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?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.102748)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102749
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A1510. Level II Preadmission Screening and Resident Review (PASRR) Conditions
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..*
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.102749)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102750
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A1550. Conditions Related to ID/DD Status
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..*
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[6 options](#opt-item.102750)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)102751
  * [Text](https://hl7.org/fhir/R4/formats.html#table): Most Recent Admission/Entry or Reentry into this Facility
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)102752
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A1600. Entry Date
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102753
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A1700. Type of Entry
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.102753)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102754
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A1800. Entered From
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[9 options](#opt-item.102754)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)102755
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A1900. Admission Date
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)102756
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A2000. Discharge Date
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102757
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A2100. Discharge Status
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102757)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-date.png)102758
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A2200. Previous Assessment Reference Date for Significant Correction
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [date](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-date)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-date.png)102759
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A2300. Assessment Reference Date. Observation end date
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [date](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-date)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)102760
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A2400. Medicare Stay
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102761
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A2400A. Has the resident had a Medicare-covered stay since the most recent entry?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.102761)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-date.png)102762
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A2400B. Start date of most recent Medicare stay
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [date](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-date)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-date.png)102763
  * [Text](https://hl7.org/fhir/R4/formats.html#table): A2400C. End date of most recent Medicare stay
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [date](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-date)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)102764
  * [Text](https://hl7.org/fhir/R4/formats.html#table): B. Hearing, Speech, and Vision
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102765
  * [Text](https://hl7.org/fhir/R4/formats.html#table): B0100. Comatose
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.102765)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102766
  * [Text](https://hl7.org/fhir/R4/formats.html#table): B0200. Hearing
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[4 options](#opt-item.102766)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102767
  * [Text](https://hl7.org/fhir/R4/formats.html#table): B0300. Hearing Aid
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.102767)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102768
  * [Text](https://hl7.org/fhir/R4/formats.html#table): B0600. Speech Clarity
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.102768)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102769
  * [Text](https://hl7.org/fhir/R4/formats.html#table): B0700. Makes Self Understood
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[4 options](#opt-item.102769)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102770
  * [Text](https://hl7.org/fhir/R4/formats.html#table): B0800. Ability to Understand Others
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[4 options](#opt-item.102770)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102771
  * [Text](https://hl7.org/fhir/R4/formats.html#table): B1000. Vision
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[5 options](#opt-item.102771)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102772
  * [Text](https://hl7.org/fhir/R4/formats.html#table): B1200. Corrective Lenses
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.102772)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)102773
  * [Text](https://hl7.org/fhir/R4/formats.html#table): C. Cognitive Patterns
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)129944
  * [Text](https://hl7.org/fhir/R4/formats.html#table): C0100. Should Brief Interview for Mental Status (C0200-C0500) be Conducted?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.129944)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)129945
  * [Text](https://hl7.org/fhir/R4/formats.html#table): Brief Interview for Mental Status (BIMS)
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)129946
  * [Text](https://hl7.org/fhir/R4/formats.html#table): C0200. Repetition of Three Words
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[4 options](#opt-item.129946)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)129947
  * [Text](https://hl7.org/fhir/R4/formats.html#table): C0300. Temporal Orientation
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)129948
  * [Text](https://hl7.org/fhir/R4/formats.html#table): C0300A. Able to report correct year
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[4 options](#opt-item.129948)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)129949
  * [Text](https://hl7.org/fhir/R4/formats.html#table): C0300B. Able to report correct month
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.129949)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)129950
  * [Text](https://hl7.org/fhir/R4/formats.html#table): C0300C. Able to report correct day of the week
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.129950)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)129951
  * [Text](https://hl7.org/fhir/R4/formats.html#table): C0400. Recall
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)129952
  * [Text](https://hl7.org/fhir/R4/formats.html#table): C0400A. Able to recall "sock"
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.129952)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)129953
  * [Text](https://hl7.org/fhir/R4/formats.html#table): C0400B. Able to recall "blue"
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.129953)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)129954
  * [Text](https://hl7.org/fhir/R4/formats.html#table): C0400C. Able to recall "bed"
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.129954)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)129955
  * [Text](https://hl7.org/fhir/R4/formats.html#table): C0500. BIMS Summary Score
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)129956
  * [Text](https://hl7.org/fhir/R4/formats.html#table): C0600. Should the Staff Assessment for Mental Status (C0700-C1000) be Conducted?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.129956)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)129940
  * [Text](https://hl7.org/fhir/R4/formats.html#table): Staff assessment for mental status
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)129960
  * [Text](https://hl7.org/fhir/R4/formats.html#table): Short-term memory OK
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.129960)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)129959
  * [Text](https://hl7.org/fhir/R4/formats.html#table): Long-term memory OK
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.129959)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)129958
  * [Text](https://hl7.org/fhir/R4/formats.html#table): Memory &or recall ability
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[5 options](#opt-item.129958)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)129957
  * [Text](https://hl7.org/fhir/R4/formats.html#table): Cognitive skills for daily decision making
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[4 options](#opt-item.129957)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)129961
  * [Text](https://hl7.org/fhir/R4/formats.html#table): Delirium
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)129962
  * [Text](https://hl7.org/fhir/R4/formats.html#table): Signs and Symptoms of Delirium (from CAM)
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)129966
  * [Text](https://hl7.org/fhir/R4/formats.html#table): Acute onset mental change. Is there evidence of an acute change in mental status from the patient's baseline?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.129966)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)129965
  * [Text](https://hl7.org/fhir/R4/formats.html#table): Inattention - Did the patient have difficulty focusing attention, for example, being easily distractible or having difficulty keeping track of what was being said?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.129965)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)129964
  * [Text](https://hl7.org/fhir/R4/formats.html#table): Disorganized thinking - Was the patient's thinking disorganized or incoherent, such as rambling or irrelevant conversation, unclear or illogical flow of ideas, or unpredictable switching from subject to subject)?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.129964)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)129963
  * [Text](https://hl7.org/fhir/R4/formats.html#table): Altered level of consciousness - Did the resident have altered level of consciousness, as indicated by any of the following crfiteria?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.129963)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)105758
  * [Text](https://hl7.org/fhir/R4/formats.html#table): D. Mood
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102799
  * [Text](https://hl7.org/fhir/R4/formats.html#table): D0100. Should Resident Mood Interview be Conducted?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.102799)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)102800
  * [Text](https://hl7.org/fhir/R4/formats.html#table): D0200. Resident Mood Interview (PHQ-9)
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)102801
  * [Text](https://hl7.org/fhir/R4/formats.html#table): D0200_1. Symptom Presence
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102802
  * [Text](https://hl7.org/fhir/R4/formats.html#table): D0200A1. Little interest or pleasure in doing things
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.102802)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102803
  * [Text](https://hl7.org/fhir/R4/formats.html#table): D0200B1. Feeling down, depressed or hopeless
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.102803)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102804
  * [Text](https://hl7.org/fhir/R4/formats.html#table): D0200C1. Trouble falling or staying asleep, or sleeping too much
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.102804)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102805
  * [Text](https://hl7.org/fhir/R4/formats.html#table): D0200D1. Feeling tired or having little energy
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.102805)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102806
  * [Text](https://hl7.org/fhir/R4/formats.html#table): D0200E1. Poor appetite or overeating
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.102806)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102807
  * [Text](https://hl7.org/fhir/R4/formats.html#table): D0200F1. Feeling bad about yourself - or that you are a failure or have let yourself or your family down
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.102807)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102808
  * [Text](https://hl7.org/fhir/R4/formats.html#table): D0200G1. Trouble concentrating on things, such as reading the newspaper or watching television
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.102808)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102809
  * [Text](https://hl7.org/fhir/R4/formats.html#table): D0200H1. 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
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.102809)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102810
  * [Text](https://hl7.org/fhir/R4/formats.html#table): D0200I1. Thoughts that you would be better off dead, or of hurting yourself in some way
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.102810)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)102811
  * [Text](https://hl7.org/fhir/R4/formats.html#table): D0200_2. Symptom Frequency
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102812
  * [Text](https://hl7.org/fhir/R4/formats.html#table): D0200A2. Little interest or pleasure in doing things
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[4 options](#opt-item.102812)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102813
  * [Text](https://hl7.org/fhir/R4/formats.html#table): D0200B2. Feeling down, depressed or hopeless
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[4 options](#opt-item.102813)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102814
  * [Text](https://hl7.org/fhir/R4/formats.html#table): D0200C2. Trouble falling or staying asleep, or sleeping too much
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[4 options](#opt-item.102814)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102815
  * [Text](https://hl7.org/fhir/R4/formats.html#table): D0200D2. Feeling tired or having little energy
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[4 options](#opt-item.102815)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102816
  * [Text](https://hl7.org/fhir/R4/formats.html#table): D0200E2. Poor appetite or overeating
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[4 options](#opt-item.102816)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102817
  * [Text](https://hl7.org/fhir/R4/formats.html#table): D0200F2. Feeling bad about yourself - or that you are a failure or have let yourself or your family down
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[4 options](#opt-item.102817)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102818
  * [Text](https://hl7.org/fhir/R4/formats.html#table): D0200G2. Trouble concentrating on things, such as reading the newspaper or watching television
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[4 options](#opt-item.102818)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102819
  * [Text](https://hl7.org/fhir/R4/formats.html#table): D0150H2. 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
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[4 options](#opt-item.102819)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102820
  * [Text](https://hl7.org/fhir/R4/formats.html#table): D0200I2. Thoughts that you would be better off dead, or of hurting yourself in some way
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[4 options](#opt-item.102820)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)102821
  * [Text](https://hl7.org/fhir/R4/formats.html#table): D0300. Total Severity Score
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)102823
  * [Text](https://hl7.org/fhir/R4/formats.html#table): D0500. Staff Assessment of Resident Mood (PHQ-9-OV)
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)102824
  * [Text](https://hl7.org/fhir/R4/formats.html#table): D0500_1. Symptom Presence
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102825
  * [Text](https://hl7.org/fhir/R4/formats.html#table): D0500A1. Little interest or pleasure in doing things
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.102825)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102826
  * [Text](https://hl7.org/fhir/R4/formats.html#table): D0500B1. Feeling or appearing down, depressed, or hopeless
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.102826)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102827
  * [Text](https://hl7.org/fhir/R4/formats.html#table): D0500C1. Trouble falling or staying asleep, or sleeping too much
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.102827)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102828
  * [Text](https://hl7.org/fhir/R4/formats.html#table): D0500D1. Feeling tired or having little energy
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.102828)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102829
  * [Text](https://hl7.org/fhir/R4/formats.html#table): D0500E1. Poor appetite or overeating
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.102829)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102830
  * [Text](https://hl7.org/fhir/R4/formats.html#table): D0500F1. Indicating that s/he feels bad about self, is a failure, or has let self or family down
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.102830)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102831
  * [Text](https://hl7.org/fhir/R4/formats.html#table): D0500G1. Trouble concentrating on things, such as reading the newspaper or watching television
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.102831)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102832
  * [Text](https://hl7.org/fhir/R4/formats.html#table): D0500H1. 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
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.102832)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102833
  * [Text](https://hl7.org/fhir/R4/formats.html#table): D0500I1. States that life isn't worth living, wishes for death, or attempts to harm self
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.102833)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102834
  * [Text](https://hl7.org/fhir/R4/formats.html#table): D0500J1. Being short-tempered, easily annoyed
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.102834)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)102835
  * [Text](https://hl7.org/fhir/R4/formats.html#table): D0500_2. Symptom Frequency
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102836
  * [Text](https://hl7.org/fhir/R4/formats.html#table): D0500A2. Little interest or pleasure in doing things
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[4 options](#opt-item.102836)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102837
  * [Text](https://hl7.org/fhir/R4/formats.html#table): D0500B2. Feeling or appearing down, depressed, or hopeless
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[4 options](#opt-item.102837)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102838
  * [Text](https://hl7.org/fhir/R4/formats.html#table): D0500C2. Trouble falling or staying asleep, or sleeping too much
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[4 options](#opt-item.102838)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102839
  * [Text](https://hl7.org/fhir/R4/formats.html#table): D0500D2. Feeling tired or having little energy
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[4 options](#opt-item.102839)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102840
  * [Text](https://hl7.org/fhir/R4/formats.html#table): D0500E2. Poor appetite or overeating
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[4 options](#opt-item.102840)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102841
  * [Text](https://hl7.org/fhir/R4/formats.html#table): D0500F2. Indicating that s/he feels bad about self, is a failure, or has let self or family down
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[4 options](#opt-item.102841)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102842
  * [Text](https://hl7.org/fhir/R4/formats.html#table): D0500G2. Trouble concentrating on things, such as reading the newspaper or watching television
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[4 options](#opt-item.102842)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102843
  * [Text](https://hl7.org/fhir/R4/formats.html#table): D0500H2. 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
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[4 options](#opt-item.102843)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102844
  * [Text](https://hl7.org/fhir/R4/formats.html#table): D0500I2. States that life isn't worth living, wishes for death, or attempts to harm self
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[4 options](#opt-item.102844)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102845
  * [Text](https://hl7.org/fhir/R4/formats.html#table): D0500J2. Being short-tempered, easily annoyed
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[4 options](#opt-item.102845)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)102846
  * [Text](https://hl7.org/fhir/R4/formats.html#table): D0600. Total Severity Score
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)102848
  * [Text](https://hl7.org/fhir/R4/formats.html#table): E. Behavior
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102849
  * [Text](https://hl7.org/fhir/R4/formats.html#table): E0100. Potential Indicators of Psychosis
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..*
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.102849)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)102850
  * [Text](https://hl7.org/fhir/R4/formats.html#table): E0200. Behavioral Symptom - Presence & Frequency
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102851
  * [Text](https://hl7.org/fhir/R4/formats.html#table): E0200A. Physical behavioral symptoms directed toward others
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[4 options](#opt-item.102851)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102852
  * [Text](https://hl7.org/fhir/R4/formats.html#table): E0200B. Verbal behavioral symptoms directed toward others
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[4 options](#opt-item.102852)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102853
  * [Text](https://hl7.org/fhir/R4/formats.html#table): E0200C. Other behavioral symptoms not directed toward others
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[4 options](#opt-item.102853)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102854
  * [Text](https://hl7.org/fhir/R4/formats.html#table): E0300. Overall Presence of Behavioral Symptoms.Were any behavioral symptoms in questions E0200 coded 1, 2, or 3?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.102854)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)102855
  * [Text](https://hl7.org/fhir/R4/formats.html#table): E0500. Impact on Resident
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102856
  * [Text](https://hl7.org/fhir/R4/formats.html#table): E0500A. Did any of the identified symptom(s): Put the resident at significant risk for physical illness or injury?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.102856)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102857
  * [Text](https://hl7.org/fhir/R4/formats.html#table): E0500B. Did any of the identified symptom(s): Significantly interfere with the resident's care?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.102857)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102858
  * [Text](https://hl7.org/fhir/R4/formats.html#table): E0500C. Did any of the identified symptom(s): Significantly interfere with the resident's participation in activities or social interactions?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.102858)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)102859
  * [Text](https://hl7.org/fhir/R4/formats.html#table): E0600. Impact on Others
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102860
  * [Text](https://hl7.org/fhir/R4/formats.html#table): E0600A. Did any of the identified symptom(s): Put others at significant risk for physical injury?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.102860)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102861
  * [Text](https://hl7.org/fhir/R4/formats.html#table): E0600B. Did any of the identified symptom(s): Significantly intrude on the privacy or activity of others?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.102861)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102862
  * [Text](https://hl7.org/fhir/R4/formats.html#table): E0600C. Did any of the identified symptom(s): Significantly disrupt care or living environment?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.102862)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102863
  * [Text](https://hl7.org/fhir/R4/formats.html#table): E0800. Rejection of Care - Presence & Frequency. Did the resident reject evaluation or care (e.g., bloodwork, taking medications, ADL assistance) that is necessary to achieve the resident's goals for health and well-being?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[4 options](#opt-item.102863)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102864
  * [Text](https://hl7.org/fhir/R4/formats.html#table): E0900. Wandering - Presence & Frequency. Has the resident wandered?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[4 options](#opt-item.102864)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)102865
  * [Text](https://hl7.org/fhir/R4/formats.html#table): E1000. Wandering - Impact
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102866
  * [Text](https://hl7.org/fhir/R4/formats.html#table): E1000A. Does the wandering place the resident at significant risk of getting to a potentially dangerous place?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.102866)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102867
  * [Text](https://hl7.org/fhir/R4/formats.html#table): E1000B. Does the wandering significantly intrude on the privacy or activities of others?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.102867)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102868
  * [Text](https://hl7.org/fhir/R4/formats.html#table): E1100. Change in Behavior or Other Symptoms.How does resident's current behavior status, care rejection, or wandering compare to prior assessment (OBRA or Scheduled PPS)?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[4 options](#opt-item.102868)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)102869
  * [Text](https://hl7.org/fhir/R4/formats.html#table): F. Preferences for Customary Routine and Activities
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102870
  * [Text](https://hl7.org/fhir/R4/formats.html#table): F0300. Should Interview for Daily and Activity Preferences be Conducted?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.102870)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)102871
  * [Text](https://hl7.org/fhir/R4/formats.html#table): F0400. Interview for Daily Preferences
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102872
  * [Text](https://hl7.org/fhir/R4/formats.html#table): F0400A. While you are in this facility how important is it to you to choose what clothes to wear?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[6 options](#opt-item.102872)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102873
  * [Text](https://hl7.org/fhir/R4/formats.html#table): F0400B. While you are in this facility how important is it to you to take care of your personal belongings or things?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[6 options](#opt-item.102873)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102874
  * [Text](https://hl7.org/fhir/R4/formats.html#table): F0400C. While you are in this facility how important is it to you to choose between a tub bath, shower, bed bath, or sponge bath?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[6 options](#opt-item.102874)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102875
  * [Text](https://hl7.org/fhir/R4/formats.html#table): F0400D. While you are in this facility how important is it to you to have snacks available between meals?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[6 options](#opt-item.102875)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102876
  * [Text](https://hl7.org/fhir/R4/formats.html#table): F0400E. While you are in this facility how important is it to you to choose your own bedtime?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[6 options](#opt-item.102876)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102877
  * [Text](https://hl7.org/fhir/R4/formats.html#table): F0400F. While you are in this facility how important is it to you to have your family or a close friend involved in discussions about your care?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[6 options](#opt-item.102877)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102878
  * [Text](https://hl7.org/fhir/R4/formats.html#table): F0400G. While you are in this facility how important is it to you to be able to use the phone in private?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[6 options](#opt-item.102878)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102879
  * [Text](https://hl7.org/fhir/R4/formats.html#table): F0400H. While you are in this facility how important is it to you to have a place to lock your things to keep them safe?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[6 options](#opt-item.102879)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)102880
  * [Text](https://hl7.org/fhir/R4/formats.html#table): F0500. Interview for Activity Preferences
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102881
  * [Text](https://hl7.org/fhir/R4/formats.html#table): F0500A. While you are in this facility how important is it to you to have books, newspapers, and magazines to read?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[6 options](#opt-item.102881)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102882
  * [Text](https://hl7.org/fhir/R4/formats.html#table): F0500B. While you are in this facility how important is it to you to listen to music you like?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[6 options](#opt-item.102882)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102883
  * [Text](https://hl7.org/fhir/R4/formats.html#table): F0500C. While you are in this facility how important is it to you to be around animals such as pets?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[6 options](#opt-item.102883)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102884
  * [Text](https://hl7.org/fhir/R4/formats.html#table): F0500D. While you are in this facility how important is it to you to keep up with the news?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[6 options](#opt-item.102884)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102885
  * [Text](https://hl7.org/fhir/R4/formats.html#table): F0500E. While you are in this facility how important is it to you to do things with groups of people?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[6 options](#opt-item.102885)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102886
  * [Text](https://hl7.org/fhir/R4/formats.html#table): F0500F. While you are in this facility how important is it to you to do your favorite activities?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[6 options](#opt-item.102886)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102887
  * [Text](https://hl7.org/fhir/R4/formats.html#table): F0500G. While you are in this facility how important is it to you to go outside to get fresh air when the weather is good?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[6 options](#opt-item.102887)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102888
  * [Text](https://hl7.org/fhir/R4/formats.html#table): F0500H. While you are in this facility how important is it to you to participate in religious services or practices?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[6 options](#opt-item.102888)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102889
  * [Text](https://hl7.org/fhir/R4/formats.html#table): F0600. Daily and Activity Preferences Primary Respondent. Indicate primary respondent for Daily and Activity Preferences (F0400 and F0500)
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.102889)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102890
  * [Text](https://hl7.org/fhir/R4/formats.html#table): F0700. Should the Staff Assessment of Daily and Activity Preferences be Conducted?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.102890)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102891
  * [Text](https://hl7.org/fhir/R4/formats.html#table): F0800. Staff Assessment of Daily and Activity Preferences. Resident Prefers:
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[21 options](#opt-item.102891)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)102892
  * [Text](https://hl7.org/fhir/R4/formats.html#table): G. Functional Status
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)102893
  * [Text](https://hl7.org/fhir/R4/formats.html#table): G0110_1. Activities of Daily Living (ADL) Assistance. Self-Performance
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102894
  * [Text](https://hl7.org/fhir/R4/formats.html#table): G0110A1. Bed mobility
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[7 options](#opt-item.102894)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102895
  * [Text](https://hl7.org/fhir/R4/formats.html#table): G0110B1. Transfer
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[7 options](#opt-item.102895)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102896
  * [Text](https://hl7.org/fhir/R4/formats.html#table): G0110C1. Walk in room
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[7 options](#opt-item.102896)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102897
  * [Text](https://hl7.org/fhir/R4/formats.html#table): G0110D1. Walk in corridor
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[7 options](#opt-item.102897)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102898
  * [Text](https://hl7.org/fhir/R4/formats.html#table): G0110E1. Locomotion on unit
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[7 options](#opt-item.102898)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102899
  * [Text](https://hl7.org/fhir/R4/formats.html#table): G0110F1. Locomotion off unit
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[7 options](#opt-item.102899)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102900
  * [Text](https://hl7.org/fhir/R4/formats.html#table): G0110G1. Dressing
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[7 options](#opt-item.102900)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102901
  * [Text](https://hl7.org/fhir/R4/formats.html#table): G0110H1. Eating
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[7 options](#opt-item.102901)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102902
  * [Text](https://hl7.org/fhir/R4/formats.html#table): G0110I1. Toilet use
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[7 options](#opt-item.102902)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102903
  * [Text](https://hl7.org/fhir/R4/formats.html#table): G0110J1. Personal hygiene
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102903)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)102904
  * [Text](https://hl7.org/fhir/R4/formats.html#table): G0110_2. Activities of Daily Living (ADL) Assistance. Support Provided
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102905
  * [Text](https://hl7.org/fhir/R4/formats.html#table): G0110A2. Bed mobility
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[5 options](#opt-item.102905)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102906
  * [Text](https://hl7.org/fhir/R4/formats.html#table): G0110B2. Transfer
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[5 options](#opt-item.102906)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102907
  * [Text](https://hl7.org/fhir/R4/formats.html#table): G0110C2. Walk in room
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[5 options](#opt-item.102907)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102908
  * [Text](https://hl7.org/fhir/R4/formats.html#table): G0110D2. Walk in corridor
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[5 options](#opt-item.102908)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102909
  * [Text](https://hl7.org/fhir/R4/formats.html#table): G0110E2. Locomotion on unit
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[5 options](#opt-item.102909)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102910
  * [Text](https://hl7.org/fhir/R4/formats.html#table): G0110F2. Locomotion off unit
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[5 options](#opt-item.102910)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102911
  * [Text](https://hl7.org/fhir/R4/formats.html#table): G0110G2. Dressing
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[5 options](#opt-item.102911)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102912
  * [Text](https://hl7.org/fhir/R4/formats.html#table): G0110H2. Eating
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[5 options](#opt-item.102912)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102913
  * [Text](https://hl7.org/fhir/R4/formats.html#table): G0110I2. Toilet use
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[5 options](#opt-item.102913)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102914
  * [Text](https://hl7.org/fhir/R4/formats.html#table): G0110J2. Personal hygiene
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[5 options](#opt-item.102914)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)102915
  * [Text](https://hl7.org/fhir/R4/formats.html#table): G0120. Bathing
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102916
  * [Text](https://hl7.org/fhir/R4/formats.html#table): G0120A. Self-performance
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[6 options](#opt-item.102916)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102917
  * [Text](https://hl7.org/fhir/R4/formats.html#table): G0120B. Support provided
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[5 options](#opt-item.102917)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)102918
  * [Text](https://hl7.org/fhir/R4/formats.html#table): G0300. Balance During Transitions and Walking
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102919
  * [Text](https://hl7.org/fhir/R4/formats.html#table): G0300A. Moving from seated to standing position
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[4 options](#opt-item.102919)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102920
  * [Text](https://hl7.org/fhir/R4/formats.html#table): G0300B. Walking (with assistive device if used)
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[4 options](#opt-item.102920)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102921
  * [Text](https://hl7.org/fhir/R4/formats.html#table): G0300C. Turning around and facing the opposite direction while walking
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[4 options](#opt-item.102921)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102922
  * [Text](https://hl7.org/fhir/R4/formats.html#table): G0300D. Moving on and off toilet
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[4 options](#opt-item.102922)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102923
  * [Text](https://hl7.org/fhir/R4/formats.html#table): G0300E. Surface-to-surface transfer (transfer between bed and chair or wheelchair)
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[4 options](#opt-item.102923)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)112227
  * [Text](https://hl7.org/fhir/R4/formats.html#table): G0400. Functional Limitation in Range of Motion
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)112228
  * [Text](https://hl7.org/fhir/R4/formats.html#table): G0400A. Upper extremity (shoulder, elbow, wrist, hand)
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.112228)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)112229
  * [Text](https://hl7.org/fhir/R4/formats.html#table): G0400B. Lower extremity (hip, knee, ankle, foot)
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.112229)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102927
  * [Text](https://hl7.org/fhir/R4/formats.html#table): G0600. Mobility Devices
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..*
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[5 options](#opt-item.102927)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)102928
  * [Text](https://hl7.org/fhir/R4/formats.html#table): G0900. Functional Rehabilitation Potential
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102929
  * [Text](https://hl7.org/fhir/R4/formats.html#table): G0900A. Resident believes he or she is capable of increased independence in at least some ADLs.
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.102929)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102930
  * [Text](https://hl7.org/fhir/R4/formats.html#table): G0900B. Direct care staff believe resident is capable of increased independence in at least some ADLs
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.102930)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)102931
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG. Functional Abilities and Goals - Start of SNF PPS Stay or State PDPM
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)102932
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0100. Prior Functioning: Everyday Activities
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102933
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0100A. Self-Care
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[5 options](#opt-item.102933)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102934
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0100B. Indoor Mobility (Ambulation)
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[5 options](#opt-item.102934)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102935
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0100C. Stairs
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[5 options](#opt-item.102935)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102936
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0100D. Functional Cognition
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[5 options](#opt-item.102936)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102937
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0110. Prior Device Use
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..*
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[6 options](#opt-item.102937)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)102938
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0130_1. Self-Care - Admission Performance
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102939
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0130A1. Eating
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102939)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102940
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0130B1. Oral hygiene
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102940)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102941
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0130C1. Toileting hygiene
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102941)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102942
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0130E1. Shower/bathe self
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102942)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102943
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0130F1. Upper body dressing
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102943)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102944
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0130G1. Lower body dressing
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102944)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102945
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0130H1. Putting on/taking off footwear
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102945)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)102946
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0130_2. Self-Care - Discharge Goal
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)136634
  * [Text](https://hl7.org/fhir/R4/formats.html#table): Oral hygiene - functional goal
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.136634)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)137359
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0130A2. Eating
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.137359)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102949
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0130C2. Toileting hygiene
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102949)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102950
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0130E2. Shower/bathe self
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102950)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102951
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0130F2. Upper body dressing
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102951)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102952
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0130G2. Lower body dressing
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102952)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102953
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0130H2. Putting on/taking off footwear
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102953)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)102954
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170_1. Mobility - Admission Performance
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102955
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170A1. Roll left and right
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102955)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102956
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170B1. Sit to lying
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102956)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102957
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170C1. Lying to sitting on side of bed
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102957)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102958
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170D1. Sit to stand
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102958)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102959
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170E1. Chair/bed-to-chair transfer
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102959)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102960
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170F1. Toilet transfer
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102960)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102961
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170G1. Car transfer
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102961)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102962
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170I1. Walk 10 feet
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102962)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102963
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170J1. Walk 50 feet with two turns
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102963)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102964
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170K1. Walk 150 feet
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102964)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102965
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170L1. Walking 10 feet on uneven surfaces
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102965)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102966
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170M1. 1 step (curb)
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102966)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102967
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170N1. 4 steps
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102967)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102968
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170O1. 12 steps
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102968)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102969
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170P1. Picking up object
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102969)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102970
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170Q1. Does the resident use a wheelchair and/or scooter?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.102970)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102971
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170R1. Wheel 50 feet with two turns
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102971)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102972
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170RR1. Indicate the type of wheelchair or scooter used
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.102972)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102973
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170S1. Wheel 150 feet
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102973)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102974
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170SS1. Indicate the type of wheelchair or scooter used
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.102974)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)102975
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170_2. Mobility - Discharge Goal
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102976
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170A2. Roll left and right
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102976)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102977
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170B2. Sit to lying
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102977)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102978
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170C2. Lying to sitting on side of bed
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102978)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102979
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170D2. Sit to stand
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102979)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102980
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170E2. Chair/bed-to-chair transfer
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102980)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102981
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170F2. Toilet transfer
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102981)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102982
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170G2. Car transfer
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102982)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102983
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170I2. Walk 10 feet
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102983)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102984
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170J2. Walk 50 feet with two turns
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102984)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102985
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170K2. Walk 150 feet
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102985)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102986
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170L2. Walking 10 feet on uneven surfaces
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102986)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102987
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170M2. 1 step (curb)
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102987)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102988
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170N2. 4 steps
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102988)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102989
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170O2. 12 steps
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102989)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102990
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170P2. Picking up object
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102990)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102991
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170R2. Wheel 50 feet with two turns
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102991)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102992
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170S2. Wheel 150 feet
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102992)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)102993
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG. Functional Abilities and Goals - Discharge (End of SNF PPS Stay)
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)102994
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0130_3. Self-Care - Discharge Performance
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102995
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0130A3. Eating
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102995)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102996
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0130B3. Oral hygiene
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102996)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102997
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0130C3. Toileting hygiene
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102997)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102998
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0130E3. Shower/bathe self
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102998)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)102999
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0130F3. Upper body dressing
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.102999)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103000
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0130G3. Lower body dressing
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.103000)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103001
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0130H3. Putting on/taking off footwear
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.103001)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)103002
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170_3. Mobility - Discharge Performance
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103003
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170A3. Roll left and right
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.103003)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103004
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170B3. Sit to lying
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.103004)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103005
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170C3. Lying to sitting on side of bed
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.103005)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103006
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170D3. Sit to stand
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.103006)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103007
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170E3. Chair/bed-to-chair transfer
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.103007)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103008
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170F3. Toilet transfer
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.103008)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103009
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170G3. Car transfer
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.103009)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103010
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170I3. Walk 10 feet
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.103010)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103011
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170J3. Walk 50 feet with two turns
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.103011)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103012
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170K3. Walk 150 feet
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.103012)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103013
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170L3. Walking 10 feet on uneven surfaces
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.103013)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103014
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170M3. 1 step (curb)
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.103014)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103015
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170N3. 4 steps
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.103015)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103016
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170O3. 12 steps
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.103016)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103017
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170P3. Picking up object
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.103017)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103018
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170Q3. Does the resident use a wheelchair and/or scooter?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.103018)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103019
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170R3. Wheel 50 feet with two turns
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.103019)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103020
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170RR3. Indicate the type of wheelchair or scooter used
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.103020)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103021
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170S3. Wheel 150 feet
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.103021)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103022
  * [Text](https://hl7.org/fhir/R4/formats.html#table): GG0170SS3. Indicate the type of wheelchair or scooter used
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.103022)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)103023
  * [Text](https://hl7.org/fhir/R4/formats.html#table): H. Bladder and Bowel
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103024
  * [Text](https://hl7.org/fhir/R4/formats.html#table): H0100. Appliances
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..*
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[5 options](#opt-item.103024)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)103025
  * [Text](https://hl7.org/fhir/R4/formats.html#table): H0200. Urinary Toileting Program
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103026
  * [Text](https://hl7.org/fhir/R4/formats.html#table): H0200A. Has a trial of a toileting program (e.g., scheduled toileting, prompted voiding, or bladder training) been attempted on admission/entry or reentry or since urinary incontinence was noted in this facility?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.103026)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103027
  * [Text](https://hl7.org/fhir/R4/formats.html#table): H0200B. Response - What was the resident's response to the trial program?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[4 options](#opt-item.103027)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103028
  * [Text](https://hl7.org/fhir/R4/formats.html#table): H0200C. Current toileting program or trial - Is a toileting program (e.g., scheduled toileting, prompted voiding, or bladder training) currently being used to manage the resident's urinary continence?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.103028)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103029
  * [Text](https://hl7.org/fhir/R4/formats.html#table): H0300. Urinary Continence
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[5 options](#opt-item.103029)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103030
  * [Text](https://hl7.org/fhir/R4/formats.html#table): H0400. Bowel Continence
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[5 options](#opt-item.103030)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103031
  * [Text](https://hl7.org/fhir/R4/formats.html#table): H0500. Bowel Toileting Program
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.103031)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103032
  * [Text](https://hl7.org/fhir/R4/formats.html#table): H0600. Bowel Patterns. Constipation present?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.103032)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)106149
  * [Text](https://hl7.org/fhir/R4/formats.html#table): I. Active Diagnoses
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103034
  * [Text](https://hl7.org/fhir/R4/formats.html#table): I0020. Indicate the resident's primary medical condition category
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[13 options](#opt-item.103034)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)106150
  * [Text](https://hl7.org/fhir/R4/formats.html#table): I0020B. ICD Code
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[1 option](#opt-item.106150)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103036
  * [Text](https://hl7.org/fhir/R4/formats.html#table): I0100-I7900. Active Diagnoses in the last 7 days
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..*
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[57 options](#opt-item.103036)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103037
  * [Text](https://hl7.org/fhir/R4/formats.html#table): I8000A-I8000J. Additional active diagnoses
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..*
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[1 option](#opt-item.103037)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)106182
  * [Text](https://hl7.org/fhir/R4/formats.html#table): J. Health Conditions
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)103039
  * [Text](https://hl7.org/fhir/R4/formats.html#table): J0100. Pain Management
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103040
  * [Text](https://hl7.org/fhir/R4/formats.html#table): J0100A. At any time in the last 5 days, has the resident: Received scheduled pain medication regimen?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.103040)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103041
  * [Text](https://hl7.org/fhir/R4/formats.html#table): J0100B. At any time in the last 5 days, has the resident: Received PRN pain medications OR was offered and declined?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.103041)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103042
  * [Text](https://hl7.org/fhir/R4/formats.html#table): J0100C. At any time in the last 5 days, has the resident: Received non-medication intervention for pain?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.103042)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103043
  * [Text](https://hl7.org/fhir/R4/formats.html#table): J0200. Should Pain Assessment Interview be Conducted?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.103043)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)103044
  * [Text](https://hl7.org/fhir/R4/formats.html#table): Pain Assessment Interview
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103045
  * [Text](https://hl7.org/fhir/R4/formats.html#table): J0300. Pain Presence. Have you had pain or hurting at any time in the last 5 days?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.103045)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103046
  * [Text](https://hl7.org/fhir/R4/formats.html#table): J0400. Pain Frequency. How much of the time have you experienced pain or hurting over the last 5 days?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[5 options](#opt-item.103046)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)103047
  * [Text](https://hl7.org/fhir/R4/formats.html#table): J0500. Pain Effect on Function
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103048
  * [Text](https://hl7.org/fhir/R4/formats.html#table): J0500A. Over the past 5 days, has pain made it hard for you to sleep at night?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.103048)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103049
  * [Text](https://hl7.org/fhir/R4/formats.html#table): J0500B. Over the past 5 days, have you limited your day-to-day activities because of pain?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.103049)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)103050
  * [Text](https://hl7.org/fhir/R4/formats.html#table): J0600. Pain Intensity
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-string.png)103051
  * [Text](https://hl7.org/fhir/R4/formats.html#table): J0600A. Numeric Rating Scale (00-10)
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [string](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103052
  * [Text](https://hl7.org/fhir/R4/formats.html#table): J0600B. Verbal Descriptor Scale
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[5 options](#opt-item.103052)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103053
  * [Text](https://hl7.org/fhir/R4/formats.html#table): J0700. Should the Staff Assessment for Pain be Conducted?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.103053)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)103054
  * [Text](https://hl7.org/fhir/R4/formats.html#table): Staff Assessment for Pain
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103055
  * [Text](https://hl7.org/fhir/R4/formats.html#table): J0800. Indicators of Pain or Possible Pain in the last 5 days
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..*
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[5 options](#opt-item.103055)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103056
  * [Text](https://hl7.org/fhir/R4/formats.html#table): J0850. Frequency of Indicator of Pain or Possible Pain in the last 5 days. Frequency with which resident complains or shows evidence of pain or possible pain
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.103056)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)103057
  * [Text](https://hl7.org/fhir/R4/formats.html#table): Other Health Conditions
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103058
  * [Text](https://hl7.org/fhir/R4/formats.html#table): J1100. Shortness of Breath (dyspnea)
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..*
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[4 options](#opt-item.103058)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103059
  * [Text](https://hl7.org/fhir/R4/formats.html#table): J1300. Current Tobacco Use
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.103059)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103060
  * [Text](https://hl7.org/fhir/R4/formats.html#table): J1400. Prognosis
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.103060)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103061
  * [Text](https://hl7.org/fhir/R4/formats.html#table): J1550. Problem Conditions
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..*
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[5 options](#opt-item.103061)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)103062
  * [Text](https://hl7.org/fhir/R4/formats.html#table): J1700. Fall History on Admission/Entry or Reentry
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103063
  * [Text](https://hl7.org/fhir/R4/formats.html#table): J1700A. Did the resident have a fall any time in the last month prior to admission/entry or reentry?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.103063)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103064
  * [Text](https://hl7.org/fhir/R4/formats.html#table): J1700B. Did the resident have a fall any time in the last 2-6 months prior to admission/entry or reentry?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.103064)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103065
  * [Text](https://hl7.org/fhir/R4/formats.html#table): J1700C. Did the resident have any fracture related to a fall in the 6 months prior to admission/entry or reentry?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.103065)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103066
  * [Text](https://hl7.org/fhir/R4/formats.html#table): J1800. Has the resident had any falls since admission/entry or reentry or the prior assessment (OBRA or Scheduled PPS), whichever is more recent?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.103066)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)103067
  * [Text](https://hl7.org/fhir/R4/formats.html#table): J1900. Number of Falls Since Admission/Entry or Reentry or Prior Assessment (OBRA or Scheduled PPS), whichever is more recent
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103068
  * [Text](https://hl7.org/fhir/R4/formats.html#table): J1900A. No injury
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.103068)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103069
  * [Text](https://hl7.org/fhir/R4/formats.html#table): J1900B. Injury (except major)
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.103069)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103070
  * [Text](https://hl7.org/fhir/R4/formats.html#table): J1900C. Major injury
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.103070)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103071
  * [Text](https://hl7.org/fhir/R4/formats.html#table): J2000. Prior Surgery
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.103071)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)106183
  * [Text](https://hl7.org/fhir/R4/formats.html#table): J2100. Recent Surgery Requiring Active SNF Care
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.106183)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)106184
  * [Text](https://hl7.org/fhir/R4/formats.html#table): J2300-J5000. Surgical Procedures
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[29 options](#opt-item.106184)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)106270
  * [Text](https://hl7.org/fhir/R4/formats.html#table): K. Swallowing/Nutritional Status
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103073
  * [Text](https://hl7.org/fhir/R4/formats.html#table): K0100. Swallowing Disorder. Signs and symptoms of possible swallowing disorder
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..*
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[5 options](#opt-item.103073)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)103074
  * [Text](https://hl7.org/fhir/R4/formats.html#table): K0200. Height and Weight
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103075
  * [Text](https://hl7.org/fhir/R4/formats.html#table): K0200A. Height (in inches)
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103076
  * [Text](https://hl7.org/fhir/R4/formats.html#table): K0200B. Weight (in pounds)
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103077
  * [Text](https://hl7.org/fhir/R4/formats.html#table): K0300. Weight Loss. Loss of 5% or more in the last month or loss of 10% or more in last 6 months
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.103077)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103078
  * [Text](https://hl7.org/fhir/R4/formats.html#table): K0310. Weight Gain. Gain of 5% or more in the last month or gain of 10% or more in last 6 months
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.103078)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)103079
  * [Text](https://hl7.org/fhir/R4/formats.html#table): K0510. Nutritional Approaches
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103080
  * [Text](https://hl7.org/fhir/R4/formats.html#table): K0510_1. Nutritional Approaches. While NOT a Resident
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..*
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.103080)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103081
  * [Text](https://hl7.org/fhir/R4/formats.html#table): K0510_2. Nutritional Approaches. While a Resident
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..*
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[5 options](#opt-item.103081)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)106271
  * [Text](https://hl7.org/fhir/R4/formats.html#table): K0710. Percent Intake by Artificial Route
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103084
  * [Text](https://hl7.org/fhir/R4/formats.html#table): K0710A2. Proportion of total calories the resident received through parenteral or tube feeding. While a Resident
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.103084)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103085
  * [Text](https://hl7.org/fhir/R4/formats.html#table): K0710A3. Proportion of total calories the resident received through parenteral or tube feeding. During Entire 7 Days
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.103085)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103087
  * [Text](https://hl7.org/fhir/R4/formats.html#table): K0710B2. Average fluid intake per day by IV or tube feeding. While a Resident
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.103087)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103088
  * [Text](https://hl7.org/fhir/R4/formats.html#table): K0710B3. Average fluid intake per day by IV or tube feeding. During Entire 7 Days
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.103088)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)103089
  * [Text](https://hl7.org/fhir/R4/formats.html#table): L. Oral/Dental Status
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103090
  * [Text](https://hl7.org/fhir/R4/formats.html#table): L0200. Dental
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..*
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[8 options](#opt-item.103090)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)103091
  * [Text](https://hl7.org/fhir/R4/formats.html#table): M. Skin Conditions
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103092
  * [Text](https://hl7.org/fhir/R4/formats.html#table): M0100. Determination of Pressure Ulcer/Injury Risk
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..*
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[4 options](#opt-item.103092)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103093
  * [Text](https://hl7.org/fhir/R4/formats.html#table): M0150. Risk of Pressure Ulcers/Injuries
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.103093)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103094
  * [Text](https://hl7.org/fhir/R4/formats.html#table): M0210. Unhealed Pressure Ulcers/Injuries
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.103094)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)103095
  * [Text](https://hl7.org/fhir/R4/formats.html#table): M0300. Current Number of Unhealed Pressure Ulcers/Injuries at Each Stage
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103096
  * [Text](https://hl7.org/fhir/R4/formats.html#table): M0300A1. Number of Stage 1 pressure injuries
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103097
  * [Text](https://hl7.org/fhir/R4/formats.html#table): M0300B1. Number of Stage 2 pressure ulcers
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103098
  * [Text](https://hl7.org/fhir/R4/formats.html#table): M0300B2. Number of these Stage 2 pressure ulcers that were present upon admission/entry or reentry
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103099
  * [Text](https://hl7.org/fhir/R4/formats.html#table): M0300C1. Number of Stage 3 pressure ulcers
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103100
  * [Text](https://hl7.org/fhir/R4/formats.html#table): M0300C2. Number of these Stage 3 pressure ulcers that were present upon admission/entry or reentry
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103101
  * [Text](https://hl7.org/fhir/R4/formats.html#table): M0300D1. Number of Stage 4 pressure ulcers
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103102
  * [Text](https://hl7.org/fhir/R4/formats.html#table): M0300D2. Number of these Stage 4 pressure ulcers that were present upon admission/entry or reentry
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103103
  * [Text](https://hl7.org/fhir/R4/formats.html#table): M0300E1. Number of unstageable pressure ulcers/injuries due to non-removable dressing/device
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103104
  * [Text](https://hl7.org/fhir/R4/formats.html#table): M0300E2. Number of these unstageable pressure ulcers/injuries that were present upon admission/entry or reentry
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103105
  * [Text](https://hl7.org/fhir/R4/formats.html#table): M0300F1. Number of unstageable pressure ulcers due to coverage of wound bed by slough and/or eschar
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103106
  * [Text](https://hl7.org/fhir/R4/formats.html#table): M0300F2. Number of these unstageable pressure ulcers that were present upon admission/entry or reentry
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103107
  * [Text](https://hl7.org/fhir/R4/formats.html#table): M0300G1. Number of unstageable pressure injuries presenting as deep tissue injury
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103108
  * [Text](https://hl7.org/fhir/R4/formats.html#table): M0300G2. Number of these unstageable pressure injuries that were present upon admission/entry or reentry
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103109
  * [Text](https://hl7.org/fhir/R4/formats.html#table): M1030. Number of Venous and Arterial Ulcers
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103110
  * [Text](https://hl7.org/fhir/R4/formats.html#table): M1040. Other Ulcers, Wounds and Skin Problems
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..*
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[9 options](#opt-item.103110)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103111
  * [Text](https://hl7.org/fhir/R4/formats.html#table): M1200. Skin and Ulcer/Injury Treatments
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..*
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[10 options](#opt-item.103111)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)103112
  * [Text](https://hl7.org/fhir/R4/formats.html#table): N. Medications
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103113
  * [Text](https://hl7.org/fhir/R4/formats.html#table): N0300. Injections. Record the number of days that injections of any type were received during the last 7 days or since admission/entry or reentry if less than 7 days.
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)103114
  * [Text](https://hl7.org/fhir/R4/formats.html#table): N0350. Insulin
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103115
  * [Text](https://hl7.org/fhir/R4/formats.html#table): N0350A. Insulin injections - Record the number of days that insulin injections were received during the last 7 days or since admission/entry or reentry if less than 7 days
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103116
  * [Text](https://hl7.org/fhir/R4/formats.html#table): N0350B. Orders for insulin - Record the number of days the physician (or authorized assistant or practitioner) changed the resident's insulin orders during the last 7 days or since admission/entry or reentry if less than 7 days
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)103117
  * [Text](https://hl7.org/fhir/R4/formats.html#table): N0410. Medications Received
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103118
  * [Text](https://hl7.org/fhir/R4/formats.html#table): N0410A. Antipsychotic
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103119
  * [Text](https://hl7.org/fhir/R4/formats.html#table): N0410B. Antianxiety
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103120
  * [Text](https://hl7.org/fhir/R4/formats.html#table): N0410C. Antidepressant
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103121
  * [Text](https://hl7.org/fhir/R4/formats.html#table): N0410D. Hypnotic
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103122
  * [Text](https://hl7.org/fhir/R4/formats.html#table): N0410E. Anticoagulant (e.g., warfarin, heparin, or low-molecular weight heparin)
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103123
  * [Text](https://hl7.org/fhir/R4/formats.html#table): N0410F. Antibiotic
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103124
  * [Text](https://hl7.org/fhir/R4/formats.html#table): N0410G. Diuretic
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103125
  * [Text](https://hl7.org/fhir/R4/formats.html#table): N0410H. Opioid
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)103126
  * [Text](https://hl7.org/fhir/R4/formats.html#table): N0450. Antipsychotic Medication Review
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103127
  * [Text](https://hl7.org/fhir/R4/formats.html#table): N0450A. Did the resident receive antipsychotic medications since admission/entry or reentry or the prior OBRA assessment, whichever is more recent?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[4 options](#opt-item.103127)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103128
  * [Text](https://hl7.org/fhir/R4/formats.html#table): N0450B. Has a gradual dose reduction (GDR) been attempted?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.103128)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-date.png)103129
  * [Text](https://hl7.org/fhir/R4/formats.html#table): N0450C. Date of last attempted GDR
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [date](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-date)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103130
  * [Text](https://hl7.org/fhir/R4/formats.html#table): N0450D. Physician documented GDR as clinically contraindicated
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.103130)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-date.png)103131
  * [Text](https://hl7.org/fhir/R4/formats.html#table): N0450E. Date physician documented GDR as clinically contraindicated
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [date](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-date)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103132
  * [Text](https://hl7.org/fhir/R4/formats.html#table): N2001. Drug Regimen Review: Did a complete drug regimen review identify potential clinically significant medication issues?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.103132)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103133
  * [Text](https://hl7.org/fhir/R4/formats.html#table): N2003. Medication Follow-up: Did the facility 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?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.103133)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103134
  * [Text](https://hl7.org/fhir/R4/formats.html#table): N2005. Did the facility 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?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.103134)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)109478
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O. Special Treatments, Procedures, and Programs
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)103136
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0100. Special Treatments, Procedures, and Programs
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103137
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0100_1. While NOT a Resident
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..*
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[13 options](#opt-item.103137)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103138
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0100_2. While a Resident
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..*
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[13 options](#opt-item.103138)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)103139
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0250. Influenza Vaccine
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103140
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0250A. Did the resident receive the influenza vaccine in this facility for this year's influenza vaccination season?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.103140)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-date.png)103141
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0250B. Date influenza vaccine received
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [date](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-date)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103142
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0250C. If influenza vaccine not received, state reason:
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[7 options](#opt-item.103142)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)103143
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0300. Pneumococcal Vaccine
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103144
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0300A. Is the resident's Pneumococcal vaccination up to date?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.103144)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103145
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0300B. If Pneumococcal vaccine not received, state reason:
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.103145)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)103146
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0400. Therapies
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)103147
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0400A. Speech-Language Pathology and Audiology Services
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103148
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0400A1. Individual minutes - record the total number of minutes this therapy was administered to the resident individually in the last 7 days
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103149
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0400A2. Concurrent minutes - record the total number of minutes this therapy was administered to the resident concurrently with one other resident in the last 7 days
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103150
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0400A3. Group minutes - record the total number of minutes this therapy was administered to the resident as part of a group of residents in the last 7 days
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103151
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0400A3A. Co-treatment minutes - record the total number of minutes this therapy was administered to the resident in co-treatment sessions in the last 7 days
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103152
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0400A4. Days - record the number of days this therapy was administered for at least 15 minutes a day in the last 7 days
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-date.png)103153
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0400A5. Therapy start date - record the date the most recent therapy regimen (since the most recent entry) started
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [date](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-date)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-date.png)103154
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0400A6. Therapy end date - record the date the most recent therapy regimen (since the most recent entry) ended
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [date](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-date)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)103155
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0400B. Occupational Therapy
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103156
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0400B1. Individual minutes - record the total number of minutes this therapy was administered to the resident individually in the last 7 days
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103157
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0400B2. Concurrent minutes - record the total number of minutes this therapy was administered to the resident concurrently with one other resident in the last 7 days
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103158
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0400B3. Group minutes - record the total number of minutes this therapy was administered to the resident as part of a group of residents in the last 7 days
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103159
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0400B3A. Co-treatment minutes - record the total number of minutes this therapy was administered to the resident in co-treatment sessions in the last 7 days
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103160
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0400B4. Days - record the number of days this therapy was administered for at least 15 minutes a day in the last 7 days
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-date.png)103161
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0400B5. Therapy start date - record the date the most recent therapy regimen (since the most recent entry) started
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [date](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-date)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-date.png)103162
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0400B6. Therapy end date - record the date the most recent therapy regimen (since the most recent entry) ended
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [date](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-date)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)103163
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0400C. Physical Therapy
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103164
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0400C1. Individual minutes - record the total number of minutes this therapy was administered to the resident individually in the last 7 days
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103165
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0400C2. Concurrent minutes - record the total number of minutes this therapy was administered to the resident concurrently with one other resident in the last 7 days
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103166
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0400C3. Group minutes - record the total number of minutes this therapy was administered to the resident as part of a group of residents in the last 7 days
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103167
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0400C3A. Co-treatment minutes - record the total number of minutes this therapy was administered to the resident in co-treatment sessions in the last 7 days
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103168
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0400C4. Days - record the number of days this therapy was administered for at least 15 minutes a day in the last 7 days
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-date.png)103169
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0400C5. Therapy start date - record the date the most recent therapy regimen (since the most recent entry) started
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [date](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-date)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-date.png)103170
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0400C6. Therapy end date - record the date the most recent therapy regimen (since the most recent entry) ended
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [date](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-date)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)103171
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0400D. Respiratory Therapy
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103172
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0400D1. Total minutes - record the total number of minutes this therapy was administered to the resident in the last 7 days
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103173
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0400D2. Days - record the number of days this therapy was administered for at least 15 minutes a day in the last 7 days
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)103174
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0400E. Psychological Therapy (by any licensed mental health professional)
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103175
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0400E1. Total minutes - record the total number of minutes this therapy was administered to the resident in the last 7 days
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103176
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0400E2. Days - record the number of days this therapy was administered for at least 15 minutes a day in the last 7 days.
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)103177
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0400F. Recreational Therapy (includes recreational and music therapy)
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103178
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0400F1. Total minutes - record the total number of minutes this therapy was administered to the resident in the last 7 days
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103179
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0400F2. Days - record the number of days this therapy was administered for at least 15 minutes a day in the last 7 days
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103180
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0420. Distinct Calendar Days of Therapy. Record the number of calendar days that the resident received Speech-Language Pathology and Audiology Services, Occupational Therapy, or Physical Therapy for at least 15 minutes in the past 7 days.
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)109459
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0425. Part A Therapies
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)109462
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0425A. Speech-Language Pathology and Audiology Services
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)109468
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0425A1. Individual minutes - record the total number of minutes this therapy was administered to the resident individually since the start date of the resident's most recent Medicare Part A stay (A2400B)
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)109471
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0425A2. Concurrent minutes - record the total number of minutes this therapy was administered to the resident concurrently with one other resident since the start date of the resident's most recent Medicare Part A stay (A2400B)
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)109469
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0425A3. Group minutes - record the total number of minutes this therapy was administered to the resident as part of a group of residents since the start date of the resident's most recent Medicare Part A stay (A2400B)
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)109470
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0425A4. Co-treatment minutes - record the total number of minutes this therapy was administered to the resident in co-treatment sessions since the start date of the resident's most recent Medicare Part A stay (A2400B)
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)109472
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0425A5. Days - record the number of days this therapy was administered for at least 15 minutes a day since the start date of the resident's most recent Medicare Part A stay (A2400B)
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)109461
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0425B. Occupational Therapy
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)109463
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0425B1. Individual minutes - record the total number of minutes this therapy was administered to the resident individually since the start date of the resident's most recent Medicare Part A stay (A2400B)
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)109467
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0425B2. Concurrent minutes - record the total number of minutes this therapy was administered to the resident concurrently with one other resident since the start date of the resident's most recent Medicare Part A stay (A2400B)
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)109465
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0425B3. Group minutes - record the total number of minutes this therapy was administered to the resident as part of a group of residents since the start date of the resident's most recent Medicare Part A stay (A2400B)
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)109466
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0425B4. Co-treatment minutes - record the total number of minutes this therapy was administered to the resident in co-treatment sessions since the start date of the resident's most recent Medicare Part A stay (A2400B)
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)109464
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0425B5. Days - record the number of days this therapy was administered for at least 15 minutes a day since the start date of the resident's most recent Medicare Part A stay (A2400B)
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)109460
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0425C. Physical Therapy
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)109473
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0425C1. Individual minutes - record the total number of minutes this therapy was administered to the resident individually since the start date of the resident's most recent Medicare Part A stay (A2400B)
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)109476
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0425C2. Concurrent minutes - record the total number of minutes this therapy was administered to the resident concurrently with one other resident since the start date of the resident's most recent Medicare Part A stay (A2400B)
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)109474
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0425C3. Group minutes - record the total number of minutes this therapy was administered to the resident as part of a group of residents since the start date of the resident's most recent Medicare Part A stay (A2400B)
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)109475
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0425C4. Co-treatment minutes - record the total number of minutes this therapy was administered to the resident in co-treatment sessions since the start date of the resident's most recent Medicare Part A stay (A2400B)
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)109477
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0425C5. Days - record the number of days this therapy was administered for at least 15 minutes a day since the start date of the resident's most recent Medicare Part A stay (A2400B)
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)109479
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0430. Distinct Calendar Days of Part A Therapy
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)103184
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0500. Restorative Nursing Programs
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103185
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0500A. Technique. Range of motion (passive)
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103186
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0500B. Technique. Range of motion (active)
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103187
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0500C. Technique. Splint or brace assistance
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103188
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0500D. Training and Skill Practice In: Bed mobility
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103189
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0500E. Training and Skill Practice In: Transfer
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103190
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0500F. Training and Skill Practice In: Walking
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103191
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0500G. Training and Skill Practice In: Dressing and/or grooming
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103192
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0500H. Training and Skill Practice In: Eating and/or swallowing
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103193
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0500I. Training and Skill Practice In: Amputation/prostheses care
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103194
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0500J. Training and Skill Practice In: Communication
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103195
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0600. Physician Examinations. Over the last 14 days, on how many days did the physician (or authorized assistant or practitioner) examine the resident?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103196
  * [Text](https://hl7.org/fhir/R4/formats.html#table): O0700. Physician Orders. Over the last 14 days, on how many days did the physician (or authorized assistant or practitioner) change the resident's orders?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)103197
  * [Text](https://hl7.org/fhir/R4/formats.html#table): P. Restraints and Alarms
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)103198
  * [Text](https://hl7.org/fhir/R4/formats.html#table): P0100. Physical Restraints
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103199
  * [Text](https://hl7.org/fhir/R4/formats.html#table): P0100A. Used in Bed. Bed rail
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.103199)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103200
  * [Text](https://hl7.org/fhir/R4/formats.html#table): P0100B. Used in Bed. Trunk restraint
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.103200)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103201
  * [Text](https://hl7.org/fhir/R4/formats.html#table): P0100C. Used in Bed. Limb restraint
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.103201)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103202
  * [Text](https://hl7.org/fhir/R4/formats.html#table): P0100D. Used in Bed. Other
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.103202)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103203
  * [Text](https://hl7.org/fhir/R4/formats.html#table): P0100E. Used in Chair or Out of Bed. Trunk restraint
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.103203)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103204
  * [Text](https://hl7.org/fhir/R4/formats.html#table): P0100F. Used in Chair or Out of Bed. Limb restraint
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.103204)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103205
  * [Text](https://hl7.org/fhir/R4/formats.html#table): P0100G. Used in Chair or Out of Bed. Chair prevents rising
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.103205)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103206
  * [Text](https://hl7.org/fhir/R4/formats.html#table): P0100H. Used in Chair or Out of Bed. Other
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.103206)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)103207
  * [Text](https://hl7.org/fhir/R4/formats.html#table): P0200. Alarms
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103208
  * [Text](https://hl7.org/fhir/R4/formats.html#table): P0200A. Bed alarm
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.103208)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103209
  * [Text](https://hl7.org/fhir/R4/formats.html#table): P0200B. Chair alarm
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.103209)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103210
  * [Text](https://hl7.org/fhir/R4/formats.html#table): P0200C. Floor mat alarm
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.103210)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103211
  * [Text](https://hl7.org/fhir/R4/formats.html#table): P0200D. Motion sensor alarm
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.103211)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103212
  * [Text](https://hl7.org/fhir/R4/formats.html#table): P0200E. Wander/elopement alarm
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.103212)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103213
  * [Text](https://hl7.org/fhir/R4/formats.html#table): P0200F. Other alarm
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.103213)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)103214
  * [Text](https://hl7.org/fhir/R4/formats.html#table): Q. Participation in Assessment and Goal Setting
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)103215
  * [Text](https://hl7.org/fhir/R4/formats.html#table): Q0100. Participation in Assessment
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103216
  * [Text](https://hl7.org/fhir/R4/formats.html#table): Q0100A. Resident participated in assessment
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.103216)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103217
  * [Text](https://hl7.org/fhir/R4/formats.html#table): Q0100B. Family or significant other participated in assessment
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.103217)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103218
  * [Text](https://hl7.org/fhir/R4/formats.html#table): Q0100C. Guardian or legally authorized representative participated in assessment
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.103218)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)103219
  * [Text](https://hl7.org/fhir/R4/formats.html#table): Q0300. Resident's Overall Expectation
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103220
  * [Text](https://hl7.org/fhir/R4/formats.html#table): Q0300A. Select one for resident's overall goal established during assessment process
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[4 options](#opt-item.103220)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103221
  * [Text](https://hl7.org/fhir/R4/formats.html#table): Q0300B. Indicate information source for Q0300A
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[4 options](#opt-item.103221)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103222
  * [Text](https://hl7.org/fhir/R4/formats.html#table): Q0400A. Discharge Plan. Is active discharge planning already occurring for the resident to return to the community?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.103222)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103223
  * [Text](https://hl7.org/fhir/R4/formats.html#table): Q0490. Resident's Preference to Avoid Being Asked Question Q0500B
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.103223)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103224
  * [Text](https://hl7.org/fhir/R4/formats.html#table): Q0500B. Return to Community. Do you want to talk to someone about the possiblity of leaving this facility and returning to live and receive services in the community?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.103224)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)103225
  * [Text](https://hl7.org/fhir/R4/formats.html#table): Q0550. Resident's Preference to Avoid Being Asked Question Q0500B Again
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103226
  * [Text](https://hl7.org/fhir/R4/formats.html#table): Q0550A. Does the resident (or family or significant other or guardian or legally authorized representative if resident is unable to understand or respond) want to be asked about returning to the community on all assessments?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.103226)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103227
  * [Text](https://hl7.org/fhir/R4/formats.html#table): Q0550B. Indicate information source for Q0550A
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[4 options](#opt-item.103227)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103228
  * [Text](https://hl7.org/fhir/R4/formats.html#table): Q0600. Referral. Has a referral been made to the Local Contact Agency?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.103228)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)103229
  * [Text](https://hl7.org/fhir/R4/formats.html#table): V. Care Area Assessment (CAA) Summary
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)103230
  * [Text](https://hl7.org/fhir/R4/formats.html#table): V0100. Items From the Most Recent Prior OBRA or Scheduled PPS Assessment
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103231
  * [Text](https://hl7.org/fhir/R4/formats.html#table): V0100A. Prior Assessment Federal OBRA Reason for Assessment
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[7 options](#opt-item.103231)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103232
  * [Text](https://hl7.org/fhir/R4/formats.html#table): V0100B. Prior Assessment PPS Reason for Assessment
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.103232)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-date.png)103233
  * [Text](https://hl7.org/fhir/R4/formats.html#table): V0100C. Prior Assessment Reference Date
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [date](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-date)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103234
  * [Text](https://hl7.org/fhir/R4/formats.html#table): V0100D. Prior Assessment Brief Interview for Mental Status (BIMS) Summary Score
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103235
  * [Text](https://hl7.org/fhir/R4/formats.html#table): V0100E. Prior Assessment Resident Mood Interview (PHQ-9©) Total Severity Score
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103236
  * [Text](https://hl7.org/fhir/R4/formats.html#table): V0100F. Prior Assessment Staff Assessment of Resident Mood (PHQ-9-OV) Total Severity Score
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)103237
  * [Text](https://hl7.org/fhir/R4/formats.html#table): V0200. CAAs and Care Planning
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)103238
  * [Text](https://hl7.org/fhir/R4/formats.html#table): V0200A. CAA Results
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103239
  * [Text](https://hl7.org/fhir/R4/formats.html#table): V0200A_A. Care Area Triggered
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[20 options](#opt-item.103239)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103240
  * [Text](https://hl7.org/fhir/R4/formats.html#table): V0200A_B. Care Planning Decision
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[20 options](#opt-item.103240)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)109861
  * [Text](https://hl7.org/fhir/R4/formats.html#table): X. Correction Request
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103242
  * [Text](https://hl7.org/fhir/R4/formats.html#table): X0150. Type of Provider
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.103242)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)103243
  * [Text](https://hl7.org/fhir/R4/formats.html#table): X0200. Name of Resident
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-string.png)103244
  * [Text](https://hl7.org/fhir/R4/formats.html#table): X0200A. Patient First name
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [string](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-string.png)103245
  * [Text](https://hl7.org/fhir/R4/formats.html#table): X0200C. Patient Last name
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [string](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103246
  * [Text](https://hl7.org/fhir/R4/formats.html#table): X0300. Gender
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.103246)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103247
  * [Text](https://hl7.org/fhir/R4/formats.html#table): X0400. Birth Date
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-string.png)103248
  * [Text](https://hl7.org/fhir/R4/formats.html#table): X0500. Social Security Number
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [string](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)110233
  * [Text](https://hl7.org/fhir/R4/formats.html#table): X0570A. Optional State Assessment. Is this assessment for state payment purposes only?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.110233)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)109825
  * [Text](https://hl7.org/fhir/R4/formats.html#table): X0600. Type of Assessment
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103250
  * [Text](https://hl7.org/fhir/R4/formats.html#table): X0600A. Federal OBRA Reason for Assessment
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[7 options](#opt-item.103250)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103251
  * [Text](https://hl7.org/fhir/R4/formats.html#table): X0600B. PPS Assessment
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[3 options](#opt-item.103251)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103254
  * [Text](https://hl7.org/fhir/R4/formats.html#table): X0600F. Entry/discharge reporting
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[5 options](#opt-item.103254)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103255
  * [Text](https://hl7.org/fhir/R4/formats.html#table): X0600H. Is this a SNF Part A PPS Discharge Assessment?
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.103255)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)103256
  * [Text](https://hl7.org/fhir/R4/formats.html#table): X0700. Date on existing record to be modified/inactivated
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-date.png)103257
  * [Text](https://hl7.org/fhir/R4/formats.html#table): X0700A. Assessment Reference Date
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [date](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-date)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103258
  * [Text](https://hl7.org/fhir/R4/formats.html#table): X0700B. Discharge Date
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103259
  * [Text](https://hl7.org/fhir/R4/formats.html#table): X0700C. Entry Date
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)103260
  * [Text](https://hl7.org/fhir/R4/formats.html#table): Correction Attestation Section
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-decimal.png)103261
  * [Text](https://hl7.org/fhir/R4/formats.html#table): X0800. Correction Number
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [decimal](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103262
  * [Text](https://hl7.org/fhir/R4/formats.html#table): X0900. Reasons for Modification
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..*
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[5 options](#opt-item.103262)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-coding.png)103263
  * [Text](https://hl7.org/fhir/R4/formats.html#table): X1050. Reasons for Inactivation
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..*
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [choice](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): Options:[2 options](#opt-item.103263)
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)103264
  * [Text](https://hl7.org/fhir/R4/formats.html#table): X1100. RN Assessment Coordinator Attestation of Completion
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-string.png)103265
  * [Text](https://hl7.org/fhir/R4/formats.html#table): X1100A. Attesting individual's first name
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [string](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-string.png)103266
  * [Text](https://hl7.org/fhir/R4/formats.html#table): X1100B. Attesting individual's last name
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [string](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-string.png)103267
  * [Text](https://hl7.org/fhir/R4/formats.html#table): X1100C. Attesting individual's title
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [string](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-date.png)103268
  * [Text](https://hl7.org/fhir/R4/formats.html#table): X1100E. Attestation date
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [date](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-date)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)110082
  * [Text](https://hl7.org/fhir/R4/formats.html#table): Z. Assessment Administration
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)110044
  * [Text](https://hl7.org/fhir/R4/formats.html#table): Z0100. Medicare Part A Billing
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-string.png)103271
  * [Text](https://hl7.org/fhir/R4/formats.html#table): Z0100A. Medicare Part A HIPPS code
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [string](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-string.png)112457
  * [Text](https://hl7.org/fhir/R4/formats.html#table): Z0100B. Version code
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [string](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)112461
  * [Text](https://hl7.org/fhir/R4/formats.html#table): Z0200. State Medicaid Billing (if required by the state)
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-string.png)103278
  * [Text](https://hl7.org/fhir/R4/formats.html#table): Z0200A. Case Mix group
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [string](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-string.png)112458
  * [Text](https://hl7.org/fhir/R4/formats.html#table): Z0200B. Version code
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [string](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)112462
  * [Text](https://hl7.org/fhir/R4/formats.html#table): Z0250. Alternate State Medicaid Billing (if required by the state)
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-string.png)103281
  * [Text](https://hl7.org/fhir/R4/formats.html#table): Z0250A. Case Mix group
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [string](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-string.png)112459
  * [Text](https://hl7.org/fhir/R4/formats.html#table): Z0250B. Version code
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [string](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-group.png)112463
  * [Text](https://hl7.org/fhir/R4/formats.html#table): Z0300. Insurance Billing
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 1..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [group](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-string.png)103284
  * [Text](https://hl7.org/fhir/R4/formats.html#table): Z0300A. Billing code
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [string](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](icon-q-string.png)112460
  * [Text](https://hl7.org/fhir/R4/formats.html#table): Z0300B. Billing version
  * [Cardinality](https://hl7.org/fhir/R4/formats.html#table): 0..1
  * [Type](https://hl7.org/fhir/R4/formats.html#table): [string](https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string)
  * [Description & Constraints](https://hl7.org/fhir/R4/formats.html#table)![](data:image/png;base64, ): 
* [LinkID](https://hl7.org/fhir/R4/formats.html#table): ![](data:image/png;base64, )Documentation for this format

-------

**Options Sets**

**Answer options for 102711**

* http://loinc.org#LA12663-3 ("Add new record")
* http://loinc.org#LA12664-1 ("Modify existing record")
* http://loinc.org#LA12665-8 ("Inactivate existing record")

**Answer options for 102716**

* http://loinc.org#LA10882-1 ("Nursing home (SNF/NF)")
* http://loinc.org#LA10883-9 ("Swing bed")

**Answer options for 105339**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 102718**

* http://loinc.org#LA10-4 ("Admission assessment (required by day 14)")
* http://loinc.org#LA15-3 ("Quarterly review assessment")
* http://loinc.org#LA12-0 ("Annual assessment")
* http://loinc.org#LA13-8 ("Significant change in status assessment")
* http://loinc.org#LA10888-8 ("Significant correction to prior comprehensive assessment")
* http://loinc.org#LA10889-6 ("Significant correction to prior quarterly assessment")
* http://loinc.org#LA9-3 ("None of the above")

**Answer options for 102719**

* http://loinc.org#LA10894-6 ("5-day scheduled assessment")
* http://loinc.org#LA29577-6 ("IPA - Interim Payment Assessment")
* http://loinc.org#LA9-3 ("None of the above")

**Answer options for 102722**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 102723**

* http://loinc.org#LA12627-8 ("Entry tracking record")
* http://loinc.org#LA12628-6 ("Discharge assessment - return not anticipated")
* http://loinc.org#LA12629-4 ("Discharge assessment - return anticipated")
* http://loinc.org#LA12630-2 ("Death in facility tracking record")
* http://loinc.org#LA9-3 ("None of the above")

**Answer options for 102724**

* http://loinc.org#LA20099-0 ("Planned")
* http://loinc.org#LA28017-4 ("Unplanned")

**Answer options for 105365**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 102725**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 102726**

* http://loinc.org#LA27983-8 ("Unit is neither Medicare nor Medicaid certified and MDS data is not required by the State")
* http://loinc.org#LA27984-6 ("Unit is neither Medicare nor Medicaid certified but MDS data is required by the State")
* http://loinc.org#LA27985-3 ("Unit is Medicare and/or Medicaid certified")

**Answer options for 102736**

* http://loinc.org#LA2-8 ("Male")
* http://loinc.org#LA3-6 ("Female")

**Answer options for 102738**

* http://loinc.org#LA6155-1 ("American Indian or Alaska Native")
* http://loinc.org#LA6156-9 ("Asian")
* http://loinc.org#LA10610-6 ("Black or African American")
* http://loinc.org#LA6214-6 ("Hispanic or Latino")
* http://loinc.org#LA10611-4 ("Native Hawaiian or Other Pacific Islander")
* http://loinc.org#LA4457-3 ("White")

**Answer options for 102740**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")
* http://loinc.org#LA11137-9 ("Unable to determine")

**Answer options for 102741**

* http://loinc.org#LA43-5 ("English")
* http://loinc.org#LA44-3 ("Spanish")
* http://loinc.org#LA4168-6 ("Chinese")
* http://loinc.org#LA4443-3 ("Vietnamese")
* http://loinc.org#LA15353-8 ("Tagalog")
* http://loinc.org#LA46-8 ("Other")

**Answer options for 102742**

* http://loinc.org#LA47-6 ("Never married")
* http://loinc.org#LA48-4 ("Married")
* http://loinc.org#LA49-2 ("Widowed")
* http://loinc.org#LA4288-2 ("Separated")
* http://loinc.org#LA51-8 ("Divorced")

**Answer options for 102747**

* http://loinc.org#null

**Answer options for 102748**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")
* http://loinc.org#LA10921-7 ("Not a Medicaid-certified unit")

**Answer options for 102749**

* http://loinc.org#LA18599-3 ("Serious mental illness")
* http://loinc.org#LA29576-8 ("Intellectual disability")
* http://loinc.org#LA18601-7 ("Other related conditions")

**Answer options for 102750**

* http://loinc.org#LA20088-3 ("Down syndrome")
* http://loinc.org#LA24638-1 ("Autism")
* http://loinc.org#LA16985-6 ("Epilepsy")
* http://loinc.org#LA27792-3 ("Other organic condition related to ID/DD")
* http://loinc.org#LA27793-1 ("ID/DD with no organic condition")
* http://loinc.org#LA9-3 ("None of the above")

**Answer options for 102753**

* http://loinc.org#LA10922-5 ("Admission")
* http://loinc.org#LA54-2 ("Reentry")

**Answer options for 102754**

* http://loinc.org#LA10924-1 ("Community (private home/apt., board/care, assisted living, group home)")
* http://loinc.org#LA10925-8 ("Another nursing home or swing bed")
* http://loinc.org#LA9928-8 ("Acute hospital")
* http://loinc.org#LA10064-6 ("Psychiatric hospital")
* http://loinc.org#LA10928-2 ("Inpatient rehabilitation facility")
* http://loinc.org#LA10929-0 ("ID/DD facility")
* http://loinc.org#LA6216-1 ("Hospice")
* http://loinc.org#LA10000-0 ("Long-Term Care Hospital (LTCH)")
* http://loinc.org#LA46-8 ("Other")

**Answer options for 102757**

* http://loinc.org#LA10924-1 ("Community (private home/apt., board/care, assisted living, group home)")
* http://loinc.org#LA10925-8 ("Another nursing home or swing bed")
* http://loinc.org#LA9928-8 ("Acute hospital")
* http://loinc.org#LA10064-6 ("Psychiatric hospital")
* http://loinc.org#LA10928-2 ("Inpatient rehabilitation facility")
* http://loinc.org#LA10929-0 ("ID/DD facility")
* http://loinc.org#LA6216-1 ("Hospice")
* http://loinc.org#LA10939-9 ("Deceased")
* http://loinc.org#LA10000-0 ("Long-Term Care Hospital (LTCH)")
* http://loinc.org#LA46-8 ("Other")

**Answer options for 102761**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 102765**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 102766**

* http://loinc.org#LA10941-5 ("Adequate - no difficulty in normal conversation, social interaction, listening to TV")
* http://loinc.org#LA10942-3 ("Minimal difficulty - difficulty in some environments (e.g., when person speaks softly or setting is noisy)")
* http://loinc.org#LA10943-1 ("Moderate difficulty - speaker has to increase volume and speak distinctly")
* http://loinc.org#LA10944-9 ("Highly impaired - absence of useful hearing")

**Answer options for 102767**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 102768**

* http://loinc.org#LA10945-6 ("Clear speech - distinct intelligible words")
* http://loinc.org#LA10946-4 ("Unclear speech - slurred or mumbled words")
* http://loinc.org#LA10947-2 ("No speech - absence of spoken words")

**Answer options for 102769**

* http://loinc.org#LA71-6 ("Understood")
* http://loinc.org#LA10949-8 ("Usually understood - difficulty communicating some words or finishing thoughts but is able if prompted or given time")
* http://loinc.org#LA10950-6 ("Sometimes understood - ability is limited to making concrete requests")
* http://loinc.org#LA74-0 ("Rarely/never understood")

**Answer options for 102770**

* http://loinc.org#LA10952-2 ("Understands - clear comprehension")
* http://loinc.org#LA10953-0 ("Usually understands - misses some part/intent of message but comprehends most conversation")
* http://loinc.org#LA10954-8 ("Sometimes understands - responds adequately to simple, direct communication only")
* http://loinc.org#LA81-5 ("Rarely/never understands")

**Answer options for 102771**

* http://loinc.org#LA10956-3 ("Adequate - sees fine detail, such as regular print in newspapers/books")
* http://loinc.org#LA10957-1 ("Impaired - sees large print, but not regular print in newspapers/books")
* http://loinc.org#LA10958-9 ("Moderately impaired - limited vision; not able to see newspaper headlines but can identify objects")
* http://loinc.org#LA10959-7 ("Highly impaired - object identification in question, but eyes appear to follow objects")
* http://loinc.org#LA10960-5 ("Severely impaired - no vision or sees only light, colors or shapes; eyes do not appear to follow objects")

**Answer options for 102772**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 129944**

* http://loinc.org#LA11150-2 ("No (resident is rarely/never understood)")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 129946**

* http://loinc.org#LA137-2 ("None")
* http://loinc.org#LA6306-0 ("One")
* http://loinc.org#LA6404-3 ("Two")
* http://loinc.org#LA6395-3 ("Three")

**Answer options for 129948**

* http://loinc.org#LA10965-4 ("Missed by > 5 years or no answer")
* http://loinc.org#LA10966-2 ("Missed by 2-5 years")
* http://loinc.org#LA10008-3 ("Missed by 1 year")
* http://loinc.org#LA9960-1 ("Correct")

**Answer options for 129949**

* http://loinc.org#LA10969-6 ("Missed by > 1 month or no answer")
* http://loinc.org#LA10010-9 ("Missed by 6 days to 1 month")
* http://loinc.org#LA9927-0 ("Accurate within 5 days")

**Answer options for 129950**

* http://loinc.org#LA9981-7 ("Incorrect or no answer")
* http://loinc.org#LA9960-1 ("Correct")

**Answer options for 129952**

* http://loinc.org#LA10974-6 ("No - could not recall")
* http://loinc.org#LA10126-3 ("Yes, after cueing ("something to wear")")
* http://loinc.org#LA10134-7 ("Yes, no cue required")

**Answer options for 129953**

* http://loinc.org#LA10974-6 ("No - could not recall")
* http://loinc.org#LA10978-7 ("Yes, after cueing ("a color")")
* http://loinc.org#LA10134-7 ("Yes, no cue required")

**Answer options for 129954**

* http://loinc.org#LA10974-6 ("No - could not recall")
* http://loinc.org#LA10125-5 ("Yes, after cueing ("a piece of furniture")")
* http://loinc.org#LA10134-7 ("Yes, no cue required")

**Answer options for 129956**

* http://loinc.org#LA28146-1 ("No (resident was able to complete Brief Interview for Mental Status)")
* http://loinc.org#LA28147-9 ("Yes (resident was unable to complete Brief Interview for Mental Status)")

**Answer options for 129960**

* http://loinc.org#LA55-9 ("Memory OK")
* http://loinc.org#LA56-7 ("Memory problem")

**Answer options for 129959**

* http://loinc.org#LA55-9 ("Memory OK")
* http://loinc.org#LA56-7 ("Memory problem")

**Answer options for 129958**

* http://loinc.org#LA9962-7 ("Current season")
* http://loinc.org#LA9998-1 ("Location of own room")
* http://loinc.org#LA10085-1 ("Staff names and faces")
* http://loinc.org#LA33609-1 ("That they are in a nursing home/hospital swing bed.")
* http://loinc.org#LA26729-6 ("None of the above were recalled")

**Answer options for 129957**

* http://loinc.org#LA10985-2 ("Independent - decisions consistent/reasonable")
* http://loinc.org#LA10986-0 ("Modified independence - some difficulty in new situations only")
* http://loinc.org#LA10987-8 ("Moderately impaired - decisions poor; cues/supervision required")
* http://loinc.org#LA10988-6 ("Severely impaired - never/rarely made decisions")

**Answer options for 129966**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 129965**

* http://loinc.org#LA61-7 ("Behavior not present")
* http://loinc.org#LA10992-8 ("Behavior continuously present, does not fluctuate")
* http://loinc.org#LA10993-6 ("Behavior present, fluctuates (comes and goes, changes in severity)")

**Answer options for 129964**

* http://loinc.org#LA61-7 ("Behavior not present")
* http://loinc.org#LA10992-8 ("Behavior continuously present, does not fluctuate")
* http://loinc.org#LA10993-6 ("Behavior present, fluctuates (comes and goes, changes in severity)")

**Answer options for 129963**

* http://loinc.org#LA61-7 ("Behavior not present")
* http://loinc.org#LA10992-8 ("Behavior continuously present, does not fluctuate")
* http://loinc.org#LA10993-6 ("Behavior present, fluctuates (comes and goes, changes in severity)")

**Answer options for 102799**

* http://loinc.org#LA11150-2 ("No (resident is rarely/never understood)")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 102802**

* http://loinc.org#LA33719-8 ("No (enter 0 in column 2)")
* http://loinc.org#LA33720-6 ("Yes (enter 0-3 in column 2)")
* http://loinc.org#LA33753-7 ("No response (leave column 2 blank)")

**Answer options for 102803**

* http://loinc.org#LA33719-8 ("No (enter 0 in column 2)")
* http://loinc.org#LA33720-6 ("Yes (enter 0-3 in column 2)")
* http://loinc.org#LA33753-7 ("No response (leave column 2 blank)")

**Answer options for 102804**

* http://loinc.org#LA33719-8 ("No (enter 0 in column 2)")
* http://loinc.org#LA33720-6 ("Yes (enter 0-3 in column 2)")
* http://loinc.org#LA33753-7 ("No response (leave column 2 blank)")

**Answer options for 102805**

* http://loinc.org#LA33719-8 ("No (enter 0 in column 2)")
* http://loinc.org#LA33720-6 ("Yes (enter 0-3 in column 2)")
* http://loinc.org#LA33753-7 ("No response (leave column 2 blank)")

**Answer options for 102806**

* http://loinc.org#LA33719-8 ("No (enter 0 in column 2)")
* http://loinc.org#LA33720-6 ("Yes (enter 0-3 in column 2)")
* http://loinc.org#LA33753-7 ("No response (leave column 2 blank)")

**Answer options for 102807**

* http://loinc.org#LA33719-8 ("No (enter 0 in column 2)")
* http://loinc.org#LA33720-6 ("Yes (enter 0-3 in column 2)")
* http://loinc.org#LA33753-7 ("No response (leave column 2 blank)")

**Answer options for 102808**

* http://loinc.org#LA33719-8 ("No (enter 0 in column 2)")
* http://loinc.org#LA33720-6 ("Yes (enter 0-3 in column 2)")
* http://loinc.org#LA33753-7 ("No response (leave column 2 blank)")

**Answer options for 102809**

* http://loinc.org#LA33719-8 ("No (enter 0 in column 2)")
* http://loinc.org#LA33720-6 ("Yes (enter 0-3 in column 2)")
* http://loinc.org#LA33753-7 ("No response (leave column 2 blank)")

**Answer options for 102810**

* http://loinc.org#LA33719-8 ("No (enter 0 in column 2)")
* http://loinc.org#LA33720-6 ("Yes (enter 0-3 in column 2)")
* http://loinc.org#LA33753-7 ("No response (leave column 2 blank)")

**Answer options for 102812**

* http://loinc.org#LA10997-7 ("Never or 1 day")
* http://loinc.org#LA10998-5 ("2-6 days (several days)")
* http://loinc.org#LA10999-3 ("7-11 days (half or more of the days)")
* http://loinc.org#LA11000-9 ("12-14 days (nearly every day)")

**Answer options for 102813**

* http://loinc.org#LA10997-7 ("Never or 1 day")
* http://loinc.org#LA10998-5 ("2-6 days (several days)")
* http://loinc.org#LA10999-3 ("7-11 days (half or more of the days)")
* http://loinc.org#LA11000-9 ("12-14 days (nearly every day)")

**Answer options for 102814**

* http://loinc.org#LA10997-7 ("Never or 1 day")
* http://loinc.org#LA10998-5 ("2-6 days (several days)")
* http://loinc.org#LA10999-3 ("7-11 days (half or more of the days)")
* http://loinc.org#LA11000-9 ("12-14 days (nearly every day)")

**Answer options for 102815**

* http://loinc.org#LA10997-7 ("Never or 1 day")
* http://loinc.org#LA10998-5 ("2-6 days (several days)")
* http://loinc.org#LA10999-3 ("7-11 days (half or more of the days)")
* http://loinc.org#LA11000-9 ("12-14 days (nearly every day)")

**Answer options for 102816**

* http://loinc.org#LA10997-7 ("Never or 1 day")
* http://loinc.org#LA10998-5 ("2-6 days (several days)")
* http://loinc.org#LA10999-3 ("7-11 days (half or more of the days)")
* http://loinc.org#LA11000-9 ("12-14 days (nearly every day)")

**Answer options for 102817**

* http://loinc.org#LA10997-7 ("Never or 1 day")
* http://loinc.org#LA10998-5 ("2-6 days (several days)")
* http://loinc.org#LA10999-3 ("7-11 days (half or more of the days)")
* http://loinc.org#LA11000-9 ("12-14 days (nearly every day)")

**Answer options for 102818**

* http://loinc.org#LA10997-7 ("Never or 1 day")
* http://loinc.org#LA10998-5 ("2-6 days (several days)")
* http://loinc.org#LA10999-3 ("7-11 days (half or more of the days)")
* http://loinc.org#LA11000-9 ("12-14 days (nearly every day)")

**Answer options for 102819**

* http://loinc.org#LA10997-7 ("Never or 1 day")
* http://loinc.org#LA10998-5 ("2-6 days (several days)")
* http://loinc.org#LA10999-3 ("7-11 days (half or more of the days)")
* http://loinc.org#LA11000-9 ("12-14 days (nearly every day)")

**Answer options for 102820**

* http://loinc.org#LA10997-7 ("Never or 1 day")
* http://loinc.org#LA10998-5 ("2-6 days (several days)")
* http://loinc.org#LA10999-3 ("7-11 days (half or more of the days)")
* http://loinc.org#LA11000-9 ("12-14 days (nearly every day)")

**Answer options for 102825**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 102826**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 102827**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 102828**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 102829**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 102830**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 102831**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 102832**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 102833**

* http://loinc.org#LA33719-8 ("No (enter 0 in column 2)")
* http://loinc.org#LA33720-6 ("Yes (enter 0-3 in column 2)")

**Answer options for 102834**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 102836**

* http://loinc.org#LA10997-7 ("Never or 1 day")
* http://loinc.org#LA10998-5 ("2-6 days (several days)")
* http://loinc.org#LA10999-3 ("7-11 days (half or more of the days)")
* http://loinc.org#LA11000-9 ("12-14 days (nearly every day)")

**Answer options for 102837**

* http://loinc.org#LA10997-7 ("Never or 1 day")
* http://loinc.org#LA10998-5 ("2-6 days (several days)")
* http://loinc.org#LA10999-3 ("7-11 days (half or more of the days)")
* http://loinc.org#LA11000-9 ("12-14 days (nearly every day)")

**Answer options for 102838**

* http://loinc.org#LA10997-7 ("Never or 1 day")
* http://loinc.org#LA10998-5 ("2-6 days (several days)")
* http://loinc.org#LA10999-3 ("7-11 days (half or more of the days)")
* http://loinc.org#LA11000-9 ("12-14 days (nearly every day)")

**Answer options for 102839**

* http://loinc.org#LA10997-7 ("Never or 1 day")
* http://loinc.org#LA10998-5 ("2-6 days (several days)")
* http://loinc.org#LA10999-3 ("7-11 days (half or more of the days)")
* http://loinc.org#LA11000-9 ("12-14 days (nearly every day)")

**Answer options for 102840**

* http://loinc.org#LA10997-7 ("Never or 1 day")
* http://loinc.org#LA10998-5 ("2-6 days (several days)")
* http://loinc.org#LA10999-3 ("7-11 days (half or more of the days)")
* http://loinc.org#LA11000-9 ("12-14 days (nearly every day)")

**Answer options for 102841**

* http://loinc.org#LA10997-7 ("Never or 1 day")
* http://loinc.org#LA10998-5 ("2-6 days (several days)")
* http://loinc.org#LA10999-3 ("7-11 days (half or more of the days)")
* http://loinc.org#LA11000-9 ("12-14 days (nearly every day)")

**Answer options for 102842**

* http://loinc.org#LA10997-7 ("Never or 1 day")
* http://loinc.org#LA10998-5 ("2-6 days (several days)")
* http://loinc.org#LA10999-3 ("7-11 days (half or more of the days)")
* http://loinc.org#LA11000-9 ("12-14 days (nearly every day)")

**Answer options for 102843**

* http://loinc.org#LA10997-7 ("Never or 1 day")
* http://loinc.org#LA10998-5 ("2-6 days (several days)")
* http://loinc.org#LA10999-3 ("7-11 days (half or more of the days)")
* http://loinc.org#LA11000-9 ("12-14 days (nearly every day)")

**Answer options for 102844**

* http://loinc.org#LA10997-7 ("Never or 1 day")
* http://loinc.org#LA10998-5 ("2-6 days (several days)")
* http://loinc.org#LA10999-3 ("7-11 days (half or more of the days)")
* http://loinc.org#LA11000-9 ("12-14 days (nearly every day)")

**Answer options for 102845**

* http://loinc.org#LA10997-7 ("Never or 1 day")
* http://loinc.org#LA10998-5 ("2-6 days (several days)")
* http://loinc.org#LA10999-3 ("7-11 days (half or more of the days)")
* http://loinc.org#LA11000-9 ("12-14 days (nearly every day)")

**Answer options for 102849**

* http://loinc.org#LA27795-6 ("Hallucinations (perceptual experiences in the absence of real external sensory stimuli)")
* http://loinc.org#LA27796-4 ("Delusions (misconceptions or beliefs that are firmly held, contrary to reality)")
* http://loinc.org#LA9-3 ("None of the above")

**Answer options for 102851**

* http://loinc.org#LA11005-8 ("Behavior not exhibited")
* http://loinc.org#LA11006-6 ("Behavior of this type occurred 1 to 3 days")
* http://loinc.org#LA94-8 ("Behavior of this type occurred 4 to 6 days, but less than daily")
* http://loinc.org#LA95-5 ("Behavior of this type occurred daily")

**Answer options for 102852**

* http://loinc.org#LA11005-8 ("Behavior not exhibited")
* http://loinc.org#LA11006-6 ("Behavior of this type occurred 1 to 3 days")
* http://loinc.org#LA94-8 ("Behavior of this type occurred 4 to 6 days, but less than daily")
* http://loinc.org#LA95-5 ("Behavior of this type occurred daily")

**Answer options for 102853**

* http://loinc.org#LA11005-8 ("Behavior not exhibited")
* http://loinc.org#LA11006-6 ("Behavior of this type occurred 1 to 3 days")
* http://loinc.org#LA94-8 ("Behavior of this type occurred 4 to 6 days, but less than daily")
* http://loinc.org#LA95-5 ("Behavior of this type occurred daily")

**Answer options for 102854**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 102856**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 102857**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 102858**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 102860**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 102861**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 102862**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 102863**

* http://loinc.org#LA11005-8 ("Behavior not exhibited")
* http://loinc.org#LA11006-6 ("Behavior of this type occurred 1 to 3 days")
* http://loinc.org#LA94-8 ("Behavior of this type occurred 4 to 6 days, but less than daily")
* http://loinc.org#LA95-5 ("Behavior of this type occurred daily")

**Answer options for 102864**

* http://loinc.org#LA11005-8 ("Behavior not exhibited")
* http://loinc.org#LA11006-6 ("Behavior of this type occurred 1 to 3 days")
* http://loinc.org#LA94-8 ("Behavior of this type occurred 4 to 6 days, but less than daily")
* http://loinc.org#LA95-5 ("Behavior of this type occurred daily")

**Answer options for 102866**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 102867**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 102868**

* http://loinc.org#LA11009-0 ("Same")
* http://loinc.org#LA65-8 ("Improved")
* http://loinc.org#LA11011-6 ("Worse")
* http://loinc.org#LA11012-4 ("N/A because no prior MDS assessment")

**Answer options for 102870**

* http://loinc.org#LA16158-0 ("No (resident is rarely/never understood and family/significant other not available)")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 102872**

* http://loinc.org#LA11013-2 ("Very important")
* http://loinc.org#LA11014-0 ("Somewhat important")
* http://loinc.org#LA11015-7 ("Not very important")
* http://loinc.org#LA11016-5 ("Not important at all")
* http://loinc.org#LA11017-3 ("Important, but can't do or no choice")
* http://loinc.org#LA11018-1 ("No response or non-responsive")

**Answer options for 102873**

* http://loinc.org#LA11013-2 ("Very important")
* http://loinc.org#LA11014-0 ("Somewhat important")
* http://loinc.org#LA11015-7 ("Not very important")
* http://loinc.org#LA11016-5 ("Not important at all")
* http://loinc.org#LA11017-3 ("Important, but can't do or no choice")
* http://loinc.org#LA11018-1 ("No response or non-responsive")

**Answer options for 102874**

* http://loinc.org#LA11013-2 ("Very important")
* http://loinc.org#LA11014-0 ("Somewhat important")
* http://loinc.org#LA11015-7 ("Not very important")
* http://loinc.org#LA11016-5 ("Not important at all")
* http://loinc.org#LA11017-3 ("Important, but can't do or no choice")
* http://loinc.org#LA11018-1 ("No response or non-responsive")

**Answer options for 102875**

* http://loinc.org#LA11013-2 ("Very important")
* http://loinc.org#LA11014-0 ("Somewhat important")
* http://loinc.org#LA11015-7 ("Not very important")
* http://loinc.org#LA11016-5 ("Not important at all")
* http://loinc.org#LA11017-3 ("Important, but can't do or no choice")
* http://loinc.org#LA11018-1 ("No response or non-responsive")

**Answer options for 102876**

* http://loinc.org#LA11013-2 ("Very important")
* http://loinc.org#LA11014-0 ("Somewhat important")
* http://loinc.org#LA11015-7 ("Not very important")
* http://loinc.org#LA11016-5 ("Not important at all")
* http://loinc.org#LA11017-3 ("Important, but can't do or no choice")
* http://loinc.org#LA11018-1 ("No response or non-responsive")

**Answer options for 102877**

* http://loinc.org#LA11013-2 ("Very important")
* http://loinc.org#LA11014-0 ("Somewhat important")
* http://loinc.org#LA11015-7 ("Not very important")
* http://loinc.org#LA11016-5 ("Not important at all")
* http://loinc.org#LA11017-3 ("Important, but can't do or no choice")
* http://loinc.org#LA11018-1 ("No response or non-responsive")

**Answer options for 102878**

* http://loinc.org#LA11013-2 ("Very important")
* http://loinc.org#LA11014-0 ("Somewhat important")
* http://loinc.org#LA11015-7 ("Not very important")
* http://loinc.org#LA11016-5 ("Not important at all")
* http://loinc.org#LA11017-3 ("Important, but can't do or no choice")
* http://loinc.org#LA11018-1 ("No response or non-responsive")

**Answer options for 102879**

* http://loinc.org#LA11013-2 ("Very important")
* http://loinc.org#LA11014-0 ("Somewhat important")
* http://loinc.org#LA11015-7 ("Not very important")
* http://loinc.org#LA11016-5 ("Not important at all")
* http://loinc.org#LA11017-3 ("Important, but can't do or no choice")
* http://loinc.org#LA11018-1 ("No response or non-responsive")

**Answer options for 102881**

* http://loinc.org#LA11013-2 ("Very important")
* http://loinc.org#LA11014-0 ("Somewhat important")
* http://loinc.org#LA11015-7 ("Not very important")
* http://loinc.org#LA11016-5 ("Not important at all")
* http://loinc.org#LA11017-3 ("Important, but can't do or no choice")
* http://loinc.org#LA11018-1 ("No response or non-responsive")

**Answer options for 102882**

* http://loinc.org#LA11013-2 ("Very important")
* http://loinc.org#LA11014-0 ("Somewhat important")
* http://loinc.org#LA11015-7 ("Not very important")
* http://loinc.org#LA11016-5 ("Not important at all")
* http://loinc.org#LA11017-3 ("Important, but can't do or no choice")
* http://loinc.org#LA11018-1 ("No response or non-responsive")

**Answer options for 102883**

* http://loinc.org#LA11013-2 ("Very important")
* http://loinc.org#LA11014-0 ("Somewhat important")
* http://loinc.org#LA11015-7 ("Not very important")
* http://loinc.org#LA11016-5 ("Not important at all")
* http://loinc.org#LA11017-3 ("Important, but can't do or no choice")
* http://loinc.org#LA11018-1 ("No response or non-responsive")

**Answer options for 102884**

* http://loinc.org#LA11013-2 ("Very important")
* http://loinc.org#LA11014-0 ("Somewhat important")
* http://loinc.org#LA11015-7 ("Not very important")
* http://loinc.org#LA11016-5 ("Not important at all")
* http://loinc.org#LA11017-3 ("Important, but can't do or no choice")
* http://loinc.org#LA11018-1 ("No response or non-responsive")

**Answer options for 102885**

* http://loinc.org#LA11013-2 ("Very important")
* http://loinc.org#LA11014-0 ("Somewhat important")
* http://loinc.org#LA11015-7 ("Not very important")
* http://loinc.org#LA11016-5 ("Not important at all")
* http://loinc.org#LA11017-3 ("Important, but can't do or no choice")
* http://loinc.org#LA11018-1 ("No response or non-responsive")

**Answer options for 102886**

* http://loinc.org#LA11013-2 ("Very important")
* http://loinc.org#LA11014-0 ("Somewhat important")
* http://loinc.org#LA11015-7 ("Not very important")
* http://loinc.org#LA11016-5 ("Not important at all")
* http://loinc.org#LA11017-3 ("Important, but can't do or no choice")
* http://loinc.org#LA11018-1 ("No response or non-responsive")

**Answer options for 102887**

* http://loinc.org#LA11013-2 ("Very important")
* http://loinc.org#LA11014-0 ("Somewhat important")
* http://loinc.org#LA11015-7 ("Not very important")
* http://loinc.org#LA11016-5 ("Not important at all")
* http://loinc.org#LA11017-3 ("Important, but can't do or no choice")
* http://loinc.org#LA11018-1 ("No response or non-responsive")

**Answer options for 102888**

* http://loinc.org#LA11013-2 ("Very important")
* http://loinc.org#LA11014-0 ("Somewhat important")
* http://loinc.org#LA11015-7 ("Not very important")
* http://loinc.org#LA11016-5 ("Not important at all")
* http://loinc.org#LA11017-3 ("Important, but can't do or no choice")
* http://loinc.org#LA11018-1 ("No response or non-responsive")

**Answer options for 102889**

* http://loinc.org#LA11019-9 ("Resident")
* http://loinc.org#LA11020-7 ("Family or significant other (close friend or other representative)")
* http://loinc.org#LA11021-5 ("Interview could not be completed by resident or family/significant other ("No response" to 3 or more items)")

**Answer options for 102890**

* http://loinc.org#LA11151-0 ("No (because Interview for Daily and Activity Preferences (F0400 and F0500) was completed by resident or family/significant other)")
* http://loinc.org#LA11152-8 ("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)")

**Answer options for 102891**

* http://loinc.org#LA27797-2 ("Choosing clothes to wear")
* http://loinc.org#LA27798-0 ("Caring for personal belongings")
* http://loinc.org#LA27799-8 ("Receiving tub bath")
* http://loinc.org#LA27800-4 ("Receiving shower")
* http://loinc.org#LA27815-2 ("Receiving bed bath")
* http://loinc.org#LA27801-2 ("Receiving sponge bath")
* http://loinc.org#LA27802-0 ("Snacks between meals")
* http://loinc.org#LA27803-8 ("Staying up past 8:00 p.m.")
* http://loinc.org#LA27804-6 ("Family or significant other involvement in care discussions")
* http://loinc.org#LA27805-3 ("Use of phone in private")
* http://loinc.org#LA27806-1 ("Place to lock personal belongings")
* http://loinc.org#LA27807-9 ("Reading books, newspapers, or magazines")
* http://loinc.org#LA17907-9 ("Listening to music")
* http://loinc.org#LA27808-7 ("Being around animals such as pets")
* http://loinc.org#LA27809-5 ("Keeping up with the news")
* http://loinc.org#LA27810-3 ("Doing things with groups of people")
* http://loinc.org#LA27811-1 ("Participating in favorite activities")
* http://loinc.org#LA27812-9 ("Spending time away from the nursing home")
* http://loinc.org#LA27813-7 ("Spending time outdoors")
* http://loinc.org#LA27814-5 ("Participating in religious activities or practices")
* http://loinc.org#LA9-3 ("None of the above")

**Answer options for 102894**

* http://loinc.org#LA12637-7 ("Independent - no help or staff oversight at any time")
* http://loinc.org#LA12638-5 ("Supervision - oversight, encouragement or cueing")
* http://loinc.org#LA12639-3 ("Limited assistance - resident highly involved in activity; staff provide guided maneuvering of limbs or other non-weight-bearing assistance")
* http://loinc.org#LA12640-1 ("Extensive assistance - resident involved in activity, staff provide weight-bearing support")
* http://loinc.org#LA12641-9 ("Total dependence - full staff performance every time during entire 7-day period")
* http://loinc.org#LA12642-7 ("Activity occurred only once or twice - activity did occur but only once or twice")
* http://loinc.org#LA18614-0 ("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")

**Answer options for 102895**

* http://loinc.org#LA12637-7 ("Independent - no help or staff oversight at any time")
* http://loinc.org#LA12638-5 ("Supervision - oversight, encouragement or cueing")
* http://loinc.org#LA12639-3 ("Limited assistance - resident highly involved in activity; staff provide guided maneuvering of limbs or other non-weight-bearing assistance")
* http://loinc.org#LA12640-1 ("Extensive assistance - resident involved in activity, staff provide weight-bearing support")
* http://loinc.org#LA12641-9 ("Total dependence - full staff performance every time during entire 7-day period")
* http://loinc.org#LA12642-7 ("Activity occurred only once or twice - activity did occur but only once or twice")
* http://loinc.org#LA18614-0 ("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")

**Answer options for 102896**

* http://loinc.org#LA12637-7 ("Independent - no help or staff oversight at any time")
* http://loinc.org#LA12638-5 ("Supervision - oversight, encouragement or cueing")
* http://loinc.org#LA12639-3 ("Limited assistance - resident highly involved in activity; staff provide guided maneuvering of limbs or other non-weight-bearing assistance")
* http://loinc.org#LA12640-1 ("Extensive assistance - resident involved in activity, staff provide weight-bearing support")
* http://loinc.org#LA12641-9 ("Total dependence - full staff performance every time during entire 7-day period")
* http://loinc.org#LA12642-7 ("Activity occurred only once or twice - activity did occur but only once or twice")
* http://loinc.org#LA18614-0 ("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")

**Answer options for 102897**

* http://loinc.org#LA12637-7 ("Independent - no help or staff oversight at any time")
* http://loinc.org#LA12638-5 ("Supervision - oversight, encouragement or cueing")
* http://loinc.org#LA12639-3 ("Limited assistance - resident highly involved in activity; staff provide guided maneuvering of limbs or other non-weight-bearing assistance")
* http://loinc.org#LA12640-1 ("Extensive assistance - resident involved in activity, staff provide weight-bearing support")
* http://loinc.org#LA12641-9 ("Total dependence - full staff performance every time during entire 7-day period")
* http://loinc.org#LA12642-7 ("Activity occurred only once or twice - activity did occur but only once or twice")
* http://loinc.org#LA18614-0 ("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")

**Answer options for 102898**

* http://loinc.org#LA12637-7 ("Independent - no help or staff oversight at any time")
* http://loinc.org#LA12638-5 ("Supervision - oversight, encouragement or cueing")
* http://loinc.org#LA12639-3 ("Limited assistance - resident highly involved in activity; staff provide guided maneuvering of limbs or other non-weight-bearing assistance")
* http://loinc.org#LA12640-1 ("Extensive assistance - resident involved in activity, staff provide weight-bearing support")
* http://loinc.org#LA12641-9 ("Total dependence - full staff performance every time during entire 7-day period")
* http://loinc.org#LA12642-7 ("Activity occurred only once or twice - activity did occur but only once or twice")
* http://loinc.org#LA18614-0 ("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")

**Answer options for 102899**

* http://loinc.org#LA12637-7 ("Independent - no help or staff oversight at any time")
* http://loinc.org#LA12638-5 ("Supervision - oversight, encouragement or cueing")
* http://loinc.org#LA12639-3 ("Limited assistance - resident highly involved in activity; staff provide guided maneuvering of limbs or other non-weight-bearing assistance")
* http://loinc.org#LA12640-1 ("Extensive assistance - resident involved in activity, staff provide weight-bearing support")
* http://loinc.org#LA12641-9 ("Total dependence - full staff performance every time during entire 7-day period")
* http://loinc.org#LA12642-7 ("Activity occurred only once or twice - activity did occur but only once or twice")
* http://loinc.org#LA18614-0 ("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")

**Answer options for 102900**

* http://loinc.org#LA12637-7 ("Independent - no help or staff oversight at any time")
* http://loinc.org#LA12638-5 ("Supervision - oversight, encouragement or cueing")
* http://loinc.org#LA12639-3 ("Limited assistance - resident highly involved in activity; staff provide guided maneuvering of limbs or other non-weight-bearing assistance")
* http://loinc.org#LA12640-1 ("Extensive assistance - resident involved in activity, staff provide weight-bearing support")
* http://loinc.org#LA12641-9 ("Total dependence - full staff performance every time during entire 7-day period")
* http://loinc.org#LA12642-7 ("Activity occurred only once or twice - activity did occur but only once or twice")
* http://loinc.org#LA18614-0 ("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")

**Answer options for 102901**

* http://loinc.org#LA12637-7 ("Independent - no help or staff oversight at any time")
* http://loinc.org#LA12638-5 ("Supervision - oversight, encouragement or cueing")
* http://loinc.org#LA12639-3 ("Limited assistance - resident highly involved in activity; staff provide guided maneuvering of limbs or other non-weight-bearing assistance")
* http://loinc.org#LA12640-1 ("Extensive assistance - resident involved in activity, staff provide weight-bearing support")
* http://loinc.org#LA12641-9 ("Total dependence - full staff performance every time during entire 7-day period")
* http://loinc.org#LA12642-7 ("Activity occurred only once or twice - activity did occur but only once or twice")
* http://loinc.org#LA18614-0 ("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")

**Answer options for 102902**

* http://loinc.org#LA12637-7 ("Independent - no help or staff oversight at any time")
* http://loinc.org#LA12638-5 ("Supervision - oversight, encouragement or cueing")
* http://loinc.org#LA12639-3 ("Limited assistance - resident highly involved in activity; staff provide guided maneuvering of limbs or other non-weight-bearing assistance")
* http://loinc.org#LA12640-1 ("Extensive assistance - resident involved in activity, staff provide weight-bearing support")
* http://loinc.org#LA12641-9 ("Total dependence - full staff performance every time during entire 7-day period")
* http://loinc.org#LA12642-7 ("Activity occurred only once or twice - activity did occur but only once or twice")
* http://loinc.org#LA18614-0 ("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")

**Answer options for 102903**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 102905**

* http://loinc.org#LA105-9 ("No setup or physical help from staff")
* http://loinc.org#LA106-7 ("Setup help only")
* http://loinc.org#LA107-5 ("One person physical assist")
* http://loinc.org#LA108-3 ("Two+ persons physical assist")
* http://loinc.org#LA109-1 ("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")

**Answer options for 102906**

* http://loinc.org#LA105-9 ("No setup or physical help from staff")
* http://loinc.org#LA106-7 ("Setup help only")
* http://loinc.org#LA107-5 ("One person physical assist")
* http://loinc.org#LA108-3 ("Two+ persons physical assist")
* http://loinc.org#LA109-1 ("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")

**Answer options for 102907**

* http://loinc.org#LA105-9 ("No setup or physical help from staff")
* http://loinc.org#LA106-7 ("Setup help only")
* http://loinc.org#LA107-5 ("One person physical assist")
* http://loinc.org#LA108-3 ("Two+ persons physical assist")
* http://loinc.org#LA109-1 ("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")

**Answer options for 102908**

* http://loinc.org#LA105-9 ("No setup or physical help from staff")
* http://loinc.org#LA106-7 ("Setup help only")
* http://loinc.org#LA107-5 ("One person physical assist")
* http://loinc.org#LA108-3 ("Two+ persons physical assist")
* http://loinc.org#LA109-1 ("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")

**Answer options for 102909**

* http://loinc.org#LA105-9 ("No setup or physical help from staff")
* http://loinc.org#LA106-7 ("Setup help only")
* http://loinc.org#LA107-5 ("One person physical assist")
* http://loinc.org#LA108-3 ("Two+ persons physical assist")
* http://loinc.org#LA109-1 ("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")

**Answer options for 102910**

* http://loinc.org#LA105-9 ("No setup or physical help from staff")
* http://loinc.org#LA106-7 ("Setup help only")
* http://loinc.org#LA107-5 ("One person physical assist")
* http://loinc.org#LA108-3 ("Two+ persons physical assist")
* http://loinc.org#LA109-1 ("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")

**Answer options for 102911**

* http://loinc.org#LA105-9 ("No setup or physical help from staff")
* http://loinc.org#LA106-7 ("Setup help only")
* http://loinc.org#LA107-5 ("One person physical assist")
* http://loinc.org#LA108-3 ("Two+ persons physical assist")
* http://loinc.org#LA109-1 ("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")

**Answer options for 102912**

* http://loinc.org#LA105-9 ("No setup or physical help from staff")
* http://loinc.org#LA106-7 ("Setup help only")
* http://loinc.org#LA107-5 ("One person physical assist")
* http://loinc.org#LA108-3 ("Two+ persons physical assist")
* http://loinc.org#LA109-1 ("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")

**Answer options for 102913**

* http://loinc.org#LA105-9 ("No setup or physical help from staff")
* http://loinc.org#LA106-7 ("Setup help only")
* http://loinc.org#LA107-5 ("One person physical assist")
* http://loinc.org#LA108-3 ("Two+ persons physical assist")
* http://loinc.org#LA109-1 ("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")

**Answer options for 102914**

* http://loinc.org#LA105-9 ("No setup or physical help from staff")
* http://loinc.org#LA106-7 ("Setup help only")
* http://loinc.org#LA107-5 ("One person physical assist")
* http://loinc.org#LA108-3 ("Two+ persons physical assist")
* http://loinc.org#LA109-1 ("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")

**Answer options for 102916**

* http://loinc.org#LA110-9 ("Independent - no help provided")
* http://loinc.org#LA111-7 ("Supervision - oversight help only")
* http://loinc.org#LA112-5 ("Physical help limited to transfer only")
* http://loinc.org#LA113-3 ("Physical help in part of bathing activity")
* http://loinc.org#LA114-1 ("Total dependence")
* http://loinc.org#LA115-8 ("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")

**Answer options for 102917**

* http://loinc.org#LA105-9 ("No setup or physical help from staff")
* http://loinc.org#LA106-7 ("Setup help only")
* http://loinc.org#LA107-5 ("One person physical assist")
* http://loinc.org#LA108-3 ("Two+ persons physical assist")
* http://loinc.org#LA109-1 ("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")

**Answer options for 102919**

* http://loinc.org#LA11031-4 ("Steady at all times")
* http://loinc.org#LA11032-2 ("Not steady, but able to stabilize without staff assistance")
* http://loinc.org#LA11033-0 ("Not steady, only able to stabilize with staff assistance")
* http://loinc.org#LA11034-8 ("Activity did not occur")

**Answer options for 102920**

* http://loinc.org#LA11031-4 ("Steady at all times")
* http://loinc.org#LA11032-2 ("Not steady, but able to stabilize without staff assistance")
* http://loinc.org#LA11033-0 ("Not steady, only able to stabilize with staff assistance")
* http://loinc.org#LA11034-8 ("Activity did not occur")

**Answer options for 102921**

* http://loinc.org#LA11031-4 ("Steady at all times")
* http://loinc.org#LA11032-2 ("Not steady, but able to stabilize without staff assistance")
* http://loinc.org#LA11033-0 ("Not steady, only able to stabilize with staff assistance")
* http://loinc.org#LA11034-8 ("Activity did not occur")

**Answer options for 102922**

* http://loinc.org#LA11031-4 ("Steady at all times")
* http://loinc.org#LA11032-2 ("Not steady, but able to stabilize without staff assistance")
* http://loinc.org#LA11033-0 ("Not steady, only able to stabilize with staff assistance")
* http://loinc.org#LA11034-8 ("Activity did not occur")

**Answer options for 102923**

* http://loinc.org#LA11031-4 ("Steady at all times")
* http://loinc.org#LA11032-2 ("Not steady, but able to stabilize without staff assistance")
* http://loinc.org#LA11033-0 ("Not steady, only able to stabilize with staff assistance")
* http://loinc.org#LA11034-8 ("Activity did not occur")

**Answer options for 112228**

* http://loinc.org#LA9606-0 ("No impairment")
* http://loinc.org#LA11036-3 ("Impairment on one side")
* http://loinc.org#LA11037-1 ("Impairment on both sides")

**Answer options for 112229**

* http://loinc.org#LA9606-0 ("No impairment")
* http://loinc.org#LA11036-3 ("Impairment on one side")
* http://loinc.org#LA11037-1 ("Impairment on both sides")

**Answer options for 102927**

* http://loinc.org#LA9941-1 ("Cane/crutch")
* http://loinc.org#LA10117-2 ("Walker")
* http://loinc.org#LA27816-0 ("Wheelchair (manual or electric)")
* http://loinc.org#LA27818-6 ("Limb prosthesis")
* http://loinc.org#LA28019-0 ("None of the above were used")

**Answer options for 102929**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")
* http://loinc.org#LA11137-9 ("Unable to determine")

**Answer options for 102930**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 102933**

* http://loinc.org#LA28862-3 ("Independent - Resident completed all the activities by themself, with or without an assistive device, with no assistance from a helper.")
* http://loinc.org#LA28863-1 ("Needed Some Help - Resident needed partial assistance from another person to complete activities.")
* http://loinc.org#LA28864-9 ("Dependent - A helper completed the activities for the resident.")
* http://loinc.org#LA4489-6 ("Unknown")
* http://loinc.org#LA4720-4 ("Not applicable")

**Answer options for 102934**

* http://loinc.org#LA28862-3 ("Independent - Resident completed all the activities by themself, with or without an assistive device, with no assistance from a helper.")
* http://loinc.org#LA28863-1 ("Needed Some Help - Resident needed partial assistance from another person to complete activities.")
* http://loinc.org#LA28864-9 ("Dependent - A helper completed the activities for the resident.")
* http://loinc.org#LA4489-6 ("Unknown")
* http://loinc.org#LA4720-4 ("Not applicable")

**Answer options for 102935**

* http://loinc.org#LA28862-3 ("Independent - Resident completed all the activities by themself, with or without an assistive device, with no assistance from a helper.")
* http://loinc.org#LA28863-1 ("Needed Some Help - Resident needed partial assistance from another person to complete activities.")
* http://loinc.org#LA28864-9 ("Dependent - A helper completed the activities for the resident.")
* http://loinc.org#LA4489-6 ("Unknown")
* http://loinc.org#LA4720-4 ("Not applicable")

**Answer options for 102936**

* http://loinc.org#LA28862-3 ("Independent - Resident completed all the activities by themself, with or without an assistive device, with no assistance from a helper.")
* http://loinc.org#LA28863-1 ("Needed Some Help - Resident needed partial assistance from another person to complete activities.")
* http://loinc.org#LA28864-9 ("Dependent - A helper completed the activities for the resident.")
* http://loinc.org#LA4489-6 ("Unknown")
* http://loinc.org#LA4720-4 ("Not applicable")

**Answer options for 102937**

* http://loinc.org#LA18363-4 ("Manual wheelchair")
* http://loinc.org#LA26730-4 ("Motorized wheelchair and/or scooter")
* http://loinc.org#LA11549-5 ("Mechanical lift")
* http://loinc.org#LA10117-2 ("Walker")
* http://loinc.org#LA10046-3 ("Orthotics/Prosthetics")
* http://loinc.org#LA9-3 ("None of the above")

**Answer options for 102939**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 102940**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 102941**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 102942**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 102943**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 102944**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 102945**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 136634**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 137359**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 102949**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 102950**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 102951**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 102952**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 102953**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 102955**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 102956**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 102957**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 102958**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 102959**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 102960**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 102961**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 102962**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 102963**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 102964**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 102965**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 102966**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 102967**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 102968**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 102969**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 102970**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 102971**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 102972**

* http://loinc.org#LA19016-7 ("Manual")
* http://loinc.org#LA26847-6 ("Motorized")

**Answer options for 102973**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 102974**

* http://loinc.org#LA19016-7 ("Manual")
* http://loinc.org#LA26847-6 ("Motorized")

**Answer options for 102976**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 102977**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 102978**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 102979**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 102980**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 102981**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 102982**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 102983**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 102984**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 102985**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 102986**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 102987**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 102988**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 102989**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 102990**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 102991**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 102992**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 102995**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 102996**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 102997**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 102998**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 102999**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 103000**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 103001**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 103003**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 103004**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 103005**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 103006**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 103007**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 103008**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 103009**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 103010**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 103011**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 103012**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 103013**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 103014**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 103015**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 103016**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 103017**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 103018**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 103019**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 103020**

* http://loinc.org#LA19016-7 ("Manual")
* http://loinc.org#LA26847-6 ("Motorized")

**Answer options for 103021**

* http://loinc.org#LA27993-7 ("Independent - Resident completes the activity by themself with no assistance from a helper.")
* http://loinc.org#LA27994-5 ("Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity.")
* http://loinc.org#LA28870-6 ("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.")
* http://loinc.org#LA27996-0 ("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.")
* http://loinc.org#LA11759-0 ("Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort.")
* http://loinc.org#LA27998-6 ("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.")
* http://loinc.org#LA27999-4 ("Resident refused")
* http://loinc.org#LA28871-4 ("Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury.")
* http://loinc.org#LA28227-9 ("Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints).")
* http://loinc.org#LA26735-3 ("Not attempted due to medical condition or safety concerns")

**Answer options for 103022**

* http://loinc.org#LA19016-7 ("Manual")
* http://loinc.org#LA26847-6 ("Motorized")

**Answer options for 103024**

* http://loinc.org#LA27819-4 ("Indwelling catheter (including suprapubic catheter and nephrostomy tube)")
* http://loinc.org#LA27820-2 ("External catheter")
* http://loinc.org#LA27821-0 ("Ostomy (including urostomy, ileostomy, and colostomy)")
* http://loinc.org#LA27822-8 ("Intermittent catheterization")
* http://loinc.org#LA9-3 ("None of the above")

**Answer options for 103026**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")
* http://loinc.org#LA11137-9 ("Unable to determine")

**Answer options for 103027**

* http://loinc.org#LA11038-9 ("No improvement")
* http://loinc.org#LA11039-7 ("Decreased wetness")
* http://loinc.org#LA11040-5 ("Completely dry (continent)")
* http://loinc.org#LA11041-3 ("Unable to determine or trial in progress")

**Answer options for 103028**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 103029**

* http://loinc.org#LA11042-1 ("Always continent")
* http://loinc.org#LA11043-9 ("Occasionally incontinent (less than 7 episodes of incontinence)")
* http://loinc.org#LA11044-7 ("Frequently incontinent (7 or more episodes of urinary incontinence, but with at least one episode of continent voiding)")
* http://loinc.org#LA11045-4 ("Always incontinent (no episodes of continent voiding)")
* http://loinc.org#LA11046-2 ("Not rated, resident had a catheter (indwelling, condom), urinary ostomy, or no urine output for the entire 7 days")

**Answer options for 103030**

* http://loinc.org#LA11042-1 ("Always continent")
* http://loinc.org#LA11048-8 ("Occasionally incontinent (one episode of bowel incontinence)")
* http://loinc.org#LA11049-6 ("Frequently incontinent (2 or more episodes of bowel incontinence, but at least one continent bowel movement)")
* http://loinc.org#LA11050-4 ("Always incontinent (no episodes of continent bowel movements)")
* http://loinc.org#LA11051-2 ("Not rated, resident had an ostomy or did not have a bowel movement for the entire 7 days")

**Answer options for 103031**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 103032**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 103034**

* http://loinc.org#LA22099-8 ("Stroke")
* http://loinc.org#LA28875-5 ("Non-traumatic brain dysfunction")
* http://loinc.org#LA28876-3 ("Traumatic brain dysfunction")
* http://loinc.org#LA28877-1 ("Non-traumatic spinal cord dysfunction")
* http://loinc.org#LA28878-9 ("Traumatic spinal cord dysfunction")
* http://loinc.org#LA28879-7 ("Progressive neurological conditions")
* http://loinc.org#LA28880-5 ("Other neurological conditions")
* http://loinc.org#LA28881-3 ("Amputation")
* http://loinc.org#LA28882-1 ("Hip and knee replacement")
* http://loinc.org#LA28883-9 ("Fractures and other multiple trauma")
* http://loinc.org#LA28884-7 ("Other orthopedic conditions")
* http://loinc.org#LA28885-4 ("Debility, cardiorespiratory conditions")
* http://loinc.org#LA28886-2 ("Medically complex conditions")

**Answer options for 106150**

* http://loinc.org#null

**Answer options for 103036**

* http://loinc.org#LA27987-9 ("Cancer (with or without metastasis)")
* http://loinc.org#LA27836-8 ("Anemia (e.g., aplastic, iron deficiency, pernicious, and sickle cell)")
* http://loinc.org#LA27837-6 ("Atrial fibrillation or other dysrhythmias (e.g. bradycardias and tachycardias)")
* http://loinc.org#LA27838-4 ("Coronary artery disease (CAD) (e.g., angina, myocardial infarction, and atherosclerotic heart disease (ASHD))")
* http://loinc.org#LA27839-2 ("Deep venous thrombosis (DVT), pulmonary embolus (PE), or Pulmonary thrombo-embolism (PTE)")
* http://loinc.org#LA27840-0 ("Heart failure (e.g., congestive heart failure (CHF) and pulmonary edema)")
* http://loinc.org#LA7444-8 ("Hypertension")
* http://loinc.org#LA27841-8 ("Orthostatic hypotension")
* http://loinc.org#LA18399-8 ("Peripheral vascular disease (PVD) or peripheral arterial disease (PAD)")
* http://loinc.org#LA9639-1 ("Cirrhosis")
* http://loinc.org#LA27842-6 ("Gastroesophageal reflux disease (GERD) or ulcer (e.g., esophageal, gastric, and peptic ulcers)")
* http://loinc.org#LA27843-4 ("Ulcerative colitis, Crohn's disease, or inflammatory bowel disease")
* http://loinc.org#LA27844-2 ("Benign prostatic hyperplasia (BPH)")
* http://loinc.org#LA27845-9 ("Renal insufficiency, renal failure, or end-stage renal disease (ESRD)")
* http://loinc.org#LA27846-7 ("Neurogenic bladder")
* http://loinc.org#LA27847-5 ("Obstructive uropathy")
* http://loinc.org#LA27848-3 ("Multidrug-resistant organism (MDRO)")
* http://loinc.org#LA7465-3 ("Pneumonia")
* http://loinc.org#LA10591-8 ("Septicemia")
* http://loinc.org#LA10513-2 ("Tuberculosis")
* http://loinc.org#LA27849-1 ("Urinary tract infection (UTI) (last 30 days)")
* http://loinc.org#LA27850-9 ("Viral hepatitis (e.g., Hepatitis A, B, C, D, and E)")
* http://loinc.org#LA27851-7 ("Wound infection (other than foot)")
* http://loinc.org#LA26741-1 ("Diabetes mellitus (DM) (e.g., diabetic retinopathy, nephropathy, and neuropathy)")
* http://loinc.org#LA27852-5 ("Hyponatremia")
* http://loinc.org#LA19699-0 ("Hyperkalemia")
* http://loinc.org#LA27853-3 ("Hyperlipidemia (e.g., hypercholesterolemia)")
* http://loinc.org#LA27854-1 ("Thyroid disorder (e.g., hypothyroidism, hyperthyroidism, and Hashimoto's thyroiditis)")
* http://loinc.org#LA27855-8 ("Arthritis (e.g., degenerative joint disease (DJD), osteoarthritis, and rheumatoid arthritis (RA))")
* http://loinc.org#LA10527-2 ("Osteoporosis")
* http://loinc.org#LA27856-6 ("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)")
* http://loinc.org#LA27857-4 ("Other fracture")
* http://loinc.org#LA22313-3 ("Alzheimer's disease")
* http://loinc.org#LA18262-8 ("Aphasia")
* http://loinc.org#LA27858-2 ("Cerebral palsy")
* http://loinc.org#LA27859-0 ("Cerebrovascular accident (CVA), transient ischemic attack (TIA), or stroke")
* http://loinc.org#LA27860-8 ("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)")
* http://loinc.org#LA27523-2 ("Hemiplegia or hemiparesis")
* http://loinc.org#LA25276-9 ("Paraplegia")
* http://loinc.org#LA27861-6 ("Quadriplegia")
* http://loinc.org#LA27531-5 ("Multiple sclerosis (MS)")
* http://loinc.org#LA27532-3 ("Huntington's disease")
* http://loinc.org#LA27533-1 ("Parkinson's disease")
* http://loinc.org#LA27862-4 ("Tourette's syndrome")
* http://loinc.org#LA27863-2 ("Seizure disorder or epilepsy")
* http://loinc.org#LA27864-0 ("Traumatic brain injury (TBI)")
* http://loinc.org#LA27865-7 ("Malnutrition (protein or calorie) or at risk for malnutrition")
* http://loinc.org#LA27866-5 ("Anxiety disorder")
* http://loinc.org#LA27867-3 ("Depression (other than bipolar)")
* http://loinc.org#LA29615-4 ("Bipolar Disorder")
* http://loinc.org#LA27869-9 ("Psychotic disorder (other than schizophrenia)")
* http://loinc.org#LA27870-7 ("Schizophrenia (e.g., schizoaffective and schizophreniform disorders)")
* http://loinc.org#LA27871-5 ("Post traumatic stress disorder (PTSD)")
* http://loinc.org#LA27872-3 ("Asthma, chronic obstructive pulmonary disease (COPD), or chronic lung disease (e.g., chronic bronchitis and restrictive lung diseases such as asbestosis)")
* http://loinc.org#LA27873-1 ("Respiratory failure")
* http://loinc.org#LA27874-9 ("Cataracts, glaucoma, or macular degeneration")
* http://loinc.org#LA27875-6 ("None of the above active diagnoses within the last 7 days")

**Answer options for 103037**

* http://loinc.org#null

**Answer options for 103040**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 103041**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 103042**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 103043**

* http://loinc.org#LA11150-2 ("No (resident is rarely/never understood)")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 103045**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")
* http://loinc.org#LA11054-6 ("Unable to answer")

**Answer options for 103046**

* http://loinc.org#LA11055-3 ("Almost constantly")
* http://loinc.org#LA6482-9 ("Frequently")
* http://loinc.org#LA6483-7 ("Occasionally")
* http://loinc.org#LA10066-1 ("Rarely")
* http://loinc.org#LA11054-6 ("Unable to answer")

**Answer options for 103048**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")
* http://loinc.org#LA11054-6 ("Unable to answer")

**Answer options for 103049**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")
* http://loinc.org#LA11054-6 ("Unable to answer")

**Answer options for 103052**

* http://loinc.org#LA6752-5 ("Mild")
* http://loinc.org#LA6751-7 ("Moderate")
* http://loinc.org#LA6750-9 ("Severe")
* http://loinc.org#LA11063-7 ("Very severe, horrible")
* http://loinc.org#LA11054-6 ("Unable to answer")

**Answer options for 103053**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 103055**

* http://loinc.org#LA10034-9 ("Non-verbal sounds (e.g., crying, whining, gasping, moaning, or groaning)")
* http://loinc.org#LA10116-4 ("Vocal complaints of pain (e.g., that hurts, ouch, stop)")
* http://loinc.org#LA9968-4 ("Facial expressions (e.g., grimaces, winces, wrinkled forehead, furrowed brow, clenched teeth or jaw)")
* http://loinc.org#LA10063-8 ("Protective body movements or postures (e.g., bracing, guarding, rubbing or massaging a body part/area, clutching or holding a body part during movement)")
* http://loinc.org#LA10032-3 ("None of these signs observed or documented")

**Answer options for 103056**

* http://loinc.org#LA12645-0 ("Indicators of pain or possible pain observed 1 to 2 days")
* http://loinc.org#LA12646-8 ("Indicators of pain or possible pain observed 3 to 4 days")
* http://loinc.org#LA12647-6 ("Indicators of pain or possible pain observed daily")

**Answer options for 103058**

* http://loinc.org#LA27988-7 ("Shortness of breath or trouble breathing with exertion (e.g., walking, bathing, transferring)")
* http://loinc.org#LA27989-5 ("Shortness of breath or trouble breathing when sitting at rest")
* http://loinc.org#LA27990-3 ("Shortness of breath or trouble breathing when lying flat")
* http://loinc.org#LA9-3 ("None of the above")

**Answer options for 103059**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 103060**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 103061**

* http://loinc.org#LA7435-6 ("Fever")
* http://loinc.org#LA15099-7 ("Vomiting")
* http://loinc.org#LA27897-0 ("Dehydrated")
* http://loinc.org#LA27898-8 ("Internal bleeding")
* http://loinc.org#LA9-3 ("None of the above")

**Answer options for 103063**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")
* http://loinc.org#LA11137-9 ("Unable to determine")

**Answer options for 103064**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")
* http://loinc.org#LA11137-9 ("Unable to determine")

**Answer options for 103065**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")
* http://loinc.org#LA11137-9 ("Unable to determine")

**Answer options for 103066**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 103068**

* http://loinc.org#LA137-2 ("None")
* http://loinc.org#LA6306-0 ("One")
* http://loinc.org#LA11073-6 ("Two or more")

**Answer options for 103069**

* http://loinc.org#LA137-2 ("None")
* http://loinc.org#LA6306-0 ("One")
* http://loinc.org#LA11073-6 ("Two or more")

**Answer options for 103070**

* http://loinc.org#LA137-2 ("None")
* http://loinc.org#LA6306-0 ("One")
* http://loinc.org#LA11073-6 ("Two or more")

**Answer options for 103071**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")
* http://loinc.org#LA4489-6 ("Unknown")

**Answer options for 106183**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")
* http://loinc.org#LA4489-6 ("Unknown")

**Answer options for 106184**

* http://loinc.org#LA29540-4 ("Knee Replacement - partial or total")
* http://loinc.org#LA29541-2 ("Hip Replacement - partial or total")
* http://loinc.org#LA29542-0 ("Ankle Replacement - partial or total")
* http://loinc.org#LA29543-8 ("Shoulder Replacement - partial or total")
* http://loinc.org#LA29544-6 ("Spinal surgery involving the spinal cord or major spinal nerves")
* http://loinc.org#LA29545-3 ("Spinal surgery involving fusion of spinal bones")
* http://loinc.org#LA29546-1 ("Spinal surgery involving lamina, discs, or facets")
* http://loinc.org#LA29547-9 ("Other major spinal surgery")
* http://loinc.org#LA29548-7 ("Other orthopedic surgery involving repair fractures of the shoulder (including clavicle and scapula) or arm (but not hand)")
* http://loinc.org#LA29549-5 ("Other orthopedic surgery involving repair fractures of the pelvis, hip, leg, knee, or ankle (not foot)")
* http://loinc.org#LA29550-3 ("Other orthopedic surgery involving repair but not replace joints")
* http://loinc.org#LA29551-1 ("Other orthopedic surgery involving repair other bones (such as hand, foot, jaw)")
* http://loinc.org#LA29552-9 ("Other major orthopedic surgery")
* http://loinc.org#LA29553-7 ("Neurological surgery involving the brain, surrounding tissue or blood vessels, (excludes skull and skin but includes cranial nerves)")
* http://loinc.org#LA29554-5 ("Neurological surgery involving the peripheral or autonomic nervous system - open or percutaneous")
* http://loinc.org#LA29555-2 ("Neurological surgery insertion or removal of spinal or brain neurostimulators, electrodes, catheters, or CSF drainage devices")
* http://loinc.org#LA29556-0 ("Other major neurological surgery")
* http://loinc.org#LA29557-8 ("Cardiopulmonary surgery involving the heart or major blood vessels - open or percutaneous procedures")
* http://loinc.org#LA29558-6 ("Cardiopulmonary surgery involving the respiratory system, including lungs, bronchi, trachea, larynx, or vocal cords - open or endoscopic")
* http://loinc.org#LA29562-8 ("Other major cardiopulmonary surgery")
* http://loinc.org#LA29563-6 ("Genitourinary surgery involving genital systems (such as prostate, testes, ovaries, uterus, vagina, external genitalia)")
* http://loinc.org#LA29564-4 ("Genitourinary surgery involving the kidneys, ureters, adrenal glands, or bladder - open or laparoscopic (includes creation or removal of nephrostomies or urostomies)")
* http://loinc.org#LA29566-9 ("Other major genitourinary surgery")
* http://loinc.org#LA29567-7 ("Other major surgery involving tendons, ligaments, or muscles")
* http://loinc.org#LA29568-5 ("Other major surgery involving the gastrointestinal tract or abdominal contents from the esophagus to the anus, the biliary tree, gall bladder, liver, pancreas, or spleen - open or laparoscopic")
* http://loinc.org#LA29569-3 ("Other major surgery involving the endocrine organs (such as thyroid, parathyroid), neck, lymph nodes, or thymus - open")
* http://loinc.org#LA29570-1 ("Other major surgery involving the breast")
* http://loinc.org#LA29571-9 ("Other major surgery involving repair of deep ulcers, internal brachytherapy, bone marrow or stem cell harvest or transplant")
* http://loinc.org#LA29572-7 ("Other major surgery not listed above")

**Answer options for 103073**

* http://loinc.org#LA10001-8 ("Loss of liquids/solids from mouth when eating or drinking")
* http://loinc.org#LA9977-5 ("Holding food in mouth/cheeks or residual food in mouth after meals")
* http://loinc.org#LA9961-9 ("Coughing or choking during meals or when swallowing medications")
* http://loinc.org#LA9952-8 ("Complaints of difficulty or pain with swallowing")
* http://loinc.org#LA9-3 ("None of the above")

**Answer options for 103077**

* http://loinc.org#LA11074-4 ("No or unknown")
* http://loinc.org#LA11075-1 ("Yes, on physician-prescribed weight-loss regimen")
* http://loinc.org#LA11076-9 ("Yes, not on physician-prescribed weight-loss regimen")

**Answer options for 103078**

* http://loinc.org#LA11074-4 ("No or unknown")
* http://loinc.org#LA18602-5 ("Yes, on physician-prescribed weight-gain regimen")
* http://loinc.org#LA18603-3 ("Yes, not on physician-prescribed weight-gain regimen")

**Answer options for 103080**

* http://loinc.org#LA18604-1 ("Parenteral/IV feeding")
* http://loinc.org#LA18605-8 ("Feeding tube - nasogastric or abdominal (PEG)")
* http://loinc.org#LA9-3 ("None of the above")

**Answer options for 103081**

* http://loinc.org#LA18604-1 ("Parenteral/IV feeding")
* http://loinc.org#LA18605-8 ("Feeding tube - nasogastric or abdominal (PEG)")
* http://loinc.org#LA18606-6 ("Mechanically altered diet - require change in texture of food or liquids (e.g., pureed food, thickened liquids)")
* http://loinc.org#LA18607-4 ("Therapeutic diet (e.g., low salt, diabetic, low cholesterol)")
* http://loinc.org#LA9-3 ("None of the above")

**Answer options for 103084**

* http://loinc.org#LA11077-7 ("25% or less")
* http://loinc.org#LA11078-5 ("26-50%")
* http://loinc.org#LA11079-3 ("51% or more")

**Answer options for 103085**

* http://loinc.org#LA11077-7 ("25% or less")
* http://loinc.org#LA11078-5 ("26-50%")
* http://loinc.org#LA11079-3 ("51% or more")

**Answer options for 103087**

* http://loinc.org#LA11080-1 ("500 cc/day or less")
* http://loinc.org#LA11081-9 ("501 cc/day or more")

**Answer options for 103088**

* http://loinc.org#LA11080-1 ("500 cc/day or less")
* http://loinc.org#LA11081-9 ("501 cc/day or more")

**Answer options for 103090**

* http://loinc.org#LA27932-5 ("Broken or loosely fitting full or partial denture (chipped, cracked, uncleanable, or loose)")
* http://loinc.org#LA27933-3 ("No natural teeth or tooth fragment(s) (edentulous)")
* http://loinc.org#LA27934-1 ("Abnormal mouth tissue (ulcers, masses, oral lesions, including under denture or partial if one is worn)")
* http://loinc.org#LA27935-8 ("Obvious or likely cavity or broken natural teeth")
* http://loinc.org#LA27936-6 ("Inflamed or bleeding gums or loose natural teeth")
* http://loinc.org#LA27937-4 ("Mouth or facial pain, discomfort or difficulty with chewing")
* http://loinc.org#LA27938-2 ("Unable to examine")
* http://loinc.org#LA27939-0 ("None of the above were present")

**Answer options for 103092**

* http://loinc.org#LA28887-0 ("Resident has a pressure ulcer/injury, a scar over bony prominence, or a non-removable dressing/device")
* http://loinc.org#LA27941-6 ("Formal assessment instrument/tool (e.g., Braden, Norton, or other)")
* http://loinc.org#LA27942-4 ("Clinical assessment")
* http://loinc.org#LA9-3 ("None of the above")

**Answer options for 103093**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 103094**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 103110**

* http://loinc.org#LA27943-2 ("Infection of the foot (e.g., cellulitis, purulent drainage)")
* http://loinc.org#LA27944-0 ("Diabetic foot ulcer(s)")
* http://loinc.org#LA27945-7 ("Other open lesion(s) on the foot")
* http://loinc.org#LA27946-5 ("Open lesion(s) other than ulcers, rashes, cuts (e.g., cancer lesion)")
* http://loinc.org#LA27947-3 ("Surgical wound(s)")
* http://loinc.org#LA27948-1 ("Burn(s) (second or third degree)")
* http://loinc.org#LA18608-2 ("Skin tear(s)")
* http://loinc.org#LA27950-7 ("Moisture associated skin damage (MASD) (e.g., incontinence-associated dermatitis [IAD], perspiration, drainage)")
* http://loinc.org#LA27939-0 ("None of the above were present")

**Answer options for 103111**

* http://loinc.org#LA27951-5 ("Pressure reducing device for chair")
* http://loinc.org#LA27952-3 ("Pressure reducing device for bed")
* http://loinc.org#LA27953-1 ("Turning/repositioning program")
* http://loinc.org#LA27954-9 ("Nutrition or hydration intervention to manage skin problems")
* http://loinc.org#LA28888-8 ("Pressure ulcer/injury care")
* http://loinc.org#LA27956-4 ("Surgical wound care")
* http://loinc.org#LA27957-2 ("Application of nonsurgical dressings (with or without topical medications) other than to feet")
* http://loinc.org#LA27958-0 ("Applications of ointments/medications other than to feet")
* http://loinc.org#LA27959-8 ("Application of dressings to feet (with or without topical medications)")
* http://loinc.org#LA27960-6 ("None of the above were provided")

**Answer options for 103127**

* http://loinc.org#LA28462-2 ("No - Antipsychotics were not received")
* http://loinc.org#LA28463-0 ("Yes - Antipsychotics were received on a routine basis only")
* http://loinc.org#LA28464-8 ("Yes - Antipsychotics were received on a PRN basis only")
* http://loinc.org#LA28465-5 ("Yes - Antipsychotics were received on a routine and PRN basis")

**Answer options for 103128**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 103130**

* http://loinc.org#LA28466-3 ("No - GDR has not been documented by a physician as clinically contraindicated")
* http://loinc.org#LA28467-1 ("Yes - GDR has been documented by a physician as clinically contraindicated")

**Answer options for 103132**

* http://loinc.org#LA27634-7 ("No - No issues found during review")
* http://loinc.org#LA27635-4 ("Yes - Issues found during review")
* http://loinc.org#LA27636-2 ("NA - Resident is not taking any medications")

**Answer options for 103133**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 103134**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")
* http://loinc.org#LA28935-7 ("NA - There were no potential clinically significant medication issues identified since admission or resident is not taking any medications")

**Answer options for 103137**

* http://loinc.org#LA6172-6 ("Chemotherapy")
* http://loinc.org#LA4351-8 ("Radiation")
* http://loinc.org#LA27962-2 ("Oxygen therapy")
* http://loinc.org#LA27963-0 ("Suctioning")
* http://loinc.org#LA27964-8 ("Tracheostomy care")
* http://loinc.org#LA28889-6 ("Invasive mechanical ventilator (ventilator or respirator)")
* http://loinc.org#LA28890-4 ("Non-invasive mechanical ventilator (BiPAP/CPAP)")
* http://loinc.org#LA27972-1 ("IV medications")
* http://loinc.org#LA27966-3 ("Transfusions")
* http://loinc.org#LA7216-0 ("Dialysis")
* http://loinc.org#LA6217-9 ("Hospice care")
* http://loinc.org#LA27970-5 ("Isolation or quarantine for active infectious disease (does not include standard body/fluid precautions)")
* http://loinc.org#LA9-3 ("None of the above")

**Answer options for 103138**

* http://loinc.org#LA6172-6 ("Chemotherapy")
* http://loinc.org#LA4351-8 ("Radiation")
* http://loinc.org#LA27962-2 ("Oxygen therapy")
* http://loinc.org#LA27963-0 ("Suctioning")
* http://loinc.org#LA27964-8 ("Tracheostomy care")
* http://loinc.org#LA28889-6 ("Invasive mechanical ventilator (ventilator or respirator)")
* http://loinc.org#LA28890-4 ("Non-invasive mechanical ventilator (BiPAP/CPAP)")
* http://loinc.org#LA27972-1 ("IV medications")
* http://loinc.org#LA27966-3 ("Transfusions")
* http://loinc.org#LA7216-0 ("Dialysis")
* http://loinc.org#LA6217-9 ("Hospice care")
* http://loinc.org#LA27970-5 ("Isolation or quarantine for active infectious disease (does not include standard body/fluid precautions)")
* http://loinc.org#LA9-3 ("None of the above")

**Answer options for 103140**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 103142**

* http://loinc.org#LA28194-1 ("Resident not in this facility during this year's influenza vaccination season")
* http://loinc.org#LA184-4 ("Received outside of this facility")
* http://loinc.org#LA11091-8 ("Not eligible - medical contraindication")
* http://loinc.org#LA186-9 ("Offered and declined")
* http://loinc.org#LA187-7 ("Not offered")
* http://loinc.org#LA26746-0 ("Inability to obtain influenza vaccine due to a declared shortage")
* http://loinc.org#LA9-3 ("None of the above")

**Answer options for 103144**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 103145**

* http://loinc.org#LA11091-8 ("Not eligible - medical contraindication")
* http://loinc.org#LA186-9 ("Offered and declined")
* http://loinc.org#LA187-7 ("Not offered")

**Answer options for 103199**

* http://loinc.org#LA157-0 ("Not used")
* http://loinc.org#LA158-8 ("Used less than daily")
* http://loinc.org#LA159-6 ("Used daily")

**Answer options for 103200**

* http://loinc.org#LA157-0 ("Not used")
* http://loinc.org#LA158-8 ("Used less than daily")
* http://loinc.org#LA159-6 ("Used daily")

**Answer options for 103201**

* http://loinc.org#LA157-0 ("Not used")
* http://loinc.org#LA158-8 ("Used less than daily")
* http://loinc.org#LA159-6 ("Used daily")

**Answer options for 103202**

* http://loinc.org#LA157-0 ("Not used")
* http://loinc.org#LA158-8 ("Used less than daily")
* http://loinc.org#LA159-6 ("Used daily")

**Answer options for 103203**

* http://loinc.org#LA157-0 ("Not used")
* http://loinc.org#LA158-8 ("Used less than daily")
* http://loinc.org#LA159-6 ("Used daily")

**Answer options for 103204**

* http://loinc.org#LA157-0 ("Not used")
* http://loinc.org#LA158-8 ("Used less than daily")
* http://loinc.org#LA159-6 ("Used daily")

**Answer options for 103205**

* http://loinc.org#LA157-0 ("Not used")
* http://loinc.org#LA158-8 ("Used less than daily")
* http://loinc.org#LA159-6 ("Used daily")

**Answer options for 103206**

* http://loinc.org#LA157-0 ("Not used")
* http://loinc.org#LA158-8 ("Used less than daily")
* http://loinc.org#LA159-6 ("Used daily")

**Answer options for 103208**

* http://loinc.org#LA157-0 ("Not used")
* http://loinc.org#LA158-8 ("Used less than daily")
* http://loinc.org#LA159-6 ("Used daily")

**Answer options for 103209**

* http://loinc.org#LA157-0 ("Not used")
* http://loinc.org#LA158-8 ("Used less than daily")
* http://loinc.org#LA159-6 ("Used daily")

**Answer options for 103210**

* http://loinc.org#LA157-0 ("Not used")
* http://loinc.org#LA158-8 ("Used less than daily")
* http://loinc.org#LA159-6 ("Used daily")

**Answer options for 103211**

* http://loinc.org#LA157-0 ("Not used")
* http://loinc.org#LA158-8 ("Used less than daily")
* http://loinc.org#LA159-6 ("Used daily")

**Answer options for 103212**

* http://loinc.org#LA157-0 ("Not used")
* http://loinc.org#LA158-8 ("Used less than daily")
* http://loinc.org#LA159-6 ("Used daily")

**Answer options for 103213**

* http://loinc.org#LA157-0 ("Not used")
* http://loinc.org#LA158-8 ("Used less than daily")
* http://loinc.org#LA159-6 ("Used daily")

**Answer options for 103216**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 103217**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")
* http://loinc.org#LA27973-9 ("Resident has no family or significant other")

**Answer options for 103218**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")
* http://loinc.org#LA27974-7 ("Resident has no guardian or legally authorized representative")

**Answer options for 103220**

* http://loinc.org#LA30462-8 ("Discharge to the community")
* http://loinc.org#LA30463-6 ("Remain in this facility")
* http://loinc.org#LA30464-4 ("Discharge to another facility/institution")
* http://loinc.org#LA11107-2 ("Unknown or uncertain")

**Answer options for 103221**

* http://loinc.org#LA11019-9 ("Resident")
* http://loinc.org#LA11116-3 ("If not resident, then family or significant other")
* http://loinc.org#LA12652-6 ("If not resident, family, or significant other, then guardian or legally authorized representative")
* http://loinc.org#LA11107-2 ("Unknown or uncertain")

**Answer options for 103222**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 103223**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 103224**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")
* http://loinc.org#LA11107-2 ("Unknown or uncertain")

**Answer options for 103226**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")
* http://loinc.org#LA21297-9 ("Information not available")

**Answer options for 103227**

* http://loinc.org#LA11019-9 ("Resident")
* http://loinc.org#LA11116-3 ("If not resident, then family or significant other")
* http://loinc.org#LA12652-6 ("If not resident, family, or significant other, then guardian or legally authorized representative")
* http://loinc.org#LA9-3 ("None of the above")

**Answer options for 103228**

* http://loinc.org#LA12660-9 ("No - referral not needed")
* http://loinc.org#LA18611-6 ("No - referral is or may be needed")
* http://loinc.org#LA18610-8 ("Yes - referral made")

**Answer options for 103231**

* http://loinc.org#LA10-4 ("Admission assessment (required by day 14)")
* http://loinc.org#LA15-3 ("Quarterly review assessment")
* http://loinc.org#LA12-0 ("Annual assessment")
* http://loinc.org#LA13-8 ("Significant change in status assessment")
* http://loinc.org#LA10888-8 ("Significant correction to prior comprehensive assessment")
* http://loinc.org#LA10889-6 ("Significant correction to prior quarterly assessment")
* http://loinc.org#LA9-3 ("None of the above")

**Answer options for 103232**

* http://loinc.org#LA10894-6 ("5-day scheduled assessment")
* http://loinc.org#LA29577-6 ("IPA - Interim Payment Assessment")
* http://loinc.org#LA9-3 ("None of the above")

**Answer options for 103239**

* http://loinc.org#LA7426-5 ("Delirium")
* http://loinc.org#LA28159-4 ("Cognitive loss/dementia")
* http://loinc.org#LA28160-2 ("Visual function")
* http://loinc.org#LA28161-0 ("Communication")
* http://loinc.org#LA28162-8 ("ADL functional/rehabilitation potential")
* http://loinc.org#LA28163-6 ("Urinary incontinence and indwelling catheter")
* http://loinc.org#LA28165-1 ("Psychosocial well-being")
* http://loinc.org#LA28166-9 ("Mood state")
* http://loinc.org#LA28167-7 ("Behavioral symptoms")
* http://loinc.org#LA28168-5 ("Activities")
* http://loinc.org#LA17133-2 ("Falls")
* http://loinc.org#LA28169-3 ("Nutritional status")
* http://loinc.org#LA28170-1 ("Feeding tube")
* http://loinc.org#LA28171-9 ("Dehydration/fluid maintenance")
* http://loinc.org#LA28172-7 ("Dental care")
* http://loinc.org#LA19028-2 ("Pressure ulcer")
* http://loinc.org#LA28173-5 ("Psychotropic drug use")
* http://loinc.org#LA28174-3 ("Physical restraints")
* http://loinc.org#LA7460-4 ("Pain")
* http://loinc.org#LA28175-0 ("Return to community referral")

**Answer options for 103240**

* http://loinc.org#LA7426-5 ("Delirium")
* http://loinc.org#LA28159-4 ("Cognitive loss/dementia")
* http://loinc.org#LA28160-2 ("Visual function")
* http://loinc.org#LA28161-0 ("Communication")
* http://loinc.org#LA28162-8 ("ADL functional/rehabilitation potential")
* http://loinc.org#LA28163-6 ("Urinary incontinence and indwelling catheter")
* http://loinc.org#LA28165-1 ("Psychosocial well-being")
* http://loinc.org#LA28166-9 ("Mood state")
* http://loinc.org#LA28167-7 ("Behavioral symptoms")
* http://loinc.org#LA28168-5 ("Activities")
* http://loinc.org#LA17133-2 ("Falls")
* http://loinc.org#LA28169-3 ("Nutritional status")
* http://loinc.org#LA28170-1 ("Feeding tube")
* http://loinc.org#LA28171-9 ("Dehydration/fluid maintenance")
* http://loinc.org#LA28172-7 ("Dental care")
* http://loinc.org#LA19028-2 ("Pressure ulcer")
* http://loinc.org#LA28173-5 ("Psychotropic drug use")
* http://loinc.org#LA28174-3 ("Physical restraints")
* http://loinc.org#LA7460-4 ("Pain")
* http://loinc.org#LA28175-0 ("Return to community referral")

**Answer options for 103242**

* http://loinc.org#LA10882-1 ("Nursing home (SNF/NF)")
* http://loinc.org#LA10883-9 ("Swing bed")

**Answer options for 103246**

* http://loinc.org#LA2-8 ("Male")
* http://loinc.org#LA3-6 ("Female")

**Answer options for 110233**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 103250**

* http://loinc.org#LA10-4 ("Admission assessment (required by day 14)")
* http://loinc.org#LA15-3 ("Quarterly review assessment")
* http://loinc.org#LA12-0 ("Annual assessment")
* http://loinc.org#LA13-8 ("Significant change in status assessment")
* http://loinc.org#LA10888-8 ("Significant correction to prior comprehensive assessment")
* http://loinc.org#LA10889-6 ("Significant correction to prior quarterly assessment")
* http://loinc.org#LA9-3 ("None of the above")

**Answer options for 103251**

* http://loinc.org#LA10894-6 ("5-day scheduled assessment")
* http://loinc.org#LA29577-6 ("IPA - Interim Payment Assessment")
* http://loinc.org#LA9-3 ("None of the above")

**Answer options for 103254**

* http://loinc.org#LA12627-8 ("Entry tracking record")
* http://loinc.org#LA12628-6 ("Discharge assessment - return not anticipated")
* http://loinc.org#LA12629-4 ("Discharge assessment - return anticipated")
* http://loinc.org#LA12630-2 ("Death in facility tracking record")
* http://loinc.org#LA9-3 ("None of the above")

**Answer options for 103255**

* http://loinc.org#LA32-8 ("No")
* http://loinc.org#LA33-6 ("Yes")

**Answer options for 103262**

* http://loinc.org#LA7512-2 ("Transcription error")
* http://loinc.org#LA28176-8 ("Data entry error")
* http://loinc.org#LA28177-6 ("Software product error")
* http://loinc.org#LA28178-4 ("Item coding error")
* http://loinc.org#LA28180-0 ("Other error requiring modification")

**Answer options for 103263**

* http://loinc.org#LA28181-8 ("Event did not occur")
* http://loinc.org#LA28183-4 ("Other error requiring inactivation")



## Resource Content

```json
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  "url" : "http://loinc.org/q/90473-0",
  "version" : "0.1.0",
  "name" : "MDS_v3_RAI_v1_Nursing_home_comprehensive_NC_item_set",
  "title" : "MDS v3.0 - RAI v1.17.1, 1.17.2 - Nursing home comprehensive (NC) item set",
  "status" : "draft",
  "subjectType" : ["Patient"],
  "date" : "2025-12-02T05:34:32+00:00",
  "publisher" : "MITRE",
  "contact" : [
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      "telecom" : [
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          "use" : "work"
        }
      ]
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  ],
  "copyright" : "This material contains content from LOINC (http://loinc.org). LOINC is copyright © Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee. All rights reserved. LOINC is available at no cost under the license at http://loinc.org/license. LOINC® is a registered United States trademark of Regenstrief Institute, Inc.\r\nCopyright © 2003 Sharon K. Inouye, M.D., MPH. Adapted from: Inouye SK, vanDyck CH, Alessi CA, Balkin S, Siegal AP, Horwitz RI. Clarifying confusion: The Confusion Assessment Method. A new method for detection of delirium. Ann Intern Med. 1990; 113: 941-948. Confusion Assessment Method: Training Manual and Coding Guide. Used with permission.\r\nCopyright © Pfizer Inc. All rights reserved. Developed by Drs. Robert L. Spitzer, Janet B.W. Williams, Kurt Kroenke and colleagues, with an educational grant from Pfizer Inc. No permission required to reproduce, translate, display or distribute.",
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  ],
  "item" : [
    {
      "linkId" : "105334",
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      "text" : "Identification Information",
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      "item" : [
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              "system" : "http://loinc.org",
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            {
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            },
            {
              "valueCoding" : {
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                "display" : "Inactivate existing record"
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            }
          ]
        },
        {
          "linkId" : "102712",
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          "text" : "Facility Provider Numbers",
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          "required" : true,
          "item" : [
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              "linkId" : "102713",
              "code" : [
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            {
              "linkId" : "102714",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "69417-4",
                  "display" : "CMS Certification Number (CCN)"
                }
              ],
              "prefix" : "A0100B",
              "text" : "CMS Certification Number (CCN)",
              "type" : "string",
              "repeats" : false
            },
            {
              "linkId" : "102715",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "45398-5",
                  "display" : "State Provider Number"
                }
              ],
              "prefix" : "A0100C",
              "text" : "State Provider Number",
              "type" : "string",
              "repeats" : false
            }
          ]
        },
        {
          "linkId" : "102716",
          "code" : [
            {
              "system" : "http://loinc.org",
              "code" : "85632-8",
              "display" : "Type of Provider"
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          ],
          "prefix" : "A0200",
          "text" : "Type of Provider",
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          "repeats" : false,
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              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA10883-9",
                "display" : "Swing bed"
              }
            }
          ]
        },
        {
          "linkId" : "110660",
          "prefix" : "A0300",
          "text" : "Optional State Assessment",
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          "required" : true,
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              "linkId" : "105339",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "90522-4",
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                }
              ],
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              "text" : "Is this assessment for state payment purposes only?",
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              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA32-8",
                    "display" : "No"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA33-6",
                    "display" : "Yes"
                  }
                }
              ]
            }
          ]
        },
        {
          "linkId" : "105364",
          "prefix" : "A0310",
          "text" : "Type of Assessment",
          "type" : "group",
          "required" : true,
          "item" : [
            {
              "linkId" : "102718",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "54583-0",
                  "display" : "Federal OBRA Reason for Assessment"
                }
              ],
              "prefix" : "A0310A",
              "text" : "Federal OBRA Reason for Assessment",
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              "repeats" : false,
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                {
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                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA13-8",
                    "display" : "Significant change in status assessment"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
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                },
                {
                  "valueCoding" : {
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                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
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                }
              ]
            },
            {
              "linkId" : "102719",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "54584-8",
                  "display" : "PPS Assessment"
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              ],
              "prefix" : "A0310B",
              "text" : "PPS Assessment",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
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                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
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                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA9-3",
                    "display" : "None of the above"
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                }
              ]
            },
            {
              "linkId" : "102722",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "54587-1",
                  "display" : "Is this assessment the first assessment (OBRA, Scheduled PPS, or Discharge) since the most recent admission/entry or reentry?"
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              ],
              "prefix" : "A0310E",
              "text" : "Is this assessment the first assessment (OBRA, Scheduled PPS, or Discharge) since the most recent admission/entry or reentry?",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA32-8",
                    "display" : "No"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA33-6",
                    "display" : "Yes"
                  }
                }
              ]
            },
            {
              "linkId" : "102723",
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                {
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                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
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                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA12628-6",
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                },
                {
                  "valueCoding" : {
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                    "code" : "LA12629-4",
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                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA12630-2",
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                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
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              ]
            },
            {
              "linkId" : "102724",
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                {
                  "system" : "http://loinc.org",
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              ],
              "prefix" : "A0310G",
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              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
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                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28017-4",
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                }
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              "linkId" : "105365",
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                {
                  "system" : "http://loinc.org",
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              ],
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                  "valueCoding" : {
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                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
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                {
                  "system" : "http://loinc.org",
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              "system" : "http://loinc.org",
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          "answerOption" : [
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              "valueCoding" : {
                "system" : "http://loinc.org",
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              "valueCoding" : {
                "system" : "http://loinc.org",
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              "valueCoding" : {
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        {
          "linkId" : "102727",
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          "type" : "group",
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              "linkId" : "102728",
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                  "system" : "http://loinc.org",
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                  "system" : "http://loinc.org",
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              ],
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          ]
        },
        {
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              "linkId" : "102734",
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                  "system" : "http://loinc.org",
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              "system" : "http://loinc.org",
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        {
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              "system" : "http://loinc.org",
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              "valueCoding" : {
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              "system" : "http://loinc.org",
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              "valueCoding" : {
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              "valueCoding" : {
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              "valueCoding" : {
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                  "valueCoding" : {
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                  "valueCoding" : {
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              "valueCoding" : {
                "system" : "http://loinc.org",
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            {
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              "valueCoding" : {
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            {
              "valueCoding" : {
                "system" : "http://loinc.org",
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            {
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        },
        {
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            {
              "linkId" : "102753",
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                {
                  "valueCoding" : {
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            {
              "linkId" : "102754",
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                },
                {
                  "valueCoding" : {
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                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
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                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
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                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
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                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
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                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
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                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
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                },
                {
                  "valueCoding" : {
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          ]
        },
        {
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          ],
          "prefix" : "A1900",
          "text" : "Admission Date",
          "type" : "decimal",
          "repeats" : false
        },
        {
          "linkId" : "102756",
          "code" : [
            {
              "system" : "http://loinc.org",
              "code" : "52525-3",
              "display" : "Discharge Date"
            }
          ],
          "prefix" : "A2000",
          "text" : "Discharge Date",
          "type" : "decimal",
          "repeats" : false
        },
        {
          "linkId" : "102757",
          "code" : [
            {
              "system" : "http://loinc.org",
              "code" : "55128-3",
              "display" : "Discharge Status"
            }
          ],
          "prefix" : "A2100",
          "text" : "Discharge Status",
          "type" : "choice",
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA10924-1",
                "display" : "Community (private home/apt., board/care, assisted living, group home)"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA10925-8",
                "display" : "Another nursing home or swing bed"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA9928-8",
                "display" : "Acute hospital"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA10064-6",
                "display" : "Psychiatric hospital"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA10928-2",
                "display" : "Inpatient rehabilitation facility"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA10929-0",
                "display" : "ID/DD facility"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA6216-1",
                "display" : "Hospice"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA10939-9",
                "display" : "Deceased"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA10000-0",
                "display" : "Long-Term Care Hospital (LTCH)"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA46-8",
                "display" : "Other"
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            }
          ]
        },
        {
          "linkId" : "102758",
          "code" : [
            {
              "system" : "http://loinc.org",
              "code" : "54592-1",
              "display" : "Previous Assessment Reference Date for Significant Correction"
            }
          ],
          "prefix" : "A2200",
          "text" : "Previous Assessment Reference Date for Significant Correction",
          "type" : "date",
          "repeats" : false
        },
        {
          "linkId" : "102759",
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            {
              "system" : "http://loinc.org",
              "code" : "54593-9",
              "display" : "Assessment Reference Date. Observation end date"
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          ],
          "prefix" : "A2300",
          "text" : "Assessment Reference Date. Observation end date",
          "type" : "date",
          "repeats" : false
        },
        {
          "linkId" : "102760",
          "prefix" : "A2400",
          "text" : "Medicare Stay",
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          "required" : true,
          "item" : [
            {
              "linkId" : "102761",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "54594-7",
                  "display" : "Has the resident had a Medicare-covered stay since the most recent entry?"
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              ],
              "prefix" : "A2400A",
              "text" : "Has the resident had a Medicare-covered stay since the most recent entry?",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA32-8",
                    "display" : "No"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA33-6",
                    "display" : "Yes"
                  }
                }
              ]
            },
            {
              "linkId" : "102762",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "54595-4",
                  "display" : "Start date of most recent Medicare stay"
                }
              ],
              "prefix" : "A2400B",
              "text" : "Start date of most recent Medicare stay",
              "type" : "date",
              "repeats" : false
            },
            {
              "linkId" : "102763",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "54596-2",
                  "display" : "End date of most recent Medicare stay"
                }
              ],
              "prefix" : "A2400C",
              "text" : "End date of most recent Medicare stay",
              "type" : "date",
              "repeats" : false
            }
          ]
        }
      ]
    },
    {
      "linkId" : "102764",
      "prefix" : "B",
      "text" : "Hearing, Speech, and Vision",
      "type" : "group",
      "required" : true,
      "item" : [
        {
          "linkId" : "102765",
          "code" : [
            {
              "system" : "http://loinc.org",
              "code" : "54597-0",
              "display" : "Comatose"
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          ],
          "prefix" : "B0100",
          "text" : "Comatose",
          "type" : "choice",
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA32-8",
                "display" : "No"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA33-6",
                "display" : "Yes"
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            }
          ]
        },
        {
          "linkId" : "102766",
          "code" : [
            {
              "system" : "http://loinc.org",
              "code" : "95744-9",
              "display" : "Hearing"
            }
          ],
          "prefix" : "B0200",
          "text" : "Hearing",
          "type" : "choice",
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA10941-5",
                "display" : "Adequate - no difficulty in normal conversation, social interaction, listening to TV"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA10942-3",
                "display" : "Minimal difficulty - difficulty in some environments (e.g., when person speaks softly or setting is noisy)"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA10943-1",
                "display" : "Moderate difficulty - speaker has to increase volume and speak distinctly"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA10944-9",
                "display" : "Highly impaired - absence of useful hearing"
              }
            }
          ]
        },
        {
          "linkId" : "102767",
          "code" : [
            {
              "system" : "http://loinc.org",
              "code" : "54599-6",
              "display" : "Hearing Aid"
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          ],
          "prefix" : "B0300",
          "text" : "Hearing Aid",
          "type" : "choice",
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA32-8",
                "display" : "No"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA33-6",
                "display" : "Yes"
              }
            }
          ]
        },
        {
          "linkId" : "102768",
          "code" : [
            {
              "system" : "http://loinc.org",
              "code" : "54600-2",
              "display" : "Speech Clarity"
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          ],
          "prefix" : "B0600",
          "text" : "Speech Clarity",
          "type" : "choice",
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA10945-6",
                "display" : "Clear speech - distinct intelligible words"
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            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA10946-4",
                "display" : "Unclear speech - slurred or mumbled words"
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            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA10947-2",
                "display" : "No speech - absence of spoken words"
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            }
          ]
        },
        {
          "linkId" : "102769",
          "code" : [
            {
              "system" : "http://loinc.org",
              "code" : "95737-3",
              "display" : "Makes Self Understood"
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          ],
          "prefix" : "B0700",
          "text" : "Makes Self Understood",
          "type" : "choice",
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA71-6",
                "display" : "Understood"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA10949-8",
                "display" : "Usually understood - difficulty communicating some words or finishing thoughts but is able if prompted or given time"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA10950-6",
                "display" : "Sometimes understood - ability is limited to making concrete requests"
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            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA74-0",
                "display" : "Rarely/never understood"
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            }
          ]
        },
        {
          "linkId" : "102770",
          "code" : [
            {
              "system" : "http://loinc.org",
              "code" : "54602-8",
              "display" : "Ability to Understand Others"
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          ],
          "prefix" : "B0800",
          "text" : "Ability to Understand Others",
          "type" : "choice",
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA10952-2",
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            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA10953-0",
                "display" : "Usually understands - misses some part/intent of message but comprehends most conversation"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA10954-8",
                "display" : "Sometimes understands - responds adequately to simple, direct communication only"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA81-5",
                "display" : "Rarely/never understands"
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            }
          ]
        },
        {
          "linkId" : "102771",
          "code" : [
            {
              "system" : "http://loinc.org",
              "code" : "95745-6",
              "display" : "Vision"
            }
          ],
          "prefix" : "B1000",
          "text" : "Vision",
          "type" : "choice",
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA10956-3",
                "display" : "Adequate - sees fine detail, such as regular print in newspapers/books"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA10957-1",
                "display" : "Impaired - sees large print, but not regular print in newspapers/books"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA10958-9",
                "display" : "Moderately impaired - limited vision; not able to see newspaper headlines but can identify objects"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA10959-7",
                "display" : "Highly impaired - object identification in question, but eyes appear to follow objects"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA10960-5",
                "display" : "Severely impaired - no vision or sees only light, colors or shapes; eyes do not appear to follow objects"
              }
            }
          ]
        },
        {
          "linkId" : "102772",
          "code" : [
            {
              "system" : "http://loinc.org",
              "code" : "54604-4",
              "display" : "Corrective Lenses"
            }
          ],
          "prefix" : "B1200",
          "text" : "Corrective Lenses",
          "type" : "choice",
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA32-8",
                "display" : "No"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA33-6",
                "display" : "Yes"
              }
            }
          ]
        }
      ]
    },
    {
      "linkId" : "102773",
      "prefix" : "C",
      "text" : "Cognitive Patterns",
      "type" : "group",
      "required" : true,
      "item" : [
        {
          "linkId" : "129944",
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            {
              "system" : "http://loinc.org",
              "code" : "54605-1",
              "display" : "Should Brief Interview for Mental Status (C0200-C0500) be Conducted?"
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          ],
          "prefix" : "C0100",
          "text" : "Should Brief Interview for Mental Status (C0200-C0500) be Conducted?",
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          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA11150-2",
                "display" : "No (resident is rarely/never understood)"
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            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA33-6",
                "display" : "Yes"
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            }
          ]
        },
        {
          "linkId" : "129945",
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          "type" : "group",
          "required" : true,
          "item" : [
            {
              "linkId" : "129946",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "103696-1",
                  "display" : "Repetition of Three Words"
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              ],
              "prefix" : "C0200",
              "text" : "Repetition of Three Words",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA137-2",
                    "display" : "None"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA6306-0",
                    "display" : "One"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA6404-3",
                    "display" : "Two"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA6395-3",
                    "display" : "Three"
                  }
                }
              ]
            },
            {
              "linkId" : "129947",
              "prefix" : "C0300",
              "text" : "Temporal Orientation",
              "type" : "group",
              "required" : true,
              "item" : [
                {
                  "linkId" : "129948",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "103697-9",
                      "display" : "Able to report correct year"
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                  ],
                  "prefix" : "C0300A",
                  "text" : "Able to report correct year",
                  "type" : "choice",
                  "repeats" : false,
                  "answerOption" : [
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA10965-4",
                        "display" : "Missed by > 5 years or no answer"
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                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA10966-2",
                        "display" : "Missed by 2-5 years"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA10008-3",
                        "display" : "Missed by 1 year"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA9960-1",
                        "display" : "Correct"
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                    }
                  ]
                },
                {
                  "linkId" : "129949",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "103698-7",
                      "display" : "Able to report correct month"
                    }
                  ],
                  "prefix" : "C0300B",
                  "text" : "Able to report correct month",
                  "type" : "choice",
                  "repeats" : false,
                  "answerOption" : [
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA10969-6",
                        "display" : "Missed by > 1 month or no answer"
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                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA10010-9",
                        "display" : "Missed by 6 days to 1 month"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA9927-0",
                        "display" : "Accurate within 5 days"
                      }
                    }
                  ]
                },
                {
                  "linkId" : "129950",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "103703-5",
                      "display" : "Able to report correct day of the week"
                    }
                  ],
                  "prefix" : "C0300C",
                  "text" : "Able to report correct day of the week",
                  "type" : "choice",
                  "repeats" : false,
                  "answerOption" : [
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA9981-7",
                        "display" : "Incorrect or no answer"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA9960-1",
                        "display" : "Correct"
                      }
                    }
                  ]
                }
              ]
            },
            {
              "linkId" : "129951",
              "prefix" : "C0400",
              "text" : "Recall",
              "type" : "group",
              "required" : true,
              "item" : [
                {
                  "linkId" : "129952",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "103699-5",
                      "display" : "Able to recall \"sock\""
                    }
                  ],
                  "prefix" : "C0400A",
                  "text" : "Able to recall \"sock\"",
                  "type" : "choice",
                  "repeats" : false,
                  "answerOption" : [
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA10974-6",
                        "display" : "No - could not recall"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA10126-3",
                        "display" : "Yes, after cueing (\"something to wear\")"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA10134-7",
                        "display" : "Yes, no cue required"
                      }
                    }
                  ]
                },
                {
                  "linkId" : "129953",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "103700-1",
                      "display" : "Able to recall \"blue\""
                    }
                  ],
                  "prefix" : "C0400B",
                  "text" : "Able to recall \"blue\"",
                  "type" : "choice",
                  "repeats" : false,
                  "answerOption" : [
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA10974-6",
                        "display" : "No - could not recall"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA10978-7",
                        "display" : "Yes, after cueing (\"a color\")"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA10134-7",
                        "display" : "Yes, no cue required"
                      }
                    }
                  ]
                },
                {
                  "linkId" : "129954",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "103701-9",
                      "display" : "Able to recall \"bed\""
                    }
                  ],
                  "prefix" : "C0400C",
                  "text" : "Able to recall \"bed\"",
                  "type" : "choice",
                  "repeats" : false,
                  "answerOption" : [
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA10974-6",
                        "display" : "No - could not recall"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA10125-5",
                        "display" : "Yes, after cueing (\"a piece of furniture\")"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA10134-7",
                        "display" : "Yes, no cue required"
                      }
                    }
                  ]
                }
              ]
            },
            {
              "linkId" : "129955",
              "prefix" : "C0500",
              "text" : "BIMS Summary Score",
              "type" : "decimal"
            }
          ]
        },
        {
          "linkId" : "129956",
          "code" : [
            {
              "system" : "http://loinc.org",
              "code" : "54615-0",
              "display" : "Should the Staff Assessment for Mental Status (C0700-C1000) be Conducted?"
            }
          ],
          "prefix" : "C0600",
          "text" : "Should the Staff Assessment for Mental Status (C0700-C1000) be Conducted?",
          "type" : "choice",
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA28146-1",
                "display" : "No (resident was able to complete Brief Interview for Mental Status)"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA28147-9",
                "display" : "Yes (resident was unable to complete Brief Interview for Mental Status)"
              }
            }
          ]
        },
        {
          "linkId" : "129940",
          "text" : "Staff assessment for mental status",
          "type" : "group",
          "required" : true,
          "item" : [
            {
              "linkId" : "129960",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "54616-8",
                  "display" : "Short-term memory OK"
                }
              ],
              "text" : "Short-term memory OK",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA55-9",
                    "display" : "Memory OK"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA56-7",
                    "display" : "Memory problem"
                  }
                }
              ]
            },
            {
              "linkId" : "129959",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "54617-6",
                  "display" : "Long-term memory OK"
                }
              ],
              "text" : "Long-term memory OK",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA55-9",
                    "display" : "Memory OK"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA56-7",
                    "display" : "Memory problem"
                  }
                }
              ]
            },
            {
              "linkId" : "129958",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "95743-1",
                  "display" : "Memory &or recall ability"
                }
              ],
              "text" : "Memory &or recall ability",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA9962-7",
                    "display" : "Current season"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA9998-1",
                    "display" : "Location of own room"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA10085-1",
                    "display" : "Staff names and faces"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA33609-1",
                    "display" : "That they are in a nursing home/hospital swing bed."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26729-6",
                    "display" : "None of the above were recalled"
                  }
                }
              ]
            },
            {
              "linkId" : "129957",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "54624-2",
                  "display" : "Cognitive skills for daily decision making"
                }
              ],
              "text" : "Cognitive skills for daily decision making",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA10985-2",
                    "display" : "Independent - decisions consistent/reasonable"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA10986-0",
                    "display" : "Modified independence - some difficulty in new situations only"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA10987-8",
                    "display" : "Moderately impaired - decisions poor; cues/supervision required"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA10988-6",
                    "display" : "Severely impaired - never/rarely made decisions"
                  }
                }
              ]
            }
          ]
        },
        {
          "linkId" : "129961",
          "text" : "Delirium",
          "type" : "group",
          "required" : true,
          "item" : [
            {
              "linkId" : "129962",
              "text" : "Signs and Symptoms of Delirium (from CAM)",
              "type" : "group",
              "required" : true,
              "item" : [
                {
                  "linkId" : "129966",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "95813-2",
                      "display" : "Acute onset mental change. Is there evidence of an acute change in mental status from the patient's baseline?"
                    }
                  ],
                  "text" : "Acute onset mental change. Is there evidence of an acute change in mental status from the patient's baseline?",
                  "type" : "choice",
                  "repeats" : false,
                  "answerOption" : [
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA32-8",
                        "display" : "No"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA33-6",
                        "display" : "Yes"
                      }
                    }
                  ]
                },
                {
                  "linkId" : "129965",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "95812-4",
                      "display" : "Inattention - Did the patient have difficulty focusing attention, for example, being easily distractible or having difficulty keeping track of what was being said?"
                    }
                  ],
                  "text" : "Inattention - Did the patient have difficulty focusing attention, for example, being easily distractible or having difficulty keeping track of what was being said?",
                  "type" : "choice",
                  "repeats" : false,
                  "answerOption" : [
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA61-7",
                        "display" : "Behavior not present"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA10992-8",
                        "display" : "Behavior continuously present, does not fluctuate"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA10993-6",
                        "display" : "Behavior present, fluctuates (comes and goes, changes in severity)"
                      }
                    }
                  ]
                },
                {
                  "linkId" : "129964",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "95814-0",
                      "display" : "Disorganized thinking - Was the patient's thinking disorganized or incoherent, such as rambling or irrelevant conversation, unclear or illogical flow of ideas, or unpredictable switching from subject to subject)?"
                    }
                  ],
                  "text" : "Disorganized thinking - Was the patient's thinking disorganized or incoherent, such as rambling or irrelevant conversation, unclear or illogical flow of ideas, or unpredictable switching from subject to subject)?",
                  "type" : "choice",
                  "repeats" : false,
                  "answerOption" : [
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA61-7",
                        "display" : "Behavior not present"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA10992-8",
                        "display" : "Behavior continuously present, does not fluctuate"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA10993-6",
                        "display" : "Behavior present, fluctuates (comes and goes, changes in severity)"
                      }
                    }
                  ]
                },
                {
                  "linkId" : "129963",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "95815-7",
                      "display" : "Altered level of consciousness - Did the resident have altered level of consciousness, as indicated by any of the following crfiteria?"
                    }
                  ],
                  "text" : "Altered level of consciousness - Did the resident have altered level of consciousness, as indicated by any of the following crfiteria?",
                  "type" : "choice",
                  "repeats" : false,
                  "answerOption" : [
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA61-7",
                        "display" : "Behavior not present"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA10992-8",
                        "display" : "Behavior continuously present, does not fluctuate"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA10993-6",
                        "display" : "Behavior present, fluctuates (comes and goes, changes in severity)"
                      }
                    }
                  ]
                }
              ]
            }
          ]
        }
      ]
    },
    {
      "linkId" : "105758",
      "prefix" : "D",
      "text" : "Mood",
      "type" : "group",
      "required" : true,
      "item" : [
        {
          "linkId" : "102799",
          "code" : [
            {
              "system" : "http://loinc.org",
              "code" : "54634-1",
              "display" : "Should Resident Mood Interview be Conducted?"
            }
          ],
          "prefix" : "D0100",
          "text" : "Should Resident Mood Interview be Conducted?",
          "type" : "choice",
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA11150-2",
                "display" : "No (resident is rarely/never understood)"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA33-6",
                "display" : "Yes"
              }
            }
          ]
        },
        {
          "linkId" : "102800",
          "prefix" : "D0200",
          "text" : "Resident Mood Interview (PHQ-9)",
          "type" : "group",
          "required" : true,
          "item" : [
            {
              "linkId" : "102801",
              "prefix" : "D0200_1",
              "text" : "Symptom Presence",
              "type" : "group",
              "required" : true,
              "item" : [
                {
                  "linkId" : "102802",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "54636-6",
                      "display" : "Little interest or pleasure in doing things"
                    }
                  ],
                  "prefix" : "D0200A1",
                  "text" : "Little interest or pleasure in doing things",
                  "type" : "choice",
                  "repeats" : false,
                  "answerOption" : [
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA33719-8",
                        "display" : "No (enter 0 in column 2)"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA33720-6",
                        "display" : "Yes (enter 0-3 in column 2)"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA33753-7",
                        "display" : "No response (leave column 2 blank)"
                      }
                    }
                  ]
                },
                {
                  "linkId" : "102803",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "54638-2",
                      "display" : "Feeling down, depressed or hopeless"
                    }
                  ],
                  "prefix" : "D0200B1",
                  "text" : "Feeling down, depressed or hopeless",
                  "type" : "choice",
                  "repeats" : false,
                  "answerOption" : [
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA33719-8",
                        "display" : "No (enter 0 in column 2)"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA33720-6",
                        "display" : "Yes (enter 0-3 in column 2)"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA33753-7",
                        "display" : "No response (leave column 2 blank)"
                      }
                    }
                  ]
                },
                {
                  "linkId" : "102804",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "54640-8",
                      "display" : "Trouble falling or staying asleep, or sleeping too much"
                    }
                  ],
                  "prefix" : "D0200C1",
                  "text" : "Trouble falling or staying asleep, or sleeping too much",
                  "type" : "choice",
                  "repeats" : false,
                  "answerOption" : [
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA33719-8",
                        "display" : "No (enter 0 in column 2)"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA33720-6",
                        "display" : "Yes (enter 0-3 in column 2)"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA33753-7",
                        "display" : "No response (leave column 2 blank)"
                      }
                    }
                  ]
                },
                {
                  "linkId" : "102805",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "54642-4",
                      "display" : "Feeling tired or having little energy"
                    }
                  ],
                  "prefix" : "D0200D1",
                  "text" : "Feeling tired or having little energy",
                  "type" : "choice",
                  "repeats" : false,
                  "answerOption" : [
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA33719-8",
                        "display" : "No (enter 0 in column 2)"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA33720-6",
                        "display" : "Yes (enter 0-3 in column 2)"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA33753-7",
                        "display" : "No response (leave column 2 blank)"
                      }
                    }
                  ]
                },
                {
                  "linkId" : "102806",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "54644-0",
                      "display" : "Poor appetite or overeating"
                    }
                  ],
                  "prefix" : "D0200E1",
                  "text" : "Poor appetite or overeating",
                  "type" : "choice",
                  "repeats" : false,
                  "answerOption" : [
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA33719-8",
                        "display" : "No (enter 0 in column 2)"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA33720-6",
                        "display" : "Yes (enter 0-3 in column 2)"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA33753-7",
                        "display" : "No response (leave column 2 blank)"
                      }
                    }
                  ]
                },
                {
                  "linkId" : "102807",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "54646-5",
                      "display" : "Feeling bad about yourself - or that you are a failure or have let yourself or your family down"
                    }
                  ],
                  "prefix" : "D0200F1",
                  "text" : "Feeling bad about yourself - or that you are a failure or have let yourself or your family down",
                  "type" : "choice",
                  "repeats" : false,
                  "answerOption" : [
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA33719-8",
                        "display" : "No (enter 0 in column 2)"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA33720-6",
                        "display" : "Yes (enter 0-3 in column 2)"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA33753-7",
                        "display" : "No response (leave column 2 blank)"
                      }
                    }
                  ]
                },
                {
                  "linkId" : "102808",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "54648-1",
                      "display" : "Trouble concentrating on things, such as reading the newspaper or watching television"
                    }
                  ],
                  "prefix" : "D0200G1",
                  "text" : "Trouble concentrating on things, such as reading the newspaper or watching television",
                  "type" : "choice",
                  "repeats" : false,
                  "answerOption" : [
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA33719-8",
                        "display" : "No (enter 0 in column 2)"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA33720-6",
                        "display" : "Yes (enter 0-3 in column 2)"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA33753-7",
                        "display" : "No response (leave column 2 blank)"
                      }
                    }
                  ]
                },
                {
                  "linkId" : "102809",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "54650-7",
                      "display" : "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"
                    }
                  ],
                  "prefix" : "D0200H1",
                  "text" : "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",
                  "type" : "choice",
                  "repeats" : false,
                  "answerOption" : [
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA33719-8",
                        "display" : "No (enter 0 in column 2)"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA33720-6",
                        "display" : "Yes (enter 0-3 in column 2)"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA33753-7",
                        "display" : "No response (leave column 2 blank)"
                      }
                    }
                  ]
                },
                {
                  "linkId" : "102810",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "54652-3",
                      "display" : "Thoughts that you would be better off dead, or of hurting yourself in some way"
                    }
                  ],
                  "prefix" : "D0200I1",
                  "text" : "Thoughts that you would be better off dead, or of hurting yourself in some way",
                  "type" : "choice",
                  "repeats" : false,
                  "answerOption" : [
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA33719-8",
                        "display" : "No (enter 0 in column 2)"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA33720-6",
                        "display" : "Yes (enter 0-3 in column 2)"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA33753-7",
                        "display" : "No response (leave column 2 blank)"
                      }
                    }
                  ]
                }
              ]
            },
            {
              "linkId" : "102811",
              "prefix" : "D0200_2",
              "text" : "Symptom Frequency",
              "type" : "group",
              "required" : true,
              "item" : [
                {
                  "linkId" : "102812",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "54637-4",
                      "display" : "Little interest or pleasure in doing things"
                    }
                  ],
                  "prefix" : "D0200A2",
                  "text" : "Little interest or pleasure in doing things",
                  "type" : "choice",
                  "repeats" : false,
                  "answerOption" : [
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA10997-7",
                        "display" : "Never or 1 day"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA10998-5",
                        "display" : "2-6 days (several days)"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA10999-3",
                        "display" : "7-11 days (half or more of the days)"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA11000-9",
                        "display" : "12-14 days (nearly every day)"
                      }
                    }
                  ]
                },
                {
                  "linkId" : "102813",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "54639-0",
                      "display" : "Feeling down, depressed or hopeless"
                    }
                  ],
                  "prefix" : "D0200B2",
                  "text" : "Feeling down, depressed or hopeless",
                  "type" : "choice",
                  "repeats" : false,
                  "answerOption" : [
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA10997-7",
                        "display" : "Never or 1 day"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA10998-5",
                        "display" : "2-6 days (several days)"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA10999-3",
                        "display" : "7-11 days (half or more of the days)"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA11000-9",
                        "display" : "12-14 days (nearly every day)"
                      }
                    }
                  ]
                },
                {
                  "linkId" : "102814",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "54641-6",
                      "display" : "Trouble falling or staying asleep, or sleeping too much"
                    }
                  ],
                  "prefix" : "D0200C2",
                  "text" : "Trouble falling or staying asleep, or sleeping too much",
                  "type" : "choice",
                  "repeats" : false,
                  "answerOption" : [
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA10997-7",
                        "display" : "Never or 1 day"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA10998-5",
                        "display" : "2-6 days (several days)"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA10999-3",
                        "display" : "7-11 days (half or more of the days)"
                      }
                    },
                    {
                      "valueCoding" : {
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                        "code" : "LA11000-9",
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                      }
                    }
                  ]
                },
                {
                  "linkId" : "102815",
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                    {
                      "system" : "http://loinc.org",
                      "code" : "54643-2",
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                    }
                  ],
                  "prefix" : "D0200D2",
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                  "repeats" : false,
                  "answerOption" : [
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                        "system" : "http://loinc.org",
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                    },
                    {
                      "valueCoding" : {
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                    },
                    {
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                        "system" : "http://loinc.org",
                        "code" : "LA10999-3",
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                    },
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                    }
                  ]
                },
                {
                  "linkId" : "102816",
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                    {
                      "system" : "http://loinc.org",
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                  ],
                  "prefix" : "D0200E2",
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                  "repeats" : false,
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                    },
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                    },
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                    }
                  ]
                },
                {
                  "linkId" : "102817",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "54647-3",
                      "display" : "Feeling bad about yourself - or that you are a failure or have let yourself or your family down"
                    }
                  ],
                  "prefix" : "D0200F2",
                  "text" : "Feeling bad about yourself - or that you are a failure or have let yourself or your family down",
                  "type" : "choice",
                  "repeats" : false,
                  "answerOption" : [
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA10997-7",
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                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
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                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
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                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA11000-9",
                        "display" : "12-14 days (nearly every day)"
                      }
                    }
                  ]
                },
                {
                  "linkId" : "102818",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "54649-9",
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                    }
                  ],
                  "prefix" : "D0200G2",
                  "text" : "Trouble concentrating on things, such as reading the newspaper or watching television",
                  "type" : "choice",
                  "repeats" : false,
                  "answerOption" : [
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
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                    },
                    {
                      "valueCoding" : {
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                    },
                    {
                      "valueCoding" : {
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                    },
                    {
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                    }
                  ]
                },
                {
                  "linkId" : "102819",
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                  ],
                  "prefix" : "D0150H2",
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                  "repeats" : false,
                  "answerOption" : [
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                      "valueCoding" : {
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                    {
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                    },
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                    },
                    {
                      "valueCoding" : {
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                        "code" : "LA11000-9",
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                    }
                  ]
                },
                {
                  "linkId" : "102820",
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                    {
                      "system" : "http://loinc.org",
                      "code" : "54653-1",
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                  ],
                  "prefix" : "D0200I2",
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                  "repeats" : false,
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                      "valueCoding" : {
                        "system" : "http://loinc.org",
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                    {
                      "valueCoding" : {
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                    },
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                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
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                    }
                  ]
                }
              ]
            }
          ]
        },
        {
          "linkId" : "102821",
          "prefix" : "D0300",
          "text" : "Total Severity Score",
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        {
          "linkId" : "102823",
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          "text" : "Staff Assessment of Resident Mood (PHQ-9-OV)",
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            {
              "linkId" : "102824",
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              "required" : true,
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                  "linkId" : "102825",
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                  ],
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                    },
                    {
                      "valueCoding" : {
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                    }
                  ]
                },
                {
                  "linkId" : "102826",
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                    {
                      "system" : "http://loinc.org",
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                  ],
                  "prefix" : "D0500B1",
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                  "repeats" : false,
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                      "valueCoding" : {
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                    },
                    {
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                    }
                  ]
                },
                {
                  "linkId" : "102827",
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                      "system" : "http://loinc.org",
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                  ],
                  "prefix" : "D0500C1",
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                  "type" : "choice",
                  "repeats" : false,
                  "answerOption" : [
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                    },
                    {
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                    }
                  ]
                },
                {
                  "linkId" : "102828",
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                    }
                  ],
                  "prefix" : "D0500D1",
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                    },
                    {
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                    }
                  ]
                },
                {
                  "linkId" : "102829",
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                    {
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                  ],
                  "prefix" : "D0500E1",
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                    },
                    {
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                    }
                  ]
                },
                {
                  "linkId" : "102830",
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                      "system" : "http://loinc.org",
                      "code" : "54668-9",
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                    }
                  ],
                  "prefix" : "D0500F1",
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                  "answerOption" : [
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                      "valueCoding" : {
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                      }
                    },
                    {
                      "valueCoding" : {
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                        "code" : "LA33-6",
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                    }
                  ]
                },
                {
                  "linkId" : "102831",
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                  ],
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                  "type" : "choice",
                  "repeats" : false,
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                    },
                    {
                      "valueCoding" : {
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                    }
                  ]
                },
                {
                  "linkId" : "102832",
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                    }
                  ],
                  "prefix" : "D0500H1",
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                  "type" : "choice",
                  "repeats" : false,
                  "answerOption" : [
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                    },
                    {
                      "valueCoding" : {
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                    }
                  ]
                },
                {
                  "linkId" : "102833",
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                      "system" : "http://loinc.org",
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                    }
                  ],
                  "prefix" : "D0500I1",
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                  "answerOption" : [
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                      "valueCoding" : {
                        "system" : "http://loinc.org",
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                    },
                    {
                      "valueCoding" : {
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                    }
                  ]
                },
                {
                  "linkId" : "102834",
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                    {
                      "system" : "http://loinc.org",
                      "code" : "54675-4",
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                  ],
                  "prefix" : "D0500J1",
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                  "repeats" : false,
                  "answerOption" : [
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                      "valueCoding" : {
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                    }
                  ]
                }
              ]
            },
            {
              "linkId" : "102835",
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              "text" : "Symptom Frequency",
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              "required" : true,
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                {
                  "linkId" : "102836",
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                    {
                      "system" : "http://loinc.org",
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                  ],
                  "prefix" : "D0500A2",
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                  "answerOption" : [
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                      "valueCoding" : {
                        "system" : "http://loinc.org",
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                    {
                      "valueCoding" : {
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                    },
                    {
                      "valueCoding" : {
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                    },
                    {
                      "valueCoding" : {
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                    }
                  ]
                },
                {
                  "linkId" : "102837",
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                      "system" : "http://loinc.org",
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                    }
                  ],
                  "prefix" : "D0500B2",
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                  "repeats" : false,
                  "answerOption" : [
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                      "valueCoding" : {
                        "system" : "http://loinc.org",
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                    },
                    {
                      "valueCoding" : {
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                      }
                    },
                    {
                      "valueCoding" : {
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                    },
                    {
                      "valueCoding" : {
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                      }
                    }
                  ]
                },
                {
                  "linkId" : "102838",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "54663-0",
                      "display" : "Trouble falling or staying asleep, or sleeping too much"
                    }
                  ],
                  "prefix" : "D0500C2",
                  "text" : "Trouble falling or staying asleep, or sleeping too much",
                  "type" : "choice",
                  "repeats" : false,
                  "answerOption" : [
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
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                        "display" : "Never or 1 day"
                      }
                    },
                    {
                      "valueCoding" : {
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                      }
                    },
                    {
                      "valueCoding" : {
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                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA11000-9",
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                      }
                    }
                  ]
                },
                {
                  "linkId" : "102839",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "54665-5",
                      "display" : "Feeling tired or having little energy"
                    }
                  ],
                  "prefix" : "D0500D2",
                  "text" : "Feeling tired or having little energy",
                  "type" : "choice",
                  "repeats" : false,
                  "answerOption" : [
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
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                        "display" : "Never or 1 day"
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                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA10998-5",
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                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA10999-3",
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                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA11000-9",
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                      }
                    }
                  ]
                },
                {
                  "linkId" : "102840",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "54667-1",
                      "display" : "Poor appetite or overeating"
                    }
                  ],
                  "prefix" : "D0500E2",
                  "text" : "Poor appetite or overeating",
                  "type" : "choice",
                  "repeats" : false,
                  "answerOption" : [
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
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                        "display" : "Never or 1 day"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA10998-5",
                        "display" : "2-6 days (several days)"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA10999-3",
                        "display" : "7-11 days (half or more of the days)"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA11000-9",
                        "display" : "12-14 days (nearly every day)"
                      }
                    }
                  ]
                },
                {
                  "linkId" : "102841",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "54669-7",
                      "display" : "Indicating that s/he feels bad about self, is a failure, or has let self or family down"
                    }
                  ],
                  "prefix" : "D0500F2",
                  "text" : "Indicating that s/he feels bad about self, is a failure, or has let self or family down",
                  "type" : "choice",
                  "repeats" : false,
                  "answerOption" : [
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA10997-7",
                        "display" : "Never or 1 day"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA10998-5",
                        "display" : "2-6 days (several days)"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA10999-3",
                        "display" : "7-11 days (half or more of the days)"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA11000-9",
                        "display" : "12-14 days (nearly every day)"
                      }
                    }
                  ]
                },
                {
                  "linkId" : "102842",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "54671-3",
                      "display" : "Trouble concentrating on things, such as reading the newspaper or watching television"
                    }
                  ],
                  "prefix" : "D0500G2",
                  "text" : "Trouble concentrating on things, such as reading the newspaper or watching television",
                  "type" : "choice",
                  "repeats" : false,
                  "answerOption" : [
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA10997-7",
                        "display" : "Never or 1 day"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA10998-5",
                        "display" : "2-6 days (several days)"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA10999-3",
                        "display" : "7-11 days (half or more of the days)"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA11000-9",
                        "display" : "12-14 days (nearly every day)"
                      }
                    }
                  ]
                },
                {
                  "linkId" : "102843",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "54904-8",
                      "display" : "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"
                    }
                  ],
                  "prefix" : "D0500H2",
                  "text" : "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",
                  "type" : "choice",
                  "repeats" : false,
                  "answerOption" : [
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA10997-7",
                        "display" : "Never or 1 day"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA10998-5",
                        "display" : "2-6 days (several days)"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA10999-3",
                        "display" : "7-11 days (half or more of the days)"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA11000-9",
                        "display" : "12-14 days (nearly every day)"
                      }
                    }
                  ]
                },
                {
                  "linkId" : "102844",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "54674-7",
                      "display" : "States that life isn't worth living, wishes for death, or attempts to harm self"
                    }
                  ],
                  "prefix" : "D0500I2",
                  "text" : "States that life isn't worth living, wishes for death, or attempts to harm self",
                  "type" : "choice",
                  "repeats" : false,
                  "answerOption" : [
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA10997-7",
                        "display" : "Never or 1 day"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA10998-5",
                        "display" : "2-6 days (several days)"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA10999-3",
                        "display" : "7-11 days (half or more of the days)"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA11000-9",
                        "display" : "12-14 days (nearly every day)"
                      }
                    }
                  ]
                },
                {
                  "linkId" : "102845",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "54676-2",
                      "display" : "Being short-tempered, easily annoyed"
                    }
                  ],
                  "prefix" : "D0500J2",
                  "text" : "Being short-tempered, easily annoyed",
                  "type" : "choice",
                  "repeats" : false,
                  "answerOption" : [
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA10997-7",
                        "display" : "Never or 1 day"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA10998-5",
                        "display" : "2-6 days (several days)"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA10999-3",
                        "display" : "7-11 days (half or more of the days)"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA11000-9",
                        "display" : "12-14 days (nearly every day)"
                      }
                    }
                  ]
                }
              ]
            }
          ]
        },
        {
          "linkId" : "102846",
          "prefix" : "D0600",
          "text" : "Total Severity Score",
          "type" : "decimal"
        }
      ]
    },
    {
      "linkId" : "102848",
      "prefix" : "E",
      "text" : "Behavior",
      "type" : "group",
      "required" : true,
      "item" : [
        {
          "linkId" : "102849",
          "code" : [
            {
              "system" : "http://loinc.org",
              "code" : "86597-2",
              "display" : "Potential Indicators of Psychosis"
            }
          ],
          "prefix" : "E0100",
          "text" : "Potential Indicators of Psychosis",
          "type" : "choice",
          "repeats" : true,
          "answerOption" : [
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27795-6",
                "display" : "Hallucinations (perceptual experiences in the absence of real external sensory stimuli)"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27796-4",
                "display" : "Delusions (misconceptions or beliefs that are firmly held, contrary to reality)"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA9-3",
                "display" : "None of the above"
              }
            }
          ]
        },
        {
          "linkId" : "102850",
          "prefix" : "E0200",
          "text" : "Behavioral Symptom - Presence & Frequency",
          "type" : "group",
          "required" : true,
          "item" : [
            {
              "linkId" : "102851",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "54682-0",
                  "display" : "Physical behavioral symptoms directed toward others"
                }
              ],
              "prefix" : "E0200A",
              "text" : "Physical behavioral symptoms directed toward others",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11005-8",
                    "display" : "Behavior not exhibited"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11006-6",
                    "display" : "Behavior of this type occurred 1 to 3 days"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA94-8",
                    "display" : "Behavior of this type occurred 4 to 6 days, but less than daily"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA95-5",
                    "display" : "Behavior of this type occurred daily"
                  }
                }
              ]
            },
            {
              "linkId" : "102852",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "54683-8",
                  "display" : "Verbal behavioral symptoms directed toward others"
                }
              ],
              "prefix" : "E0200B",
              "text" : "Verbal behavioral symptoms directed toward others",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11005-8",
                    "display" : "Behavior not exhibited"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11006-6",
                    "display" : "Behavior of this type occurred 1 to 3 days"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA94-8",
                    "display" : "Behavior of this type occurred 4 to 6 days, but less than daily"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA95-5",
                    "display" : "Behavior of this type occurred daily"
                  }
                }
              ]
            },
            {
              "linkId" : "102853",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "54684-6",
                  "display" : "Other behavioral symptoms not directed toward others"
                }
              ],
              "prefix" : "E0200C",
              "text" : "Other behavioral symptoms not directed toward others",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11005-8",
                    "display" : "Behavior not exhibited"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11006-6",
                    "display" : "Behavior of this type occurred 1 to 3 days"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA94-8",
                    "display" : "Behavior of this type occurred 4 to 6 days, but less than daily"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA95-5",
                    "display" : "Behavior of this type occurred daily"
                  }
                }
              ]
            }
          ]
        },
        {
          "linkId" : "102854",
          "code" : [
            {
              "system" : "http://loinc.org",
              "code" : "54685-3",
              "display" : "Overall Presence of Behavioral Symptoms.Were any behavioral symptoms in questions E0200 coded 1, 2, or 3?"
            }
          ],
          "prefix" : "E0300",
          "text" : "Overall Presence of Behavioral Symptoms.Were any behavioral symptoms in questions E0200 coded 1, 2, or 3?",
          "type" : "choice",
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA32-8",
                "display" : "No"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA33-6",
                "display" : "Yes"
              }
            }
          ]
        },
        {
          "linkId" : "102855",
          "prefix" : "E0500",
          "text" : "Impact on Resident",
          "type" : "group",
          "required" : true,
          "item" : [
            {
              "linkId" : "102856",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "54686-1",
                  "display" : "Did any of the identified symptom(s): Put the resident at significant risk for physical illness or injury?"
                }
              ],
              "prefix" : "E0500A",
              "text" : "Did any of the identified symptom(s): Put the resident at significant risk for physical illness or injury?",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA32-8",
                    "display" : "No"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA33-6",
                    "display" : "Yes"
                  }
                }
              ]
            },
            {
              "linkId" : "102857",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "54687-9",
                  "display" : "Did any of the identified symptom(s): Significantly interfere with the resident's care?"
                }
              ],
              "prefix" : "E0500B",
              "text" : "Did any of the identified symptom(s): Significantly interfere with the resident's care?",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA32-8",
                    "display" : "No"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA33-6",
                    "display" : "Yes"
                  }
                }
              ]
            },
            {
              "linkId" : "102858",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "54688-7",
                  "display" : "Did any of the identified symptom(s): Significantly interfere with the resident's participation in activities or social interactions?"
                }
              ],
              "prefix" : "E0500C",
              "text" : "Did any of the identified symptom(s): Significantly interfere with the resident's participation in activities or social interactions?",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA32-8",
                    "display" : "No"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA33-6",
                    "display" : "Yes"
                  }
                }
              ]
            }
          ]
        },
        {
          "linkId" : "102859",
          "prefix" : "E0600",
          "text" : "Impact on Others",
          "type" : "group",
          "required" : true,
          "item" : [
            {
              "linkId" : "102860",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "54689-5",
                  "display" : "Did any of the identified symptom(s): Put others at significant risk for physical injury?"
                }
              ],
              "prefix" : "E0600A",
              "text" : "Did any of the identified symptom(s): Put others at significant risk for physical injury?",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA32-8",
                    "display" : "No"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA33-6",
                    "display" : "Yes"
                  }
                }
              ]
            },
            {
              "linkId" : "102861",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "54690-3",
                  "display" : "Did any of the identified symptom(s): Significantly intrude on the privacy or activity of others?"
                }
              ],
              "prefix" : "E0600B",
              "text" : "Did any of the identified symptom(s): Significantly intrude on the privacy or activity of others?",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA32-8",
                    "display" : "No"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA33-6",
                    "display" : "Yes"
                  }
                }
              ]
            },
            {
              "linkId" : "102862",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "54691-1",
                  "display" : "Did any of the identified symptom(s): Significantly disrupt care or living environment?"
                }
              ],
              "prefix" : "E0600C",
              "text" : "Did any of the identified symptom(s): Significantly disrupt care or living environment?",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA32-8",
                    "display" : "No"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA33-6",
                    "display" : "Yes"
                  }
                }
              ]
            }
          ]
        },
        {
          "linkId" : "102863",
          "code" : [
            {
              "system" : "http://loinc.org",
              "code" : "54692-9",
              "display" : "Rejection of Care - Presence & Frequency. Did the resident reject evaluation or care (e.g., bloodwork, taking medications, ADL assistance) that is necessary to achieve the resident's goals for health and well-being?"
            }
          ],
          "prefix" : "E0800",
          "text" : "Rejection of Care - Presence & Frequency. Did the resident reject evaluation or care (e.g., bloodwork, taking medications, ADL assistance) that is necessary to achieve the resident's goals for health and well-being?",
          "type" : "choice",
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA11005-8",
                "display" : "Behavior not exhibited"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA11006-6",
                "display" : "Behavior of this type occurred 1 to 3 days"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA94-8",
                "display" : "Behavior of this type occurred 4 to 6 days, but less than daily"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA95-5",
                "display" : "Behavior of this type occurred daily"
              }
            }
          ]
        },
        {
          "linkId" : "102864",
          "code" : [
            {
              "system" : "http://loinc.org",
              "code" : "54693-7",
              "display" : "Wandering - Presence & Frequency. Has the resident wandered?"
            }
          ],
          "prefix" : "E0900",
          "text" : "Wandering - Presence & Frequency. Has the resident wandered?",
          "type" : "choice",
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA11005-8",
                "display" : "Behavior not exhibited"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA11006-6",
                "display" : "Behavior of this type occurred 1 to 3 days"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA94-8",
                "display" : "Behavior of this type occurred 4 to 6 days, but less than daily"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA95-5",
                "display" : "Behavior of this type occurred daily"
              }
            }
          ]
        },
        {
          "linkId" : "102865",
          "prefix" : "E1000",
          "text" : "Wandering - Impact",
          "type" : "group",
          "required" : true,
          "item" : [
            {
              "linkId" : "102866",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "54694-5",
                  "display" : "Does the wandering place the resident at significant risk of getting to a potentially dangerous place?"
                }
              ],
              "prefix" : "E1000A",
              "text" : "Does the wandering place the resident at significant risk of getting to a potentially dangerous place?",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA32-8",
                    "display" : "No"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA33-6",
                    "display" : "Yes"
                  }
                }
              ]
            },
            {
              "linkId" : "102867",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "54695-2",
                  "display" : "Does the wandering significantly intrude on the privacy or activities of others?"
                }
              ],
              "prefix" : "E1000B",
              "text" : "Does the wandering significantly intrude on the privacy or activities of others?",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA32-8",
                    "display" : "No"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA33-6",
                    "display" : "Yes"
                  }
                }
              ]
            }
          ]
        },
        {
          "linkId" : "102868",
          "code" : [
            {
              "system" : "http://loinc.org",
              "code" : "54696-0",
              "display" : "Change in Behavior or Other Symptoms.How does resident's current behavior status, care rejection, or wandering compare to prior assessment (OBRA or Scheduled PPS)?"
            }
          ],
          "prefix" : "E1100",
          "text" : "Change in Behavior or Other Symptoms.How does resident's current behavior status, care rejection, or wandering compare to prior assessment (OBRA or Scheduled PPS)?",
          "type" : "choice",
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA11009-0",
                "display" : "Same"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA65-8",
                "display" : "Improved"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA11011-6",
                "display" : "Worse"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA11012-4",
                "display" : "N/A because no prior MDS assessment"
              }
            }
          ]
        }
      ]
    },
    {
      "linkId" : "102869",
      "prefix" : "F",
      "text" : "Preferences for Customary Routine and Activities",
      "type" : "group",
      "required" : true,
      "item" : [
        {
          "linkId" : "102870",
          "code" : [
            {
              "system" : "http://loinc.org",
              "code" : "54697-8",
              "display" : "Should Interview for Daily and Activity Preferences be Conducted?"
            }
          ],
          "prefix" : "F0300",
          "text" : "Should Interview for Daily and Activity Preferences be Conducted?",
          "type" : "choice",
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA16158-0",
                "display" : "No (resident is rarely/never understood and family/significant other not available)"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA33-6",
                "display" : "Yes"
              }
            }
          ]
        },
        {
          "linkId" : "102871",
          "prefix" : "F0400",
          "text" : "Interview for Daily Preferences",
          "type" : "group",
          "required" : true,
          "item" : [
            {
              "linkId" : "102872",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "54698-6",
                  "display" : "While you are in this facility how important is it to you to choose what clothes to wear?"
                }
              ],
              "prefix" : "F0400A",
              "text" : "While you are in this facility how important is it to you to choose what clothes to wear?",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11013-2",
                    "display" : "Very important"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11014-0",
                    "display" : "Somewhat important"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11015-7",
                    "display" : "Not very important"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11016-5",
                    "display" : "Not important at all"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11017-3",
                    "display" : "Important, but can't do or no choice"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11018-1",
                    "display" : "No response or non-responsive"
                  }
                }
              ]
            },
            {
              "linkId" : "102873",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "54699-4",
                  "display" : "While you are in this facility how important is it to you to take care of your personal belongings or things?"
                }
              ],
              "prefix" : "F0400B",
              "text" : "While you are in this facility how important is it to you to take care of your personal belongings or things?",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11013-2",
                    "display" : "Very important"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11014-0",
                    "display" : "Somewhat important"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11015-7",
                    "display" : "Not very important"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11016-5",
                    "display" : "Not important at all"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11017-3",
                    "display" : "Important, but can't do or no choice"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11018-1",
                    "display" : "No response or non-responsive"
                  }
                }
              ]
            },
            {
              "linkId" : "102874",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "54700-0",
                  "display" : "While you are in this facility how important is it to you to choose between a tub bath, shower, bed bath, or sponge bath?"
                }
              ],
              "prefix" : "F0400C",
              "text" : "While you are in this facility how important is it to you to choose between a tub bath, shower, bed bath, or sponge bath?",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11013-2",
                    "display" : "Very important"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11014-0",
                    "display" : "Somewhat important"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11015-7",
                    "display" : "Not very important"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11016-5",
                    "display" : "Not important at all"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11017-3",
                    "display" : "Important, but can't do or no choice"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11018-1",
                    "display" : "No response or non-responsive"
                  }
                }
              ]
            },
            {
              "linkId" : "102875",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "54701-8",
                  "display" : "While you are in this facility how important is it to you to have snacks available between meals?"
                }
              ],
              "prefix" : "F0400D",
              "text" : "While you are in this facility how important is it to you to have snacks available between meals?",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11013-2",
                    "display" : "Very important"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11014-0",
                    "display" : "Somewhat important"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11015-7",
                    "display" : "Not very important"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11016-5",
                    "display" : "Not important at all"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11017-3",
                    "display" : "Important, but can't do or no choice"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11018-1",
                    "display" : "No response or non-responsive"
                  }
                }
              ]
            },
            {
              "linkId" : "102876",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "54702-6",
                  "display" : "While you are in this facility how important is it to you to choose your own bedtime?"
                }
              ],
              "prefix" : "F0400E",
              "text" : "While you are in this facility how important is it to you to choose your own bedtime?",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11013-2",
                    "display" : "Very important"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11014-0",
                    "display" : "Somewhat important"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11015-7",
                    "display" : "Not very important"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11016-5",
                    "display" : "Not important at all"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11017-3",
                    "display" : "Important, but can't do or no choice"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11018-1",
                    "display" : "No response or non-responsive"
                  }
                }
              ]
            },
            {
              "linkId" : "102877",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "54703-4",
                  "display" : "While you are in this facility how important is it to you to have your family or a close friend involved in discussions about your care?"
                }
              ],
              "prefix" : "F0400F",
              "text" : "While you are in this facility how important is it to you to have your family or a close friend involved in discussions about your care?",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11013-2",
                    "display" : "Very important"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11014-0",
                    "display" : "Somewhat important"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11015-7",
                    "display" : "Not very important"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11016-5",
                    "display" : "Not important at all"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11017-3",
                    "display" : "Important, but can't do or no choice"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11018-1",
                    "display" : "No response or non-responsive"
                  }
                }
              ]
            },
            {
              "linkId" : "102878",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "54704-2",
                  "display" : "While you are in this facility how important is it to you to be able to use the phone in private?"
                }
              ],
              "prefix" : "F0400G",
              "text" : "While you are in this facility how important is it to you to be able to use the phone in private?",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11013-2",
                    "display" : "Very important"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11014-0",
                    "display" : "Somewhat important"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11015-7",
                    "display" : "Not very important"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11016-5",
                    "display" : "Not important at all"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11017-3",
                    "display" : "Important, but can't do or no choice"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11018-1",
                    "display" : "No response or non-responsive"
                  }
                }
              ]
            },
            {
              "linkId" : "102879",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "54705-9",
                  "display" : "While you are in this facility how important is it to you to have a place to lock your things to keep them safe?"
                }
              ],
              "prefix" : "F0400H",
              "text" : "While you are in this facility how important is it to you to have a place to lock your things to keep them safe?",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11013-2",
                    "display" : "Very important"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11014-0",
                    "display" : "Somewhat important"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11015-7",
                    "display" : "Not very important"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11016-5",
                    "display" : "Not important at all"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11017-3",
                    "display" : "Important, but can't do or no choice"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11018-1",
                    "display" : "No response or non-responsive"
                  }
                }
              ]
            }
          ]
        },
        {
          "linkId" : "102880",
          "prefix" : "F0500",
          "text" : "Interview for Activity Preferences",
          "type" : "group",
          "required" : true,
          "item" : [
            {
              "linkId" : "102881",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "54706-7",
                  "display" : "While you are in this facility how important is it to you to have books, newspapers, and magazines to read?"
                }
              ],
              "prefix" : "F0500A",
              "text" : "While you are in this facility how important is it to you to have books, newspapers, and magazines to read?",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11013-2",
                    "display" : "Very important"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11014-0",
                    "display" : "Somewhat important"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11015-7",
                    "display" : "Not very important"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11016-5",
                    "display" : "Not important at all"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11017-3",
                    "display" : "Important, but can't do or no choice"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11018-1",
                    "display" : "No response or non-responsive"
                  }
                }
              ]
            },
            {
              "linkId" : "102882",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "54707-5",
                  "display" : "While you are in this facility how important is it to you to listen to music you like?"
                }
              ],
              "prefix" : "F0500B",
              "text" : "While you are in this facility how important is it to you to listen to music you like?",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11013-2",
                    "display" : "Very important"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11014-0",
                    "display" : "Somewhat important"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11015-7",
                    "display" : "Not very important"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11016-5",
                    "display" : "Not important at all"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11017-3",
                    "display" : "Important, but can't do or no choice"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11018-1",
                    "display" : "No response or non-responsive"
                  }
                }
              ]
            },
            {
              "linkId" : "102883",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "54708-3",
                  "display" : "While you are in this facility how important is it to you to be around animals such as pets?"
                }
              ],
              "prefix" : "F0500C",
              "text" : "While you are in this facility how important is it to you to be around animals such as pets?",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11013-2",
                    "display" : "Very important"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11014-0",
                    "display" : "Somewhat important"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11015-7",
                    "display" : "Not very important"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11016-5",
                    "display" : "Not important at all"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11017-3",
                    "display" : "Important, but can't do or no choice"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11018-1",
                    "display" : "No response or non-responsive"
                  }
                }
              ]
            },
            {
              "linkId" : "102884",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "54709-1",
                  "display" : "While you are in this facility how important is it to you to keep up with the news?"
                }
              ],
              "prefix" : "F0500D",
              "text" : "While you are in this facility how important is it to you to keep up with the news?",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11013-2",
                    "display" : "Very important"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11014-0",
                    "display" : "Somewhat important"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11015-7",
                    "display" : "Not very important"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11016-5",
                    "display" : "Not important at all"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11017-3",
                    "display" : "Important, but can't do or no choice"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11018-1",
                    "display" : "No response or non-responsive"
                  }
                }
              ]
            },
            {
              "linkId" : "102885",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "54710-9",
                  "display" : "While you are in this facility how important is it to you to do things with groups of people?"
                }
              ],
              "prefix" : "F0500E",
              "text" : "While you are in this facility how important is it to you to do things with groups of people?",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11013-2",
                    "display" : "Very important"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11014-0",
                    "display" : "Somewhat important"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11015-7",
                    "display" : "Not very important"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11016-5",
                    "display" : "Not important at all"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11017-3",
                    "display" : "Important, but can't do or no choice"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11018-1",
                    "display" : "No response or non-responsive"
                  }
                }
              ]
            },
            {
              "linkId" : "102886",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "54711-7",
                  "display" : "While you are in this facility how important is it to you to do your favorite activities?"
                }
              ],
              "prefix" : "F0500F",
              "text" : "While you are in this facility how important is it to you to do your favorite activities?",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11013-2",
                    "display" : "Very important"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11014-0",
                    "display" : "Somewhat important"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11015-7",
                    "display" : "Not very important"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11016-5",
                    "display" : "Not important at all"
                  }
                },
                {
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              ],
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                }
              ]
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              ],
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                }
              ]
            },
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              ],
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                },
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              ],
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                  "system" : "http://loinc.org",
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                  }
                },
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                },
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                },
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                },
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                  "valueCoding" : {
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                    "code" : "LA26735-3",
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                  }
                }
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            },
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                {
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              ],
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                  }
                },
                {
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                },
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                },
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                },
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                }
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                {
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              ],
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                },
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                  }
                },
                {
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                  }
                },
                {
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                  }
                },
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                    "code" : "LA28227-9",
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                },
                {
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                    "code" : "LA26735-3",
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                  }
                }
              ]
            },
            {
              "linkId" : "102942",
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                {
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                }
              ],
              "prefix" : "GG0130E1",
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              "type" : "choice",
              "repeats" : false,
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                },
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                  }
                },
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                },
                {
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                  }
                },
                {
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                },
                {
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                  }
                },
                {
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                    "code" : "LA28227-9",
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                  }
                },
                {
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                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "102943",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "95014-7",
                  "display" : "Upper body dressing"
                }
              ],
              "prefix" : "GG0130F1",
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                },
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                },
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                },
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                },
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                  }
                },
                {
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                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
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                  }
                },
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                  }
                },
                {
                  "valueCoding" : {
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                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "102944",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "95013-9",
                  "display" : "Lower body dressing"
                }
              ],
              "prefix" : "GG0130G1",
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              "repeats" : false,
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                },
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                },
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                },
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                  }
                },
                {
                  "valueCoding" : {
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                    "code" : "LA27999-4",
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                  }
                },
                {
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                  }
                },
                {
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                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
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                },
                {
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                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "102945",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "95012-1",
                  "display" : "Putting on/taking off footwear"
                }
              ],
              "prefix" : "GG0130H1",
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              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
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                },
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                },
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                },
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                  }
                },
                {
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                    "code" : "LA27999-4",
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                },
                {
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
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                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            }
          ]
        },
        {
          "linkId" : "102946",
          "prefix" : "GG0130_2",
          "text" : "Self-Care - Discharge Goal",
          "type" : "group",
          "required" : true,
          "item" : [
            {
              "linkId" : "136634",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "89404-8",
                  "display" : "Oral hygiene - functional goal"
                }
              ],
              "text" : "Oral hygiene - functional goal",
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              "repeats" : false,
              "answerOption" : [
                {
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                },
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                },
                {
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                {
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                },
                {
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                },
                {
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                  }
                },
                {
                  "valueCoding" : {
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                    "code" : "LA27999-4",
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                },
                {
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                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
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                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
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                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
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                }
              ]
            },
            {
              "linkId" : "137359",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "89409-7",
                  "display" : "Eating"
                }
              ],
              "prefix" : "GG0130A2",
              "text" : "Eating",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
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                },
                {
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                },
                {
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                },
                {
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                },
                {
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                  }
                },
                {
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                  }
                },
                {
                  "valueCoding" : {
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                    "code" : "LA27999-4",
                    "display" : "Resident refused"
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                },
                {
                  "valueCoding" : {
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                    "code" : "LA28871-4",
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "102949",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "89389-1",
                  "display" : "Toileting hygiene"
                }
              ],
              "prefix" : "GG0130C2",
              "text" : "Toileting hygiene",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27993-7",
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27994-5",
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                  }
                },
                {
                  "valueCoding" : {
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                    "code" : "LA28870-6",
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27996-0",
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                  }
                },
                {
                  "valueCoding" : {
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                    "code" : "LA11759-0",
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27998-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "102950",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "89396-6",
                  "display" : "Shower/bathe self"
                }
              ],
              "prefix" : "GG0130E2",
              "text" : "Shower/bathe self",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
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                  }
                },
                {
                  "valueCoding" : {
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                    "code" : "LA27994-5",
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28870-6",
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27996-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11759-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27998-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "102951",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "89387-5",
                  "display" : "Upper body dressing"
                }
              ],
              "prefix" : "GG0130F2",
              "text" : "Upper body dressing",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27993-7",
                    "display" : "Independent - Resident completes the activity by themself with no assistance from a helper."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27994-5",
                    "display" : "Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28870-6",
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27996-0",
                    "display" : "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" : {
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                    "code" : "LA11759-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27998-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "102952",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "89406-3",
                  "display" : "Lower body dressing"
                }
              ],
              "prefix" : "GG0130G2",
              "text" : "Lower body dressing",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27993-7",
                    "display" : "Independent - Resident completes the activity by themself with no assistance from a helper."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27994-5",
                    "display" : "Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28870-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27996-0",
                    "display" : "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" : {
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                    "code" : "LA11759-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27998-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "102953",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "89400-6",
                  "display" : "Putting on/taking off footwear"
                }
              ],
              "prefix" : "GG0130H2",
              "text" : "Putting on/taking off footwear",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27993-7",
                    "display" : "Independent - Resident completes the activity by themself with no assistance from a helper."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27994-5",
                    "display" : "Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28870-6",
                    "display" : "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."
                  }
                },
                {
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                    "code" : "LA27996-0",
                    "display" : "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" : {
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                    "code" : "LA11759-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27998-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            }
          ]
        },
        {
          "linkId" : "102954",
          "prefix" : "GG0170_1",
          "text" : "Mobility - Admission Performance",
          "type" : "group",
          "required" : true,
          "item" : [
            {
              "linkId" : "102955",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "95011-3",
                  "display" : "Roll left and right"
                }
              ],
              "prefix" : "GG0170A1",
              "text" : "Roll left and right",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27993-7",
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                  }
                },
                {
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                    "code" : "LA27994-5",
                    "display" : "Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28870-6",
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27996-0",
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                  }
                },
                {
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                    "code" : "LA11759-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27998-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "102956",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "95010-5",
                  "display" : "Sit to lying"
                }
              ],
              "prefix" : "GG0170B1",
              "text" : "Sit to lying",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27993-7",
                    "display" : "Independent - Resident completes the activity by themself with no assistance from a helper."
                  }
                },
                {
                  "valueCoding" : {
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                    "code" : "LA27994-5",
                    "display" : "Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28870-6",
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                  }
                },
                {
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                    "code" : "LA27996-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11759-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27998-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "102957",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "95009-7",
                  "display" : "Lying to sitting on side of bed"
                }
              ],
              "prefix" : "GG0170C1",
              "text" : "Lying to sitting on side of bed",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27993-7",
                    "display" : "Independent - Resident completes the activity by themself with no assistance from a helper."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27994-5",
                    "display" : "Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28870-6",
                    "display" : "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" : {
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                    "code" : "LA27996-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11759-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27998-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "102958",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "95008-9",
                  "display" : "Sit to stand"
                }
              ],
              "prefix" : "GG0170D1",
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              "repeats" : false,
              "answerOption" : [
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                  "valueCoding" : {
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                  }
                },
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                    "code" : "LA27994-5",
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                  }
                },
                {
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                  }
                },
                {
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                  }
                },
                {
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                    "code" : "LA11759-0",
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                  }
                },
                {
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                    "system" : "http://loinc.org",
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
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                    "code" : "LA26735-3",
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                  }
                }
              ]
            },
            {
              "linkId" : "102959",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "95007-1",
                  "display" : "Chair/bed-to-chair transfer"
                }
              ],
              "prefix" : "GG0170E1",
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              "repeats" : false,
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                },
                {
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                  }
                },
                {
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                  }
                },
                {
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                  }
                },
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                  }
                },
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
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                    "code" : "LA28871-4",
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "102960",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "95006-3",
                  "display" : "Toilet transfer"
                }
              ],
              "prefix" : "GG0170F1",
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              "repeats" : false,
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                },
                {
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                  }
                },
                {
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                  }
                },
                {
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                  }
                },
                {
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                  }
                },
                {
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
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                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
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                  }
                },
                {
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                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "102961",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "95005-5",
                  "display" : "Car transfer"
                }
              ],
              "prefix" : "GG0170G1",
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              "type" : "choice",
              "repeats" : false,
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                  }
                },
                {
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                  }
                },
                {
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                  }
                },
                {
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                  }
                },
                {
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                  }
                },
                {
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                    "code" : "LA27998-6",
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
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                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
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                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "102962",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "95004-8",
                  "display" : "Walk 10 feet"
                }
              ],
              "prefix" : "GG0170I1",
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              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
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                  "valueCoding" : {
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                  }
                },
                {
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                    "code" : "LA27994-5",
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                  }
                },
                {
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                  }
                },
                {
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                  }
                },
                {
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                  }
                },
                {
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                    "code" : "LA27998-6",
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
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                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "102963",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "95003-0",
                  "display" : "Walk 50 feet with two turns"
                }
              ],
              "prefix" : "GG0170J1",
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              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
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                    "system" : "http://loinc.org",
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                  }
                },
                {
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                    "code" : "LA27994-5",
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                  }
                },
                {
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                  }
                },
                {
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                  }
                },
                {
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                  }
                },
                {
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                    "code" : "LA27998-6",
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "102964",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "95002-2",
                  "display" : "Walk 150 feet"
                }
              ],
              "prefix" : "GG0170K1",
              "text" : "Walk 150 feet",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
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                    "system" : "http://loinc.org",
                    "code" : "LA27993-7",
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                },
                {
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                    "code" : "LA27994-5",
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                  }
                },
                {
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                  }
                },
                {
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                  }
                },
                {
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                  }
                },
                {
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                    "code" : "LA27998-6",
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "102965",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "95001-4",
                  "display" : "Walking 10 feet on uneven surfaces"
                }
              ],
              "prefix" : "GG0170L1",
              "text" : "Walking 10 feet on uneven surfaces",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27993-7",
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                  }
                },
                {
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                    "code" : "LA27994-5",
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                  }
                },
                {
                  "valueCoding" : {
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                    "code" : "LA28870-6",
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                  }
                },
                {
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                  }
                },
                {
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                    "code" : "LA11759-0",
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                  }
                },
                {
                  "valueCoding" : {
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                    "code" : "LA27998-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "102966",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "95000-6",
                  "display" : "1 step (curb)"
                }
              ],
              "prefix" : "GG0170M1",
              "text" : "1 step (curb)",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27993-7",
                    "display" : "Independent - Resident completes the activity by themself with no assistance from a helper."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27994-5",
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                  }
                },
                {
                  "valueCoding" : {
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                    "code" : "LA28870-6",
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                  }
                },
                {
                  "valueCoding" : {
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                    "code" : "LA27996-0",
                    "display" : "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" : {
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                    "code" : "LA11759-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27998-6",
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "102967",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "94999-0",
                  "display" : "4 steps"
                }
              ],
              "prefix" : "GG0170N1",
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              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27993-7",
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                  }
                },
                {
                  "valueCoding" : {
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                    "code" : "LA27994-5",
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                  }
                },
                {
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                  }
                },
                {
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                  }
                },
                {
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                  }
                },
                {
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "102968",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "94998-2",
                  "display" : "12 steps"
                }
              ],
              "prefix" : "GG0170O1",
              "text" : "12 steps",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
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                  }
                },
                {
                  "valueCoding" : {
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                    "code" : "LA27994-5",
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                  }
                },
                {
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                  }
                },
                {
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                    "system" : "http://loinc.org",
                    "code" : "LA27996-0",
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                  }
                },
                {
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                    "code" : "LA11759-0",
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27998-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "102969",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "94997-4",
                  "display" : "Picking up object"
                }
              ],
              "prefix" : "GG0170P1",
              "text" : "Picking up object",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27993-7",
                    "display" : "Independent - Resident completes the activity by themself with no assistance from a helper."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27994-5",
                    "display" : "Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28870-6",
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27996-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11759-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27998-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "102970",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "95738-1",
                  "display" : "Does the resident use a wheelchair and/or scooter?"
                }
              ],
              "prefix" : "GG0170Q1",
              "text" : "Does the resident use a wheelchair and/or scooter?",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA32-8",
                    "display" : "No"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA33-6",
                    "display" : "Yes"
                  }
                }
              ]
            },
            {
              "linkId" : "102971",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "94992-5",
                  "display" : "Wheel 50 feet with two turns"
                }
              ],
              "prefix" : "GG0170R1",
              "text" : "Wheel 50 feet with two turns",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27993-7",
                    "display" : "Independent - Resident completes the activity by themself with no assistance from a helper."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27994-5",
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                  }
                },
                {
                  "valueCoding" : {
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                    "code" : "LA28870-6",
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                  }
                },
                {
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                  }
                },
                {
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                  }
                },
                {
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "102972",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "95739-9",
                  "display" : "Indicate the type of wheelchair or scooter used"
                }
              ],
              "prefix" : "GG0170RR1",
              "text" : "Indicate the type of wheelchair or scooter used",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA19016-7",
                    "display" : "Manual"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26847-6",
                    "display" : "Motorized"
                  }
                }
              ]
            },
            {
              "linkId" : "102973",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "94991-7",
                  "display" : "Wheel 150 feet"
                }
              ],
              "prefix" : "GG0170S1",
              "text" : "Wheel 150 feet",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27993-7",
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27994-5",
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                  }
                },
                {
                  "valueCoding" : {
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                    "code" : "LA28870-6",
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                  }
                },
                {
                  "valueCoding" : {
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                    "code" : "LA27996-0",
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                  }
                },
                {
                  "valueCoding" : {
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                    "code" : "LA11759-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27998-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "102974",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "95739-9",
                  "display" : "Indicate the type of wheelchair or scooter used"
                }
              ],
              "prefix" : "GG0170SS1",
              "text" : "Indicate the type of wheelchair or scooter used",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA19016-7",
                    "display" : "Manual"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26847-6",
                    "display" : "Motorized"
                  }
                }
              ]
            }
          ]
        },
        {
          "linkId" : "102975",
          "prefix" : "GG0170_2",
          "text" : "Mobility - Discharge Goal",
          "type" : "group",
          "required" : true,
          "item" : [
            {
              "linkId" : "102976",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "89398-2",
                  "display" : "Roll left and right"
                }
              ],
              "prefix" : "GG0170A2",
              "text" : "Roll left and right",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27993-7",
                    "display" : "Independent - Resident completes the activity by themself with no assistance from a helper."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27994-5",
                    "display" : "Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28870-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27996-0",
                    "display" : "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" : {
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                    "code" : "LA11759-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27998-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "102977",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "89394-1",
                  "display" : "Sit to lying"
                }
              ],
              "prefix" : "GG0170B2",
              "text" : "Sit to lying",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27993-7",
                    "display" : "Independent - Resident completes the activity by themself with no assistance from a helper."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27994-5",
                    "display" : "Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28870-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27996-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11759-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27998-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "102978",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "85927-2",
                  "display" : "Lying to sitting on side of bed"
                }
              ],
              "prefix" : "GG0170C2",
              "text" : "Lying to sitting on side of bed",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27993-7",
                    "display" : "Independent - Resident completes the activity by themself with no assistance from a helper."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27994-5",
                    "display" : "Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28870-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27996-0",
                    "display" : "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" : {
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                    "code" : "LA11759-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27998-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "102979",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "89392-5",
                  "display" : "Sit to stand"
                }
              ],
              "prefix" : "GG0170D2",
              "text" : "Sit to stand",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27993-7",
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27994-5",
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28870-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27996-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11759-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27998-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "102980",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "89414-7",
                  "display" : "Chair/bed-to-chair transfer"
                }
              ],
              "prefix" : "GG0170E2",
              "text" : "Chair/bed-to-chair transfer",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27993-7",
                    "display" : "Independent - Resident completes the activity by themself with no assistance from a helper."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27994-5",
                    "display" : "Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28870-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27996-0",
                    "display" : "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."
                  }
                },
                {
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                    "code" : "LA11759-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27998-6",
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "102981",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "89390-9",
                  "display" : "Toilet transfer"
                }
              ],
              "prefix" : "GG0170F2",
              "text" : "Toilet transfer",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27993-7",
                    "display" : "Independent - Resident completes the activity by themself with no assistance from a helper."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27994-5",
                    "display" : "Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28870-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27996-0",
                    "display" : "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" : {
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                    "code" : "LA11759-0",
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27998-6",
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "102982",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "89412-1",
                  "display" : "Car transfer"
                }
              ],
              "prefix" : "GG0170G2",
              "text" : "Car transfer",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27993-7",
                    "display" : "Independent - Resident completes the activity by themself with no assistance from a helper."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27994-5",
                    "display" : "Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28870-6",
                    "display" : "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."
                  }
                },
                {
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                    "system" : "http://loinc.org",
                    "code" : "LA27996-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11759-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27998-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "102983",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "89385-9",
                  "display" : "Walk 10 feet"
                }
              ],
              "prefix" : "GG0170I2",
              "text" : "Walk 10 feet",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27993-7",
                    "display" : "Independent - Resident completes the activity by themself with no assistance from a helper."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27994-5",
                    "display" : "Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28870-6",
                    "display" : "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."
                  }
                },
                {
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                    "system" : "http://loinc.org",
                    "code" : "LA27996-0",
                    "display" : "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" : {
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                    "code" : "LA11759-0",
                    "display" : "Substantial/maximal assistance - Helper does more than half the effort. Helper lifts or holds trunk or limbs and provides more than half the effort."
                  }
                },
                {
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                    "system" : "http://loinc.org",
                    "code" : "LA27998-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "102984",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "89381-8",
                  "display" : "Walk 50 feet with two turns"
                }
              ],
              "prefix" : "GG0170J2",
              "text" : "Walk 50 feet with two turns",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27993-7",
                    "display" : "Independent - Resident completes the activity by themself with no assistance from a helper."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27994-5",
                    "display" : "Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28870-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27996-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11759-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27998-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "102985",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "89383-4",
                  "display" : "Walk 150 feet"
                }
              ],
              "prefix" : "GG0170K2",
              "text" : "Walk 150 feet",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27993-7",
                    "display" : "Independent - Resident completes the activity by themself with no assistance from a helper."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27994-5",
                    "display" : "Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28870-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27996-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11759-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27998-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "102986",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "89379-2",
                  "display" : "Walking 10 feet on uneven surfaces"
                }
              ],
              "prefix" : "GG0170L2",
              "text" : "Walking 10 feet on uneven surfaces",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27993-7",
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                  }
                },
                {
                  "valueCoding" : {
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                    "code" : "LA27994-5",
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28870-6",
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                  }
                },
                {
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                    "code" : "LA27996-0",
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                  }
                },
                {
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                    "code" : "LA11759-0",
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27998-6",
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "102987",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "89420-4",
                  "display" : "1 step (curb)"
                }
              ],
              "prefix" : "GG0170M2",
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              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
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                  }
                },
                {
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                  }
                },
                {
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                    "system" : "http://loinc.org",
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                  }
                },
                {
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                    "code" : "LA27996-0",
                    "display" : "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."
                  }
                },
                {
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                  }
                },
                {
                  "valueCoding" : {
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "102988",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "89416-2",
                  "display" : "4 steps"
                }
              ],
              "prefix" : "GG0170N2",
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              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
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                  }
                },
                {
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                  }
                },
                {
                  "valueCoding" : {
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                  }
                },
                {
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                  }
                },
                {
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                  }
                },
                {
                  "valueCoding" : {
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "102989",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "89418-8",
                  "display" : "12 steps"
                }
              ],
              "prefix" : "GG0170O2",
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              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
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                  }
                },
                {
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                    "code" : "LA27994-5",
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                  }
                },
                {
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                  }
                },
                {
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                  }
                },
                {
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                  }
                },
                {
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                    "code" : "LA27998-6",
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "102990",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "89402-2",
                  "display" : "Picking up object"
                }
              ],
              "prefix" : "GG0170P2",
              "text" : "Picking up object",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
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                  }
                },
                {
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                    "code" : "LA27994-5",
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                  }
                },
                {
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                  }
                },
                {
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                  }
                },
                {
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                  }
                },
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
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                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "102991",
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                {
                  "system" : "http://loinc.org",
                  "code" : "89375-0",
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                }
              ],
              "prefix" : "GG0170R2",
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              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
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                },
                {
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                  }
                },
                {
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                },
                {
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                  }
                },
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                },
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                  }
                },
                {
                  "valueCoding" : {
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                    "code" : "LA27999-4",
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
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                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "102992",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "89377-6",
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                }
              ],
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              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
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                },
                {
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                },
                {
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                },
                {
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                {
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                  }
                },
                {
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            }
          ]
        }
      ]
    },
    {
      "linkId" : "102993",
      "prefix" : "GG",
      "text" : "Functional Abilities and Goals - Discharge (End of SNF PPS Stay)",
      "type" : "group",
      "required" : true,
      "item" : [
        {
          "linkId" : "102994",
          "prefix" : "GG0130_3",
          "text" : "Self-Care - Discharge Performance",
          "type" : "group",
          "required" : true,
          "item" : [
            {
              "linkId" : "102995",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "95019-6",
                  "display" : "Eating"
                }
              ],
              "prefix" : "GG0130A3",
              "text" : "Eating",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
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                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27994-5",
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                  }
                },
                {
                  "valueCoding" : {
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
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                  }
                },
                {
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27998-6",
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
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                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "102996",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "95018-8",
                  "display" : "Oral hygiene"
                }
              ],
              "prefix" : "GG0130B3",
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              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27993-7",
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                  }
                },
                {
                  "valueCoding" : {
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                    "code" : "LA27994-5",
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                  }
                },
                {
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                    "system" : "http://loinc.org",
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                  }
                },
                {
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                  }
                },
                {
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                    "code" : "LA11759-0",
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                  }
                },
                {
                  "valueCoding" : {
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                    "code" : "LA27998-6",
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "102997",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "95017-0",
                  "display" : "Toileting hygiene"
                }
              ],
              "prefix" : "GG0130C3",
              "text" : "Toileting hygiene",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
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                  "valueCoding" : {
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                  }
                },
                {
                  "valueCoding" : {
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                    "code" : "LA27994-5",
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                  }
                },
                {
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                  }
                },
                {
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                    "code" : "LA27996-0",
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                  }
                },
                {
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                    "code" : "LA11759-0",
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27998-6",
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "102998",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "95015-4",
                  "display" : "Shower/bathe self"
                }
              ],
              "prefix" : "GG0130E3",
              "text" : "Shower/bathe self",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
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                  }
                },
                {
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                  }
                },
                {
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                  }
                },
                {
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                    "code" : "LA27996-0",
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                  }
                },
                {
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                    "code" : "LA11759-0",
                    "display" : "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" : {
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                    "code" : "LA27998-6",
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "102999",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "95014-7",
                  "display" : "Upper body dressing"
                }
              ],
              "prefix" : "GG0130F3",
              "text" : "Upper body dressing",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
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                  }
                },
                {
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                    "system" : "http://loinc.org",
                    "code" : "LA27994-5",
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                  }
                },
                {
                  "valueCoding" : {
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                    "code" : "LA28870-6",
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                  }
                },
                {
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                    "code" : "LA27996-0",
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                  }
                },
                {
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                    "code" : "LA11759-0",
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27998-6",
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
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                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "103000",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "95013-9",
                  "display" : "Lower body dressing"
                }
              ],
              "prefix" : "GG0130G3",
              "text" : "Lower body dressing",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
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                  }
                },
                {
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                    "code" : "LA27994-5",
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                  }
                },
                {
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                    "code" : "LA28870-6",
                    "display" : "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."
                  }
                },
                {
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                  }
                },
                {
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                  }
                },
                {
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                    "code" : "LA27998-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "103001",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "95012-1",
                  "display" : "Putting on/taking off footwear"
                }
              ],
              "prefix" : "GG0130H3",
              "text" : "Putting on/taking off footwear",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27993-7",
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                  }
                },
                {
                  "valueCoding" : {
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                    "code" : "LA27994-5",
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                  }
                },
                {
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                    "code" : "LA28870-6",
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                  }
                },
                {
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                    "code" : "LA27996-0",
                    "display" : "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."
                  }
                },
                {
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                    "code" : "LA11759-0",
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                  }
                },
                {
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                    "system" : "http://loinc.org",
                    "code" : "LA27998-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            }
          ]
        },
        {
          "linkId" : "103002",
          "prefix" : "GG0170_3",
          "text" : "Mobility - Discharge Performance",
          "type" : "group",
          "required" : true,
          "item" : [
            {
              "linkId" : "103003",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "95011-3",
                  "display" : "Roll left and right"
                }
              ],
              "prefix" : "GG0170A3",
              "text" : "Roll left and right",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27993-7",
                    "display" : "Independent - Resident completes the activity by themself with no assistance from a helper."
                  }
                },
                {
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                    "code" : "LA27994-5",
                    "display" : "Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity."
                  }
                },
                {
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                    "code" : "LA28870-6",
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                  }
                },
                {
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                    "code" : "LA27996-0",
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                  }
                },
                {
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                    "system" : "http://loinc.org",
                    "code" : "LA11759-0",
                    "display" : "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" : {
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                    "code" : "LA27998-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "103004",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "95010-5",
                  "display" : "Sit to lying"
                }
              ],
              "prefix" : "GG0170B3",
              "text" : "Sit to lying",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27993-7",
                    "display" : "Independent - Resident completes the activity by themself with no assistance from a helper."
                  }
                },
                {
                  "valueCoding" : {
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                    "code" : "LA27994-5",
                    "display" : "Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28870-6",
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                  }
                },
                {
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                    "code" : "LA27996-0",
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                  }
                },
                {
                  "valueCoding" : {
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                    "code" : "LA11759-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27998-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "103005",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "95009-7",
                  "display" : "Lying to sitting on side of bed"
                }
              ],
              "prefix" : "GG0170C3",
              "text" : "Lying to sitting on side of bed",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27993-7",
                    "display" : "Independent - Resident completes the activity by themself with no assistance from a helper."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27994-5",
                    "display" : "Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28870-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27996-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11759-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27998-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "103006",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "95008-9",
                  "display" : "Sit to stand"
                }
              ],
              "prefix" : "GG0170D3",
              "text" : "Sit to stand",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27993-7",
                    "display" : "Independent - Resident completes the activity by themself with no assistance from a helper."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27994-5",
                    "display" : "Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28870-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27996-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11759-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27998-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "103007",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "95007-1",
                  "display" : "Chair/bed-to-chair transfer"
                }
              ],
              "prefix" : "GG0170E3",
              "text" : "Chair/bed-to-chair transfer",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27993-7",
                    "display" : "Independent - Resident completes the activity by themself with no assistance from a helper."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27994-5",
                    "display" : "Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28870-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27996-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11759-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27998-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "103008",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "95006-3",
                  "display" : "Toilet transfer"
                }
              ],
              "prefix" : "GG0170F3",
              "text" : "Toilet transfer",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27993-7",
                    "display" : "Independent - Resident completes the activity by themself with no assistance from a helper."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27994-5",
                    "display" : "Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28870-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27996-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11759-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27998-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "103009",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "95005-5",
                  "display" : "Car transfer"
                }
              ],
              "prefix" : "GG0170G3",
              "text" : "Car transfer",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27993-7",
                    "display" : "Independent - Resident completes the activity by themself with no assistance from a helper."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27994-5",
                    "display" : "Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28870-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27996-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11759-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27998-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "103010",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "95004-8",
                  "display" : "Walk 10 feet"
                }
              ],
              "prefix" : "GG0170I3",
              "text" : "Walk 10 feet",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27993-7",
                    "display" : "Independent - Resident completes the activity by themself with no assistance from a helper."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27994-5",
                    "display" : "Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28870-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27996-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11759-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27998-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "103011",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "95003-0",
                  "display" : "Walk 50 feet with two turns"
                }
              ],
              "prefix" : "GG0170J3",
              "text" : "Walk 50 feet with two turns",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27993-7",
                    "display" : "Independent - Resident completes the activity by themself with no assistance from a helper."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27994-5",
                    "display" : "Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28870-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27996-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11759-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27998-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "103012",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "95002-2",
                  "display" : "Walk 150 feet"
                }
              ],
              "prefix" : "GG0170K3",
              "text" : "Walk 150 feet",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27993-7",
                    "display" : "Independent - Resident completes the activity by themself with no assistance from a helper."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27994-5",
                    "display" : "Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28870-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27996-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11759-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27998-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "103013",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "95001-4",
                  "display" : "Walking 10 feet on uneven surfaces"
                }
              ],
              "prefix" : "GG0170L3",
              "text" : "Walking 10 feet on uneven surfaces",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27993-7",
                    "display" : "Independent - Resident completes the activity by themself with no assistance from a helper."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27994-5",
                    "display" : "Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28870-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27996-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11759-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27998-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "103014",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "95000-6",
                  "display" : "1 step (curb)"
                }
              ],
              "prefix" : "GG0170M3",
              "text" : "1 step (curb)",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27993-7",
                    "display" : "Independent - Resident completes the activity by themself with no assistance from a helper."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27994-5",
                    "display" : "Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28870-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27996-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11759-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27998-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "103015",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "94999-0",
                  "display" : "4 steps"
                }
              ],
              "prefix" : "GG0170N3",
              "text" : "4 steps",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27993-7",
                    "display" : "Independent - Resident completes the activity by themself with no assistance from a helper."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27994-5",
                    "display" : "Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28870-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27996-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11759-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27998-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "103016",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "94998-2",
                  "display" : "12 steps"
                }
              ],
              "prefix" : "GG0170O3",
              "text" : "12 steps",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27993-7",
                    "display" : "Independent - Resident completes the activity by themself with no assistance from a helper."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27994-5",
                    "display" : "Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28870-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27996-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11759-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27998-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "103017",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "94997-4",
                  "display" : "Picking up object"
                }
              ],
              "prefix" : "GG0170P3",
              "text" : "Picking up object",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27993-7",
                    "display" : "Independent - Resident completes the activity by themself with no assistance from a helper."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27994-5",
                    "display" : "Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28870-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27996-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11759-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27998-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "103018",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "95738-1",
                  "display" : "Does the resident use a wheelchair and/or scooter?"
                }
              ],
              "prefix" : "GG0170Q3",
              "text" : "Does the resident use a wheelchair and/or scooter?",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA32-8",
                    "display" : "No"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA33-6",
                    "display" : "Yes"
                  }
                }
              ]
            },
            {
              "linkId" : "103019",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "94992-5",
                  "display" : "Wheel 50 feet with two turns"
                }
              ],
              "prefix" : "GG0170R3",
              "text" : "Wheel 50 feet with two turns",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27993-7",
                    "display" : "Independent - Resident completes the activity by themself with no assistance from a helper."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27994-5",
                    "display" : "Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28870-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27996-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11759-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27998-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "103020",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "95739-9",
                  "display" : "Indicate the type of wheelchair or scooter used"
                }
              ],
              "prefix" : "GG0170RR3",
              "text" : "Indicate the type of wheelchair or scooter used",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA19016-7",
                    "display" : "Manual"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26847-6",
                    "display" : "Motorized"
                  }
                }
              ]
            },
            {
              "linkId" : "103021",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "94991-7",
                  "display" : "Wheel 150 feet"
                }
              ],
              "prefix" : "GG0170S3",
              "text" : "Wheel 150 feet",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27993-7",
                    "display" : "Independent - Resident completes the activity by themself with no assistance from a helper."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27994-5",
                    "display" : "Setup or clean-up assistance - Helper sets up or cleans up; resident completes activity. Helper assists only prior to or following the activity."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28870-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27996-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11759-0",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27998-6",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27999-4",
                    "display" : "Resident refused"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28871-4",
                    "display" : "Not applicable - Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28227-9",
                    "display" : "Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints)."
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26735-3",
                    "display" : "Not attempted due to medical condition or safety concerns"
                  }
                }
              ]
            },
            {
              "linkId" : "103022",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "95739-9",
                  "display" : "Indicate the type of wheelchair or scooter used"
                }
              ],
              "prefix" : "GG0170SS3",
              "text" : "Indicate the type of wheelchair or scooter used",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA19016-7",
                    "display" : "Manual"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26847-6",
                    "display" : "Motorized"
                  }
                }
              ]
            }
          ]
        }
      ]
    },
    {
      "linkId" : "103023",
      "prefix" : "H",
      "text" : "Bladder and Bowel",
      "type" : "group",
      "required" : true,
      "item" : [
        {
          "linkId" : "103024",
          "code" : [
            {
              "system" : "http://loinc.org",
              "code" : "86624-4",
              "display" : "Appliances"
            }
          ],
          "prefix" : "H0100",
          "text" : "Appliances",
          "type" : "choice",
          "repeats" : true,
          "answerOption" : [
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27819-4",
                "display" : "Indwelling catheter (including suprapubic catheter and nephrostomy tube)"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27820-2",
                "display" : "External catheter"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27821-0",
                "display" : "Ostomy (including urostomy, ileostomy, and colostomy)"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27822-8",
                "display" : "Intermittent catheterization"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA9-3",
                "display" : "None of the above"
              }
            }
          ]
        },
        {
          "linkId" : "103025",
          "prefix" : "H0200",
          "text" : "Urinary Toileting Program",
          "type" : "group",
          "required" : true,
          "item" : [
            {
              "linkId" : "103026",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "54767-9",
                  "display" : "Has a trial of a toileting program (e.g., scheduled toileting, prompted voiding, or bladder training) been attempted on admission/entry or reentry or since urinary incontinence was noted in this facility?"
                }
              ],
              "prefix" : "H0200A",
              "text" : "Has a trial of a toileting program (e.g., scheduled toileting, prompted voiding, or bladder training) been attempted on admission/entry or reentry or since urinary incontinence was noted in this facility?",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA32-8",
                    "display" : "No"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA33-6",
                    "display" : "Yes"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11137-9",
                    "display" : "Unable to determine"
                  }
                }
              ]
            },
            {
              "linkId" : "103027",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "54768-7",
                  "display" : "Response - What was the resident's response to the trial program?"
                }
              ],
              "prefix" : "H0200B",
              "text" : "Response - What was the resident's response to the trial program?",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11038-9",
                    "display" : "No improvement"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11039-7",
                    "display" : "Decreased wetness"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11040-5",
                    "display" : "Completely dry (continent)"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11041-3",
                    "display" : "Unable to determine or trial in progress"
                  }
                }
              ]
            },
            {
              "linkId" : "103028",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "54769-5",
                  "display" : "Current toileting program or trial - Is a toileting program (e.g., scheduled toileting, prompted voiding, or bladder training) currently being used to manage the resident's urinary continence?"
                }
              ],
              "prefix" : "H0200C",
              "text" : "Current toileting program or trial - Is a toileting program (e.g., scheduled toileting, prompted voiding, or bladder training) currently being used to manage the resident's urinary continence?",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA32-8",
                    "display" : "No"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA33-6",
                    "display" : "Yes"
                  }
                }
              ]
            }
          ]
        },
        {
          "linkId" : "103029",
          "code" : [
            {
              "system" : "http://loinc.org",
              "code" : "95735-7",
              "display" : "Urinary Continence"
            }
          ],
          "prefix" : "H0300",
          "text" : "Urinary Continence",
          "type" : "choice",
          "required" : true,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA11042-1",
                "display" : "Always continent"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA11043-9",
                "display" : "Occasionally incontinent (less than 7 episodes of incontinence)"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA11044-7",
                "display" : "Frequently incontinent (7 or more episodes of urinary incontinence, but with at least one episode of continent voiding)"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA11045-4",
                "display" : "Always incontinent (no episodes of continent voiding)"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA11046-2",
                "display" : "Not rated, resident had a catheter (indwelling, condom), urinary ostomy, or no urine output for the entire 7 days"
              }
            }
          ]
        },
        {
          "linkId" : "103030",
          "code" : [
            {
              "system" : "http://loinc.org",
              "code" : "95736-5",
              "display" : "Bowel Continence"
            }
          ],
          "prefix" : "H0400",
          "text" : "Bowel Continence",
          "type" : "choice",
          "required" : true,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA11042-1",
                "display" : "Always continent"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA11048-8",
                "display" : "Occasionally incontinent (one episode of bowel incontinence)"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA11049-6",
                "display" : "Frequently incontinent (2 or more episodes of bowel incontinence, but at least one continent bowel movement)"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA11050-4",
                "display" : "Always incontinent (no episodes of continent bowel movements)"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA11051-2",
                "display" : "Not rated, resident had an ostomy or did not have a bowel movement for the entire 7 days"
              }
            }
          ]
        },
        {
          "linkId" : "103031",
          "code" : [
            {
              "system" : "http://loinc.org",
              "code" : "88695-2",
              "display" : "Bowel Toileting Program"
            }
          ],
          "prefix" : "H0500",
          "text" : "Bowel Toileting Program",
          "type" : "choice",
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA32-8",
                "display" : "No"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA33-6",
                "display" : "Yes"
              }
            }
          ]
        },
        {
          "linkId" : "103032",
          "code" : [
            {
              "system" : "http://loinc.org",
              "code" : "54773-7",
              "display" : "Bowel Patterns. Constipation present?"
            }
          ],
          "prefix" : "H0600",
          "text" : "Bowel Patterns. Constipation present?",
          "type" : "choice",
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA32-8",
                "display" : "No"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA33-6",
                "display" : "Yes"
              }
            }
          ]
        }
      ]
    },
    {
      "linkId" : "106149",
      "prefix" : "I",
      "text" : "Active Diagnoses",
      "type" : "group",
      "required" : true,
      "item" : [
        {
          "linkId" : "103034",
          "code" : [
            {
              "system" : "http://loinc.org",
              "code" : "96095-5",
              "display" : "Indicate the resident's primary medical condition category"
            }
          ],
          "prefix" : "I0020",
          "text" : "Indicate the resident's primary medical condition category",
          "type" : "choice",
          "required" : true,
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA22099-8",
                "display" : "Stroke"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA28875-5",
                "display" : "Non-traumatic brain dysfunction"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA28876-3",
                "display" : "Traumatic brain dysfunction"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA28877-1",
                "display" : "Non-traumatic spinal cord dysfunction"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA28878-9",
                "display" : "Traumatic spinal cord dysfunction"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA28879-7",
                "display" : "Progressive neurological conditions"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA28880-5",
                "display" : "Other neurological conditions"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA28881-3",
                "display" : "Amputation"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA28882-1",
                "display" : "Hip and knee replacement"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA28883-9",
                "display" : "Fractures and other multiple trauma"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA28884-7",
                "display" : "Other orthopedic conditions"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA28885-4",
                "display" : "Debility, cardiorespiratory conditions"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA28886-2",
                "display" : "Medically complex conditions"
              }
            }
          ]
        },
        {
          "linkId" : "106150",
          "code" : [
            {
              "system" : "http://loinc.org",
              "code" : "52797-8",
              "display" : "ICD Code"
            }
          ],
          "prefix" : "I0020B",
          "text" : "ICD Code",
          "type" : "choice",
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "system" : "http://loinc.org"
              }
            }
          ]
        },
        {
          "linkId" : "103036",
          "code" : [
            {
              "system" : "http://loinc.org",
              "code" : "86671-5",
              "display" : "Active Diagnoses in the last 7 days"
            }
          ],
          "prefix" : "I0100-I7900",
          "text" : "Active Diagnoses in the last 7 days",
          "type" : "choice",
          "repeats" : true,
          "answerOption" : [
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27987-9",
                "display" : "Cancer (with or without metastasis)"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27836-8",
                "display" : "Anemia (e.g., aplastic, iron deficiency, pernicious, and sickle cell)"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27837-6",
                "display" : "Atrial fibrillation or other dysrhythmias (e.g. bradycardias and tachycardias)"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27838-4",
                "display" : "Coronary artery disease (CAD) (e.g., angina, myocardial infarction, and atherosclerotic heart disease (ASHD))"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27839-2",
                "display" : "Deep venous thrombosis (DVT), pulmonary embolus (PE), or Pulmonary thrombo-embolism (PTE)"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27840-0",
                "display" : "Heart failure (e.g., congestive heart failure (CHF) and pulmonary edema)"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA7444-8",
                "display" : "Hypertension"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27841-8",
                "display" : "Orthostatic hypotension"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA18399-8",
                "display" : "Peripheral vascular disease (PVD) or peripheral arterial disease (PAD)"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA9639-1",
                "display" : "Cirrhosis"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27842-6",
                "display" : "Gastroesophageal reflux disease (GERD) or ulcer (e.g., esophageal, gastric, and peptic ulcers)"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27843-4",
                "display" : "Ulcerative colitis, Crohn's disease, or inflammatory bowel disease"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27844-2",
                "display" : "Benign prostatic hyperplasia (BPH)"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27845-9",
                "display" : "Renal insufficiency, renal failure, or end-stage renal disease (ESRD)"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27846-7",
                "display" : "Neurogenic bladder"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27847-5",
                "display" : "Obstructive uropathy"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27848-3",
                "display" : "Multidrug-resistant organism (MDRO)"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA7465-3",
                "display" : "Pneumonia"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA10591-8",
                "display" : "Septicemia"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA10513-2",
                "display" : "Tuberculosis"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27849-1",
                "display" : "Urinary tract infection (UTI) (last 30 days)"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27850-9",
                "display" : "Viral hepatitis (e.g., Hepatitis A, B, C, D, and E)"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27851-7",
                "display" : "Wound infection (other than foot)"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA26741-1",
                "display" : "Diabetes mellitus (DM) (e.g., diabetic retinopathy, nephropathy, and neuropathy)"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27852-5",
                "display" : "Hyponatremia"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA19699-0",
                "display" : "Hyperkalemia"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27853-3",
                "display" : "Hyperlipidemia (e.g., hypercholesterolemia)"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27854-1",
                "display" : "Thyroid disorder (e.g., hypothyroidism, hyperthyroidism, and Hashimoto's thyroiditis)"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27855-8",
                "display" : "Arthritis (e.g., degenerative joint disease (DJD), osteoarthritis, and rheumatoid arthritis (RA))"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA10527-2",
                "display" : "Osteoporosis"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27856-6",
                "display" : "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" : {
                "system" : "http://loinc.org",
                "code" : "LA27857-4",
                "display" : "Other fracture"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA22313-3",
                "display" : "Alzheimer's disease"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA18262-8",
                "display" : "Aphasia"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27858-2",
                "display" : "Cerebral palsy"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27859-0",
                "display" : "Cerebrovascular accident (CVA), transient ischemic attack (TIA), or stroke"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27860-8",
                "display" : "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" : {
                "system" : "http://loinc.org",
                "code" : "LA27523-2",
                "display" : "Hemiplegia or hemiparesis"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA25276-9",
                "display" : "Paraplegia"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27861-6",
                "display" : "Quadriplegia"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27531-5",
                "display" : "Multiple sclerosis (MS)"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27532-3",
                "display" : "Huntington's disease"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27533-1",
                "display" : "Parkinson's disease"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27862-4",
                "display" : "Tourette's syndrome"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27863-2",
                "display" : "Seizure disorder or epilepsy"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27864-0",
                "display" : "Traumatic brain injury (TBI)"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27865-7",
                "display" : "Malnutrition (protein or calorie) or at risk for malnutrition"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27866-5",
                "display" : "Anxiety disorder"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27867-3",
                "display" : "Depression (other than bipolar)"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA29615-4",
                "display" : "Bipolar Disorder"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27869-9",
                "display" : "Psychotic disorder (other than schizophrenia)"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27870-7",
                "display" : "Schizophrenia (e.g., schizoaffective and schizophreniform disorders)"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27871-5",
                "display" : "Post traumatic stress disorder (PTSD)"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27872-3",
                "display" : "Asthma, chronic obstructive pulmonary disease (COPD), or chronic lung disease (e.g., chronic bronchitis and restrictive lung diseases such as asbestosis)"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27873-1",
                "display" : "Respiratory failure"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27874-9",
                "display" : "Cataracts, glaucoma, or macular degeneration"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27875-6",
                "display" : "None of the above active diagnoses within the last 7 days"
              }
            }
          ]
        },
        {
          "linkId" : "103037",
          "code" : [
            {
              "system" : "http://loinc.org",
              "code" : "52797-8",
              "display" : "Additional active diagnoses"
            }
          ],
          "prefix" : "I8000A-I8000J",
          "text" : "Additional active diagnoses",
          "type" : "choice",
          "repeats" : true,
          "answerOption" : [
            {
              "valueCoding" : {
                "system" : "http://loinc.org"
              }
            }
          ]
        }
      ]
    },
    {
      "linkId" : "106182",
      "prefix" : "J",
      "text" : "Health Conditions",
      "type" : "group",
      "required" : true,
      "item" : [
        {
          "linkId" : "103039",
          "prefix" : "J0100",
          "text" : "Pain Management",
          "type" : "group",
          "required" : true,
          "item" : [
            {
              "linkId" : "103040",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "71447-7",
                  "display" : "At any time in the last 5 days, has the resident: Received scheduled pain medication regimen?"
                }
              ],
              "prefix" : "J0100A",
              "text" : "At any time in the last 5 days, has the resident: Received scheduled pain medication regimen?",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA32-8",
                    "display" : "No"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA33-6",
                    "display" : "Yes"
                  }
                }
              ]
            },
            {
              "linkId" : "103041",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "71448-5",
                  "display" : "At any time in the last 5 days, has the resident: Received PRN pain medications OR was offered and declined?"
                }
              ],
              "prefix" : "J0100B",
              "text" : "At any time in the last 5 days, has the resident: Received PRN pain medications OR was offered and declined?",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA32-8",
                    "display" : "No"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA33-6",
                    "display" : "Yes"
                  }
                }
              ]
            },
            {
              "linkId" : "103042",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "71449-3",
                  "display" : "At any time in the last 5 days, has the resident: Received non-medication intervention for pain?"
                }
              ],
              "prefix" : "J0100C",
              "text" : "At any time in the last 5 days, has the resident: Received non-medication intervention for pain?",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA32-8",
                    "display" : "No"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA33-6",
                    "display" : "Yes"
                  }
                }
              ]
            }
          ]
        },
        {
          "linkId" : "103043",
          "code" : [
            {
              "system" : "http://loinc.org",
              "code" : "54828-9",
              "display" : "Should Pain Assessment Interview be Conducted?"
            }
          ],
          "prefix" : "J0200",
          "text" : "Should Pain Assessment Interview be Conducted?",
          "type" : "choice",
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA11150-2",
                "display" : "No (resident is rarely/never understood)"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA33-6",
                "display" : "Yes"
              }
            }
          ]
        },
        {
          "linkId" : "103044",
          "text" : "Pain Assessment Interview",
          "type" : "group",
          "required" : true,
          "item" : [
            {
              "linkId" : "103045",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "54829-7",
                  "display" : "Pain Presence. Have you had pain or hurting at any time in the last 5 days?"
                }
              ],
              "prefix" : "J0300",
              "text" : "Pain Presence. Have you had pain or hurting at any time in the last 5 days?",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA32-8",
                    "display" : "No"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA33-6",
                    "display" : "Yes"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11054-6",
                    "display" : "Unable to answer"
                  }
                }
              ]
            },
            {
              "linkId" : "103046",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "54830-5",
                  "display" : "Pain Frequency. How much of the time have you experienced pain or hurting over the last 5 days?"
                }
              ],
              "prefix" : "J0400",
              "text" : "Pain Frequency. How much of the time have you experienced pain or hurting over the last 5 days?",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11055-3",
                    "display" : "Almost constantly"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA6482-9",
                    "display" : "Frequently"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA6483-7",
                    "display" : "Occasionally"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA10066-1",
                    "display" : "Rarely"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11054-6",
                    "display" : "Unable to answer"
                  }
                }
              ]
            },
            {
              "linkId" : "103047",
              "prefix" : "J0500",
              "text" : "Pain Effect on Function",
              "type" : "group",
              "required" : true,
              "item" : [
                {
                  "linkId" : "103048",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "54831-3",
                      "display" : "Over the past 5 days, has pain made it hard for you to sleep at night?"
                    }
                  ],
                  "prefix" : "J0500A",
                  "text" : "Over the past 5 days, has pain made it hard for you to sleep at night?",
                  "type" : "choice",
                  "repeats" : false,
                  "answerOption" : [
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA32-8",
                        "display" : "No"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA33-6",
                        "display" : "Yes"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA11054-6",
                        "display" : "Unable to answer"
                      }
                    }
                  ]
                },
                {
                  "linkId" : "103049",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "54832-1",
                      "display" : "Over the past 5 days, have you limited your day-to-day activities because of pain?"
                    }
                  ],
                  "prefix" : "J0500B",
                  "text" : "Over the past 5 days, have you limited your day-to-day activities because of pain?",
                  "type" : "choice",
                  "repeats" : false,
                  "answerOption" : [
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA32-8",
                        "display" : "No"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA33-6",
                        "display" : "Yes"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA11054-6",
                        "display" : "Unable to answer"
                      }
                    }
                  ]
                }
              ]
            },
            {
              "linkId" : "103050",
              "prefix" : "J0600",
              "text" : "Pain Intensity",
              "type" : "group",
              "required" : true,
              "item" : [
                {
                  "linkId" : "103051",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "54833-9",
                      "display" : "Numeric Rating Scale (00-10)"
                    }
                  ],
                  "prefix" : "J0600A",
                  "text" : "Numeric Rating Scale (00-10)",
                  "type" : "string",
                  "repeats" : false
                },
                {
                  "linkId" : "103052",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "54834-7",
                      "display" : "Verbal Descriptor Scale"
                    }
                  ],
                  "prefix" : "J0600B",
                  "text" : "Verbal Descriptor Scale",
                  "type" : "choice",
                  "repeats" : false,
                  "answerOption" : [
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA6752-5",
                        "display" : "Mild"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA6751-7",
                        "display" : "Moderate"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA6750-9",
                        "display" : "Severe"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA11063-7",
                        "display" : "Very severe, horrible"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA11054-6",
                        "display" : "Unable to answer"
                      }
                    }
                  ]
                }
              ]
            }
          ]
        },
        {
          "linkId" : "103053",
          "code" : [
            {
              "system" : "http://loinc.org",
              "code" : "58117-3",
              "display" : "Should the Staff Assessment for Pain be Conducted?"
            }
          ],
          "prefix" : "J0700",
          "text" : "Should the Staff Assessment for Pain be Conducted?",
          "type" : "choice",
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA32-8",
                "display" : "No"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA33-6",
                "display" : "Yes"
              }
            }
          ]
        },
        {
          "linkId" : "103054",
          "text" : "Staff Assessment for Pain",
          "type" : "group",
          "required" : true,
          "item" : [
            {
              "linkId" : "103055",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "86673-1",
                  "display" : "Indicators of Pain or Possible Pain in the last 5 days"
                }
              ],
              "prefix" : "J0800",
              "text" : "Indicators of Pain or Possible Pain in the last 5 days",
              "type" : "choice",
              "repeats" : true,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA10034-9",
                    "display" : "Non-verbal sounds (e.g., crying, whining, gasping, moaning, or groaning)"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA10116-4",
                    "display" : "Vocal complaints of pain (e.g., that hurts, ouch, stop)"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA9968-4",
                    "display" : "Facial expressions (e.g., grimaces, winces, wrinkled forehead, furrowed brow, clenched teeth or jaw)"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA10063-8",
                    "display" : "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" : {
                    "system" : "http://loinc.org",
                    "code" : "LA10032-3",
                    "display" : "None of these signs observed or documented"
                  }
                }
              ]
            },
            {
              "linkId" : "103056",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "58118-1",
                  "display" : "Frequency of Indicator of Pain or Possible Pain in the last 5 days. Frequency with which resident complains or shows evidence of pain or possible pain"
                }
              ],
              "prefix" : "J0850",
              "text" : "Frequency of Indicator of Pain or Possible Pain in the last 5 days. Frequency with which resident complains or shows evidence of pain or possible pain",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA12645-0",
                    "display" : "Indicators of pain or possible pain observed 1 to 2 days"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA12646-8",
                    "display" : "Indicators of pain or possible pain observed 3 to 4 days"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA12647-6",
                    "display" : "Indicators of pain or possible pain observed daily"
                  }
                }
              ]
            }
          ]
        },
        {
          "linkId" : "103057",
          "text" : "Other Health Conditions",
          "type" : "group",
          "required" : true,
          "item" : [
            {
              "linkId" : "103058",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "86675-6",
                  "display" : "Shortness of Breath (dyspnea)"
                }
              ],
              "prefix" : "J1100",
              "text" : "Shortness of Breath (dyspnea)",
              "type" : "choice",
              "repeats" : true,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27988-7",
                    "display" : "Shortness of breath or trouble breathing with exertion (e.g., walking, bathing, transferring)"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27989-5",
                    "display" : "Shortness of breath or trouble breathing when sitting at rest"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27990-3",
                    "display" : "Shortness of breath or trouble breathing when lying flat"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA9-3",
                    "display" : "None of the above"
                  }
                }
              ]
            },
            {
              "linkId" : "103059",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "54845-3",
                  "display" : "Current Tobacco Use"
                }
              ],
              "prefix" : "J1300",
              "text" : "Current Tobacco Use",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA32-8",
                    "display" : "No"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA33-6",
                    "display" : "Yes"
                  }
                }
              ]
            },
            {
              "linkId" : "103060",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "54846-1",
                  "display" : "Prognosis"
                }
              ],
              "prefix" : "J1400",
              "text" : "Prognosis",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA32-8",
                    "display" : "No"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA33-6",
                    "display" : "Yes"
                  }
                }
              ]
            },
            {
              "linkId" : "103061",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "86676-4",
                  "display" : "Problem Conditions"
                }
              ],
              "prefix" : "J1550",
              "text" : "Problem Conditions",
              "type" : "choice",
              "repeats" : true,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA7435-6",
                    "display" : "Fever"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA15099-7",
                    "display" : "Vomiting"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27897-0",
                    "display" : "Dehydrated"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27898-8",
                    "display" : "Internal bleeding"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA9-3",
                    "display" : "None of the above"
                  }
                }
              ]
            },
            {
              "linkId" : "103062",
              "prefix" : "J1700",
              "text" : "Fall History on Admission/Entry or Reentry",
              "type" : "group",
              "required" : true,
              "item" : [
                {
                  "linkId" : "103063",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "54850-3",
                      "display" : "Did the resident have a fall any time in the last month prior to admission/entry or reentry?"
                    }
                  ],
                  "prefix" : "J1700A",
                  "text" : "Did the resident have a fall any time in the last month prior to admission/entry or reentry?",
                  "type" : "choice",
                  "repeats" : false,
                  "answerOption" : [
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA32-8",
                        "display" : "No"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA33-6",
                        "display" : "Yes"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA11137-9",
                        "display" : "Unable to determine"
                      }
                    }
                  ]
                },
                {
                  "linkId" : "103064",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "54851-1",
                      "display" : "Did the resident have a fall any time in the last 2-6 months prior to admission/entry or reentry?"
                    }
                  ],
                  "prefix" : "J1700B",
                  "text" : "Did the resident have a fall any time in the last 2-6 months prior to admission/entry or reentry?",
                  "type" : "choice",
                  "repeats" : false,
                  "answerOption" : [
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA32-8",
                        "display" : "No"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA33-6",
                        "display" : "Yes"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA11137-9",
                        "display" : "Unable to determine"
                      }
                    }
                  ]
                },
                {
                  "linkId" : "103065",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "54852-9",
                      "display" : "Did the resident have any fracture related to a fall in the 6 months prior to admission/entry or reentry?"
                    }
                  ],
                  "prefix" : "J1700C",
                  "text" : "Did the resident have any fracture related to a fall in the 6 months prior to admission/entry or reentry?",
                  "type" : "choice",
                  "repeats" : false,
                  "answerOption" : [
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA32-8",
                        "display" : "No"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA33-6",
                        "display" : "Yes"
                      }
                    },
                    {
                      "valueCoding" : {
                        "system" : "http://loinc.org",
                        "code" : "LA11137-9",
                        "display" : "Unable to determine"
                      }
                    }
                  ]
                }
              ]
            },
            {
              "linkId" : "103066",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "54853-7",
                  "display" : "Has the resident had any falls since admission/entry or reentry or the prior assessment (OBRA or Scheduled PPS), whichever is more recent?"
                }
              ],
              "prefix" : "J1800",
              "text" : "Has the resident had any falls since admission/entry or reentry or the prior assessment (OBRA or Scheduled PPS), whichever is more recent?",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA32-8",
                    "display" : "No"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA33-6",
                    "display" : "Yes"
                  }
                }
              ]
            },
            {
              "linkId" : "103067",
              "prefix" : "J1900",
              "text" : "Number of Falls Since Admission/Entry or Reentry or Prior Assessment (OBRA or Scheduled PPS), whichever is more recent",
              "type" : "group",
              "required" : true,
              "item" : [
                {
                  "linkId" : "103068",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "54855-2",
                      "display" : "No injury"
                    }
                  ],
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                  "linkId" : "103070",
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                      "system" : "http://loinc.org",
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                  ],
                  "prefix" : "J1900C",
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          "prefix" : "J2000",
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            {
              "valueCoding" : {
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              "valueCoding" : {
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          ],
          "prefix" : "J2300-J5000",
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          "repeats" : false,
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              "valueCoding" : {
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              "valueCoding" : {
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              "valueCoding" : {
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            {
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                "system" : "http://loinc.org",
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              "valueCoding" : {
                "system" : "http://loinc.org",
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                "system" : "http://loinc.org",
                "code" : "LA29564-4",
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              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA29566-9",
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              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA29567-7",
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                "system" : "http://loinc.org",
                "code" : "LA29569-3",
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              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA29570-1",
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            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA29571-9",
                "display" : "Other major surgery involving repair of deep ulcers, internal brachytherapy, bone marrow or stem cell harvest or transplant"
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            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA29572-7",
                "display" : "Other major surgery not listed above"
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            }
          ]
        }
      ]
    },
    {
      "linkId" : "106270",
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          "prefix" : "K0100",
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                "system" : "http://loinc.org",
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              "valueCoding" : {
                "system" : "http://loinc.org",
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            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA9961-9",
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            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA9952-8",
                "display" : "Complaints of difficulty or pain with swallowing"
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            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA9-3",
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          ]
        },
        {
          "linkId" : "103074",
          "prefix" : "K0200",
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          "required" : true,
          "item" : [
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              "linkId" : "103075",
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                {
                  "system" : "http://loinc.org",
                  "code" : "103692-0",
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              "prefix" : "K0200A",
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              "type" : "decimal",
              "repeats" : false
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            {
              "linkId" : "103076",
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                  "system" : "http://loinc.org",
                  "code" : "103693-8",
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              ],
              "prefix" : "K0200B",
              "text" : "Weight (in pounds)",
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              "repeats" : false
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          ]
        },
        {
          "linkId" : "103077",
          "code" : [
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              "system" : "http://loinc.org",
              "code" : "54863-6",
              "display" : "Weight Loss. Loss of 5% or more in the last month or loss of 10% or more in last 6 months"
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          ],
          "prefix" : "K0300",
          "text" : "Weight Loss. Loss of 5% or more in the last month or loss of 10% or more in last 6 months",
          "type" : "choice",
          "repeats" : false,
          "answerOption" : [
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              "valueCoding" : {
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                "code" : "LA11074-4",
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            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA11075-1",
                "display" : "Yes, on physician-prescribed weight-loss regimen"
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            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA11076-9",
                "display" : "Yes, not on physician-prescribed weight-loss regimen"
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            }
          ]
        },
        {
          "linkId" : "103078",
          "code" : [
            {
              "system" : "http://loinc.org",
              "code" : "86678-0",
              "display" : "Weight Gain. Gain of 5% or more in the last month or gain of 10% or more in last 6 months"
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          ],
          "prefix" : "K0310",
          "text" : "Weight Gain. Gain of 5% or more in the last month or gain of 10% or more in last 6 months",
          "type" : "choice",
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA11074-4",
                "display" : "No or unknown"
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            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA18602-5",
                "display" : "Yes, on physician-prescribed weight-gain regimen"
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            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA18603-3",
                "display" : "Yes, not on physician-prescribed weight-gain regimen"
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            }
          ]
        },
        {
          "linkId" : "103079",
          "prefix" : "K0510",
          "text" : "Nutritional Approaches",
          "type" : "group",
          "required" : true,
          "item" : [
            {
              "linkId" : "103080",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "71444-4",
                  "display" : "Nutritional Approaches. While NOT a Resident"
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              ],
              "prefix" : "K0510_1",
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              "type" : "choice",
              "repeats" : true,
              "answerOption" : [
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                    "system" : "http://loinc.org",
                    "code" : "LA18604-1",
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                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA18605-8",
                    "display" : "Feeding tube - nasogastric or abdominal (PEG)"
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                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA9-3",
                    "display" : "None of the above"
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                }
              ]
            },
            {
              "linkId" : "103081",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "71445-1",
                  "display" : "Nutritional Approaches. While a Resident"
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              ],
              "prefix" : "K0510_2",
              "text" : "Nutritional Approaches. While a Resident",
              "type" : "choice",
              "repeats" : true,
              "answerOption" : [
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                  "valueCoding" : {
                    "system" : "http://loinc.org",
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                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA18605-8",
                    "display" : "Feeding tube - nasogastric or abdominal (PEG)"
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                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA18606-6",
                    "display" : "Mechanically altered diet - require change in texture of food or liquids (e.g., pureed food, thickened liquids)"
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                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA18607-4",
                    "display" : "Therapeutic diet (e.g., low salt, diabetic, low cholesterol)"
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                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA9-3",
                    "display" : "None of the above"
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                }
              ]
            }
          ]
        },
        {
          "linkId" : "106271",
          "prefix" : "K0710",
          "text" : "Percent Intake by Artificial Route",
          "type" : "group",
          "required" : true,
          "item" : [
            {
              "linkId" : "103084",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "86681-4",
                  "display" : "Proportion of total calories the resident received through parenteral or tube feeding. While a Resident"
                }
              ],
              "prefix" : "K0710A2",
              "text" : "Proportion of total calories the resident received through parenteral or tube feeding. While a Resident",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11077-7",
                    "display" : "25% or less"
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                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11078-5",
                    "display" : "26-50%"
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                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11079-3",
                    "display" : "51% or more"
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                }
              ]
            },
            {
              "linkId" : "103085",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "86687-1",
                  "display" : "Proportion of total calories the resident received through parenteral or tube feeding. During Entire 7 Days"
                }
              ],
              "prefix" : "K0710A3",
              "text" : "Proportion of total calories the resident received through parenteral or tube feeding. During Entire 7 Days",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11077-7",
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                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11078-5",
                    "display" : "26-50%"
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                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11079-3",
                    "display" : "51% or more"
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                }
              ]
            },
            {
              "linkId" : "103087",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "86683-0",
                  "display" : "Average fluid intake per day by IV or tube feeding. While a Resident"
                }
              ],
              "prefix" : "K0710B2",
              "text" : "Average fluid intake per day by IV or tube feeding. While a Resident",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
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                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11080-1",
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                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11081-9",
                    "display" : "501 cc/day or more"
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                }
              ]
            },
            {
              "linkId" : "103088",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "86684-8",
                  "display" : "Average fluid intake per day by IV or tube feeding. During Entire 7 Days"
                }
              ],
              "prefix" : "K0710B3",
              "text" : "Average fluid intake per day by IV or tube feeding. During Entire 7 Days",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11080-1",
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                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11081-9",
                    "display" : "501 cc/day or more"
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                }
              ]
            }
          ]
        }
      ]
    },
    {
      "linkId" : "103089",
      "prefix" : "L",
      "text" : "Oral/Dental Status",
      "type" : "group",
      "required" : true,
      "item" : [
        {
          "linkId" : "103090",
          "code" : [
            {
              "system" : "http://loinc.org",
              "code" : "86706-9",
              "display" : "Dental"
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          ],
          "prefix" : "L0200",
          "text" : "Dental",
          "type" : "choice",
          "repeats" : true,
          "answerOption" : [
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              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27932-5",
                "display" : "Broken or loosely fitting full or partial denture (chipped, cracked, uncleanable, or loose)"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27933-3",
                "display" : "No natural teeth or tooth fragment(s) (edentulous)"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27934-1",
                "display" : "Abnormal mouth tissue (ulcers, masses, oral lesions, including under denture or partial if one is worn)"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27935-8",
                "display" : "Obvious or likely cavity or broken natural teeth"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27936-6",
                "display" : "Inflamed or bleeding gums or loose natural teeth"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27937-4",
                "display" : "Mouth or facial pain, discomfort or difficulty with chewing"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27938-2",
                "display" : "Unable to examine"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27939-0",
                "display" : "None of the above were present"
              }
            }
          ]
        }
      ]
    },
    {
      "linkId" : "103091",
      "prefix" : "M",
      "text" : "Skin Conditions",
      "type" : "group",
      "required" : true,
      "item" : [
        {
          "linkId" : "103092",
          "code" : [
            {
              "system" : "http://loinc.org",
              "code" : "86708-5",
              "display" : "Determination of Pressure Ulcer/Injury Risk"
            }
          ],
          "prefix" : "M0100",
          "text" : "Determination of Pressure Ulcer/Injury Risk",
          "type" : "choice",
          "repeats" : true,
          "answerOption" : [
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA28887-0",
                "display" : "Resident has a pressure ulcer/injury, a scar over bony prominence, or a non-removable dressing/device"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27941-6",
                "display" : "Formal assessment instrument/tool (e.g., Braden, Norton, or other)"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27942-4",
                "display" : "Clinical assessment"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA9-3",
                "display" : "None of the above"
              }
            }
          ]
        },
        {
          "linkId" : "103093",
          "code" : [
            {
              "system" : "http://loinc.org",
              "code" : "57280-0",
              "display" : "Risk of Pressure Ulcers/Injuries"
            }
          ],
          "prefix" : "M0150",
          "text" : "Risk of Pressure Ulcers/Injuries",
          "type" : "choice",
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA32-8",
                "display" : "No"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA33-6",
                "display" : "Yes"
              }
            }
          ]
        },
        {
          "linkId" : "103094",
          "code" : [
            {
              "system" : "http://loinc.org",
              "code" : "58214-8",
              "display" : "Unhealed Pressure Ulcers/Injuries"
            }
          ],
          "prefix" : "M0210",
          "text" : "Unhealed Pressure Ulcers/Injuries",
          "type" : "choice",
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA32-8",
                "display" : "No"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA33-6",
                "display" : "Yes"
              }
            }
          ]
        },
        {
          "linkId" : "103095",
          "prefix" : "M0300",
          "text" : "Current Number of Unhealed Pressure Ulcers/Injuries at Each Stage",
          "type" : "group",
          "required" : true,
          "item" : [
            {
              "linkId" : "103096",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "54884-2",
                  "display" : "Number of Stage 1 pressure injuries"
                }
              ],
              "prefix" : "M0300A1",
              "text" : "Number of Stage 1 pressure injuries",
              "type" : "decimal",
              "repeats" : false
            },
            {
              "linkId" : "103097",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "55124-2",
                  "display" : "Number of Stage 2 pressure ulcers"
                }
              ],
              "prefix" : "M0300B1",
              "text" : "Number of Stage 2 pressure ulcers",
              "type" : "decimal",
              "repeats" : false
            },
            {
              "linkId" : "103098",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "54886-7",
                  "display" : "Number of these Stage 2 pressure ulcers that were present upon admission/entry or reentry"
                }
              ],
              "prefix" : "M0300B2",
              "text" : "Number of these Stage 2 pressure ulcers that were present upon admission/entry or reentry",
              "type" : "decimal",
              "repeats" : false
            },
            {
              "linkId" : "103099",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "55125-9",
                  "display" : "Number of Stage 3 pressure ulcers"
                }
              ],
              "prefix" : "M0300C1",
              "text" : "Number of Stage 3 pressure ulcers",
              "type" : "decimal",
              "repeats" : false
            },
            {
              "linkId" : "103100",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "54887-5",
                  "display" : "Number of these Stage 3 pressure ulcers that were present upon admission/entry or reentry"
                }
              ],
              "prefix" : "M0300C2",
              "text" : "Number of these Stage 3 pressure ulcers that were present upon admission/entry or reentry",
              "type" : "decimal",
              "repeats" : false
            },
            {
              "linkId" : "103101",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "55126-7",
                  "display" : "Number of Stage 4 pressure ulcers"
                }
              ],
              "prefix" : "M0300D1",
              "text" : "Number of Stage 4 pressure ulcers",
              "type" : "decimal",
              "repeats" : false
            },
            {
              "linkId" : "103102",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "54890-9",
                  "display" : "Number of these Stage 4 pressure ulcers that were present upon admission/entry or reentry"
                }
              ],
              "prefix" : "M0300D2",
              "text" : "Number of these Stage 4 pressure ulcers that were present upon admission/entry or reentry",
              "type" : "decimal",
              "repeats" : false
            },
            {
              "linkId" : "103103",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "54893-3",
                  "display" : "Number of unstageable pressure ulcers/injuries due to non-removable dressing/device"
                }
              ],
              "prefix" : "M0300E1",
              "text" : "Number of unstageable pressure ulcers/injuries due to non-removable dressing/device",
              "type" : "decimal",
              "repeats" : false
            },
            {
              "linkId" : "103104",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "54894-1",
                  "display" : "Number of these unstageable pressure ulcers/injuries that were present upon admission/entry or reentry"
                }
              ],
              "prefix" : "M0300E2",
              "text" : "Number of these unstageable pressure ulcers/injuries that were present upon admission/entry or reentry",
              "type" : "decimal",
              "repeats" : false
            },
            {
              "linkId" : "103105",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "54946-9",
                  "display" : "Number of unstageable pressure ulcers due to coverage of wound bed by slough and/or eschar"
                }
              ],
              "prefix" : "M0300F1",
              "text" : "Number of unstageable pressure ulcers due to coverage of wound bed by slough and/or eschar",
              "type" : "decimal",
              "repeats" : false
            },
            {
              "linkId" : "103106",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "54947-7",
                  "display" : "Number of these unstageable pressure ulcers that were present upon admission/entry or reentry"
                }
              ],
              "prefix" : "M0300F2",
              "text" : "Number of these unstageable pressure ulcers that were present upon admission/entry or reentry",
              "type" : "decimal",
              "repeats" : false
            },
            {
              "linkId" : "103107",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "54950-1",
                  "display" : "Number of unstageable pressure injuries presenting as deep tissue injury"
                }
              ],
              "prefix" : "M0300G1",
              "text" : "Number of unstageable pressure injuries presenting as deep tissue injury",
              "type" : "decimal",
              "repeats" : false
            },
            {
              "linkId" : "103108",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "54951-9",
                  "display" : "Number of these unstageable pressure injuries that were present upon admission/entry or reentry"
                }
              ],
              "prefix" : "M0300G2",
              "text" : "Number of these unstageable pressure injuries that were present upon admission/entry or reentry",
              "type" : "decimal",
              "repeats" : false
            }
          ]
        },
        {
          "linkId" : "103109",
          "code" : [
            {
              "system" : "http://loinc.org",
              "code" : "54970-9",
              "display" : "Number of Venous and Arterial Ulcers"
            }
          ],
          "prefix" : "M1030",
          "text" : "Number of Venous and Arterial Ulcers",
          "type" : "decimal",
          "repeats" : false
        },
        {
          "linkId" : "103110",
          "code" : [
            {
              "system" : "http://loinc.org",
              "code" : "88696-0",
              "display" : "Other Ulcers, Wounds and Skin Problems"
            }
          ],
          "prefix" : "M1040",
          "text" : "Other Ulcers, Wounds and Skin Problems",
          "type" : "choice",
          "repeats" : true,
          "answerOption" : [
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27943-2",
                "display" : "Infection of the foot (e.g., cellulitis, purulent drainage)"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27944-0",
                "display" : "Diabetic foot ulcer(s)"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27945-7",
                "display" : "Other open lesion(s) on the foot"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27946-5",
                "display" : "Open lesion(s) other than ulcers, rashes, cuts (e.g., cancer lesion)"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27947-3",
                "display" : "Surgical wound(s)"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27948-1",
                "display" : "Burn(s) (second or third degree)"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA18608-2",
                "display" : "Skin tear(s)"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27950-7",
                "display" : "Moisture associated skin damage (MASD) (e.g., incontinence-associated dermatitis [IAD], perspiration, drainage)"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27939-0",
                "display" : "None of the above were present"
              }
            }
          ]
        },
        {
          "linkId" : "103111",
          "code" : [
            {
              "system" : "http://loinc.org",
              "code" : "86748-1",
              "display" : "Skin and Ulcer/Injury Treatments"
            }
          ],
          "prefix" : "M1200",
          "text" : "Skin and Ulcer/Injury Treatments",
          "type" : "choice",
          "repeats" : true,
          "answerOption" : [
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27951-5",
                "display" : "Pressure reducing device for chair"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27952-3",
                "display" : "Pressure reducing device for bed"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27953-1",
                "display" : "Turning/repositioning program"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27954-9",
                "display" : "Nutrition or hydration intervention to manage skin problems"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA28888-8",
                "display" : "Pressure ulcer/injury care"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27956-4",
                "display" : "Surgical wound care"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27957-2",
                "display" : "Application of nonsurgical dressings (with or without topical medications) other than to feet"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27958-0",
                "display" : "Applications of ointments/medications other than to feet"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27959-8",
                "display" : "Application of dressings to feet (with or without topical medications)"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27960-6",
                "display" : "None of the above were provided"
              }
            }
          ]
        }
      ]
    },
    {
      "linkId" : "103112",
      "prefix" : "N",
      "text" : "Medications",
      "type" : "group",
      "required" : true,
      "item" : [
        {
          "linkId" : "103113",
          "code" : [
            {
              "system" : "http://loinc.org",
              "code" : "54982-4",
              "display" : "Injections. Record the number of days that injections of any type were received during the last 7 days or since admission/entry or reentry if less than 7 days."
            }
          ],
          "prefix" : "N0300",
          "text" : "Injections. Record the number of days that injections of any type were received during the last 7 days or since admission/entry or reentry if less than 7 days.",
          "type" : "decimal",
          "repeats" : false
        },
        {
          "linkId" : "103114",
          "prefix" : "N0350",
          "text" : "Insulin",
          "type" : "group",
          "required" : true,
          "item" : [
            {
              "linkId" : "103115",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "58127-2",
                  "display" : "Insulin injections - Record the number of days that insulin injections were received during the last 7 days or since admission/entry or reentry if less than 7 days"
                }
              ],
              "prefix" : "N0350A",
              "text" : "Insulin injections - Record the number of days that insulin injections were received during the last 7 days or since admission/entry or reentry if less than 7 days",
              "type" : "decimal",
              "repeats" : false
            },
            {
              "linkId" : "103116",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "58128-0",
                  "display" : "Orders for insulin - Record the number of days the physician (or authorized assistant or practitioner) changed the resident's insulin orders during the last 7 days or since admission/entry or reentry if less than 7 days"
                }
              ],
              "prefix" : "N0350B",
              "text" : "Orders for insulin - Record the number of days the physician (or authorized assistant or practitioner) changed the resident's insulin orders during the last 7 days or since admission/entry or reentry if less than 7 days",
              "type" : "decimal",
              "repeats" : false
            }
          ]
        },
        {
          "linkId" : "103117",
          "prefix" : "N0410",
          "text" : "Medications Received",
          "type" : "group",
          "required" : true,
          "item" : [
            {
              "linkId" : "103118",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "86751-5",
                  "display" : "Antipsychotic"
                }
              ],
              "prefix" : "N0410A",
              "text" : "Antipsychotic",
              "type" : "decimal",
              "repeats" : false
            },
            {
              "linkId" : "103119",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "86752-3",
                  "display" : "Antianxiety"
                }
              ],
              "prefix" : "N0410B",
              "text" : "Antianxiety",
              "type" : "decimal",
              "repeats" : false
            },
            {
              "linkId" : "103120",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "86753-1",
                  "display" : "Antidepressant"
                }
              ],
              "prefix" : "N0410C",
              "text" : "Antidepressant",
              "type" : "decimal",
              "repeats" : false
            },
            {
              "linkId" : "103121",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "86754-9",
                  "display" : "Hypnotic"
                }
              ],
              "prefix" : "N0410D",
              "text" : "Hypnotic",
              "type" : "decimal",
              "repeats" : false
            },
            {
              "linkId" : "103122",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "86755-6",
                  "display" : "Anticoagulant (e.g., warfarin, heparin, or low-molecular weight heparin)"
                }
              ],
              "prefix" : "N0410E",
              "text" : "Anticoagulant (e.g., warfarin, heparin, or low-molecular weight heparin)",
              "type" : "decimal",
              "repeats" : false
            },
            {
              "linkId" : "103123",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "86756-4",
                  "display" : "Antibiotic"
                }
              ],
              "prefix" : "N0410F",
              "text" : "Antibiotic",
              "type" : "decimal",
              "repeats" : false
            },
            {
              "linkId" : "103124",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "86757-2",
                  "display" : "Diuretic"
                }
              ],
              "prefix" : "N0410G",
              "text" : "Diuretic",
              "type" : "decimal",
              "repeats" : false
            },
            {
              "linkId" : "103125",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "88291-0",
                  "display" : "Opioid"
                }
              ],
              "prefix" : "N0410H",
              "text" : "Opioid",
              "type" : "decimal",
              "repeats" : false
            }
          ]
        },
        {
          "linkId" : "103126",
          "prefix" : "N0450",
          "text" : "Antipsychotic Medication Review",
          "type" : "group",
          "required" : true,
          "item" : [
            {
              "linkId" : "103127",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "88296-9",
                  "display" : "Did the resident receive antipsychotic medications since admission/entry or reentry or the prior OBRA assessment, whichever is more recent?"
                }
              ],
              "prefix" : "N0450A",
              "text" : "Did the resident receive antipsychotic medications since admission/entry or reentry or the prior OBRA assessment, whichever is more recent?",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28462-2",
                    "display" : "No - Antipsychotics were not received"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28463-0",
                    "display" : "Yes - Antipsychotics were received on a routine basis only"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28464-8",
                    "display" : "Yes - Antipsychotics were received on a PRN basis only"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28465-5",
                    "display" : "Yes - Antipsychotics were received on a routine and PRN basis"
                  }
                }
              ]
            },
            {
              "linkId" : "103128",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "88297-7",
                  "display" : "Has a gradual dose reduction (GDR) been attempted?"
                }
              ],
              "prefix" : "N0450B",
              "text" : "Has a gradual dose reduction (GDR) been attempted?",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA32-8",
                    "display" : "No"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA33-6",
                    "display" : "Yes"
                  }
                }
              ]
            },
            {
              "linkId" : "103129",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "88298-5",
                  "display" : "Date of last attempted GDR"
                }
              ],
              "prefix" : "N0450C",
              "text" : "Date of last attempted GDR",
              "type" : "date",
              "repeats" : false
            },
            {
              "linkId" : "103130",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "88299-3",
                  "display" : "Physician documented GDR as clinically contraindicated"
                }
              ],
              "prefix" : "N0450D",
              "text" : "Physician documented GDR as clinically contraindicated",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28466-3",
                    "display" : "No - GDR has not been documented by a physician as clinically contraindicated"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28467-1",
                    "display" : "Yes - GDR has been documented by a physician as clinically contraindicated"
                  }
                }
              ]
            },
            {
              "linkId" : "103131",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "88300-9",
                  "display" : "Date physician documented GDR as clinically contraindicated"
                }
              ],
              "prefix" : "N0450E",
              "text" : "Date physician documented GDR as clinically contraindicated",
              "type" : "date",
              "repeats" : false
            }
          ]
        },
        {
          "linkId" : "103132",
          "code" : [
            {
              "system" : "http://loinc.org",
              "code" : "57255-2",
              "display" : "Drug Regimen Review: Did a complete drug regimen review identify potential clinically significant medication issues?"
            }
          ],
          "prefix" : "N2001",
          "text" : "Drug Regimen Review: Did a complete drug regimen review identify potential clinically significant medication issues?",
          "type" : "choice",
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27634-7",
                "display" : "No - No issues found during review"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27635-4",
                "display" : "Yes - Issues found during review"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA27636-2",
                "display" : "NA - Resident is not taking any medications"
              }
            }
          ]
        },
        {
          "linkId" : "103133",
          "code" : [
            {
              "system" : "http://loinc.org",
              "code" : "57281-8",
              "display" : "Medication Follow-up: Did the facility 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?"
            }
          ],
          "prefix" : "N2003",
          "text" : "Medication Follow-up: Did the facility 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" : "choice",
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA32-8",
                "display" : "No"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA33-6",
                "display" : "Yes"
              }
            }
          ]
        },
        {
          "linkId" : "103134",
          "code" : [
            {
              "system" : "http://loinc.org",
              "code" : "57256-0",
              "display" : "Did the facility 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?"
            }
          ],
          "prefix" : "N2005",
          "text" : "Did the facility 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" : "choice",
          "repeats" : false,
          "answerOption" : [
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA32-8",
                "display" : "No"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA33-6",
                "display" : "Yes"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
                "code" : "LA28935-7",
                "display" : "NA - There were no potential clinically significant medication issues identified since admission or resident is not taking any medications"
              }
            }
          ]
        }
      ]
    },
    {
      "linkId" : "109478",
      "prefix" : "O",
      "text" : "Special Treatments, Procedures, and Programs",
      "type" : "group",
      "required" : true,
      "item" : [
        {
          "linkId" : "103136",
          "prefix" : "O0100",
          "text" : "Special Treatments, Procedures, and Programs",
          "type" : "group",
          "required" : true,
          "item" : [
            {
              "linkId" : "103137",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "86760-6",
                  "display" : "While NOT a Resident"
                }
              ],
              "prefix" : "O0100_1",
              "text" : "While NOT a Resident",
              "type" : "choice",
              "repeats" : true,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA6172-6",
                    "display" : "Chemotherapy"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA4351-8",
                    "display" : "Radiation"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27962-2",
                    "display" : "Oxygen therapy"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27963-0",
                    "display" : "Suctioning"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27964-8",
                    "display" : "Tracheostomy care"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28889-6",
                    "display" : "Invasive mechanical ventilator (ventilator or respirator)"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28890-4",
                    "display" : "Non-invasive mechanical ventilator (BiPAP/CPAP)"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27972-1",
                    "display" : "IV medications"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27966-3",
                    "display" : "Transfusions"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA7216-0",
                    "display" : "Dialysis"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA6217-9",
                    "display" : "Hospice care"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27970-5",
                    "display" : "Isolation or quarantine for active infectious disease (does not include standard body/fluid precautions)"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA9-3",
                    "display" : "None of the above"
                  }
                }
              ]
            },
            {
              "linkId" : "103138",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "86761-4",
                  "display" : "While a Resident"
                }
              ],
              "prefix" : "O0100_2",
              "text" : "While a Resident",
              "type" : "choice",
              "repeats" : true,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA6172-6",
                    "display" : "Chemotherapy"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA4351-8",
                    "display" : "Radiation"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27962-2",
                    "display" : "Oxygen therapy"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27963-0",
                    "display" : "Suctioning"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27964-8",
                    "display" : "Tracheostomy care"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28889-6",
                    "display" : "Invasive mechanical ventilator (ventilator or respirator)"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28890-4",
                    "display" : "Non-invasive mechanical ventilator (BiPAP/CPAP)"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27972-1",
                    "display" : "IV medications"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27966-3",
                    "display" : "Transfusions"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA7216-0",
                    "display" : "Dialysis"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA6217-9",
                    "display" : "Hospice care"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27970-5",
                    "display" : "Isolation or quarantine for active infectious disease (does not include standard body/fluid precautions)"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA9-3",
                    "display" : "None of the above"
                  }
                }
              ]
            }
          ]
        },
        {
          "linkId" : "103139",
          "prefix" : "O0250",
          "text" : "Influenza Vaccine",
          "type" : "group",
          "required" : true,
          "item" : [
            {
              "linkId" : "103140",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "55019-4",
                  "display" : "Did the resident receive the influenza vaccine in this facility for this year's influenza vaccination season?"
                }
              ],
              "prefix" : "O0250A",
              "text" : "Did the resident receive the influenza vaccine in this facility for this year's influenza vaccination season?",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA32-8",
                    "display" : "No"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA33-6",
                    "display" : "Yes"
                  }
                }
              ]
            },
            {
              "linkId" : "103141",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "58131-4",
                  "display" : "Date influenza vaccine received"
                }
              ],
              "prefix" : "O0250B",
              "text" : "Date influenza vaccine received",
              "type" : "date",
              "repeats" : false
            },
            {
              "linkId" : "103142",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "55020-2",
                  "display" : "If influenza vaccine not received, state reason:"
                }
              ],
              "prefix" : "O0250C",
              "text" : "If influenza vaccine not received, state reason:",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28194-1",
                    "display" : "Resident not in this facility during this year's influenza vaccination season"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA184-4",
                    "display" : "Received outside of this facility"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11091-8",
                    "display" : "Not eligible - medical contraindication"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA186-9",
                    "display" : "Offered and declined"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA187-7",
                    "display" : "Not offered"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA26746-0",
                    "display" : "Inability to obtain influenza vaccine due to a declared shortage"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA9-3",
                    "display" : "None of the above"
                  }
                }
              ]
            }
          ]
        },
        {
          "linkId" : "103143",
          "prefix" : "O0300",
          "text" : "Pneumococcal Vaccine",
          "type" : "group",
          "required" : true,
          "item" : [
            {
              "linkId" : "103144",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "55022-8",
                  "display" : "Is the resident's Pneumococcal vaccination up to date?"
                }
              ],
              "prefix" : "O0300A",
              "text" : "Is the resident's Pneumococcal vaccination up to date?",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA32-8",
                    "display" : "No"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA33-6",
                    "display" : "Yes"
                  }
                }
              ]
            },
            {
              "linkId" : "103145",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "45956-0",
                  "display" : "If Pneumococcal vaccine not received, state reason:"
                }
              ],
              "prefix" : "O0300B",
              "text" : "If Pneumococcal vaccine not received, state reason:",
              "type" : "choice",
              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11091-8",
                    "display" : "Not eligible - medical contraindication"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA186-9",
                    "display" : "Offered and declined"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA187-7",
                    "display" : "Not offered"
                  }
                }
              ]
            }
          ]
        },
        {
          "linkId" : "103146",
          "prefix" : "O0400",
          "text" : "Therapies",
          "type" : "group",
          "required" : true,
          "item" : [
            {
              "linkId" : "103147",
              "prefix" : "O0400A",
              "text" : "Speech-Language Pathology and Audiology Services",
              "type" : "group",
              "required" : true,
              "item" : [
                {
                  "linkId" : "103148",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "58218-9",
                      "display" : "Individual minutes - record the total number of minutes this therapy was administered to the resident individually\r\nin the last 7 days"
                    }
                  ],
                  "prefix" : "O0400A1",
                  "text" : "Individual minutes - record the total number of minutes this therapy was administered to the resident individually\r\nin the last 7 days",
                  "type" : "decimal",
                  "repeats" : false
                },
                {
                  "linkId" : "103149",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "58133-0",
                      "display" : "Concurrent minutes - record the total number of minutes this therapy was administered to the resident concurrently with one other resident in the last 7 days"
                    }
                  ],
                  "prefix" : "O0400A2",
                  "text" : "Concurrent minutes - record the total number of minutes this therapy was administered to the resident concurrently with one other resident in the last 7 days",
                  "type" : "decimal",
                  "repeats" : false
                },
                {
                  "linkId" : "103150",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "58134-8",
                      "display" : "Group minutes - record the total number of minutes this therapy was administered to the resident as part of a group of residents in the last 7 days"
                    }
                  ],
                  "prefix" : "O0400A3",
                  "text" : "Group minutes - record the total number of minutes this therapy was administered to the resident as part of a group of residents in the last 7 days",
                  "type" : "decimal",
                  "repeats" : false
                },
                {
                  "linkId" : "103151",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "86765-5",
                      "display" : "Co-treatment minutes - record the total number of minutes this therapy was administered to the resident in co-treatment sessions in the last 7 days"
                    }
                  ],
                  "prefix" : "O0400A3A",
                  "text" : "Co-treatment minutes - record the total number of minutes this therapy was administered to the resident in co-treatment sessions in the last 7 days",
                  "type" : "decimal",
                  "repeats" : false
                },
                {
                  "linkId" : "103152",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "45760-6",
                      "display" : "Days - record the number of days this therapy was administered for at least 15 minutes a day in the last 7 days"
                    }
                  ],
                  "prefix" : "O0400A4",
                  "text" : "Days - record the number of days this therapy was administered for at least 15 minutes a day in the last 7 days",
                  "type" : "decimal",
                  "repeats" : false
                },
                {
                  "linkId" : "103153",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "55025-1",
                      "display" : "Therapy start date - record the date the most recent therapy regimen (since the most recent entry) started"
                    }
                  ],
                  "prefix" : "O0400A5",
                  "text" : "Therapy start date - record the date the most recent therapy regimen (since the most recent entry) started",
                  "type" : "date",
                  "repeats" : false
                },
                {
                  "linkId" : "103154",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "55026-9",
                      "display" : "Therapy end date - record the date the most recent therapy regimen (since the most recent entry) ended"
                    }
                  ],
                  "prefix" : "O0400A6",
                  "text" : "Therapy end date - record the date the most recent therapy regimen (since the most recent entry) ended",
                  "type" : "date",
                  "repeats" : false
                }
              ]
            },
            {
              "linkId" : "103155",
              "prefix" : "O0400B",
              "text" : "Occupational Therapy",
              "type" : "group",
              "required" : true,
              "item" : [
                {
                  "linkId" : "103156",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "58219-7",
                      "display" : "Individual minutes - record the total number of minutes this therapy was administered to the resident individually in the last 7 days"
                    }
                  ],
                  "prefix" : "O0400B1",
                  "text" : "Individual minutes - record the total number of minutes this therapy was administered to the resident individually in the last 7 days",
                  "type" : "decimal",
                  "repeats" : false
                },
                {
                  "linkId" : "103157",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "58136-3",
                      "display" : "Concurrent minutes - record the total number of minutes this therapy was administered to the resident concurrently with one other resident in the last 7 days"
                    }
                  ],
                  "prefix" : "O0400B2",
                  "text" : "Concurrent minutes - record the total number of minutes this therapy was administered to the resident concurrently with one other resident in the last 7 days",
                  "type" : "decimal",
                  "repeats" : false
                },
                {
                  "linkId" : "103158",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "58137-1",
                      "display" : "Group minutes - record the total number of minutes this therapy was administered to the resident as part of a group of residents in the last 7 days"
                    }
                  ],
                  "prefix" : "O0400B3",
                  "text" : "Group minutes - record the total number of minutes this therapy was administered to the resident as part of a group of residents in the last 7 days",
                  "type" : "decimal",
                  "repeats" : false
                },
                {
                  "linkId" : "103159",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "86764-8",
                      "display" : "Co-treatment minutes - record the total number of minutes this therapy was administered to the resident in co-treatment sessions in the last 7 days"
                    }
                  ],
                  "prefix" : "O0400B3A",
                  "text" : "Co-treatment minutes - record the total number of minutes this therapy was administered to the resident in co-treatment sessions in the last 7 days",
                  "type" : "decimal",
                  "repeats" : false
                },
                {
                  "linkId" : "103160",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "45762-2",
                      "display" : "Days - record the number of days this therapy was administered for at least 15 minutes a day in the last 7 days"
                    }
                  ],
                  "prefix" : "O0400B4",
                  "text" : "Days - record the number of days this therapy was administered for at least 15 minutes a day in the last 7 days",
                  "type" : "decimal",
                  "repeats" : false
                },
                {
                  "linkId" : "103161",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "55027-7",
                      "display" : "Therapy start date - record the date the most recent therapy regimen (since the most recent entry) started"
                    }
                  ],
                  "prefix" : "O0400B5",
                  "text" : "Therapy start date - record the date the most recent therapy regimen (since the most recent entry) started",
                  "type" : "date",
                  "repeats" : false
                },
                {
                  "linkId" : "103162",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "55028-5",
                      "display" : "Therapy end date - record the date the most recent therapy regimen (since the most recent entry) ended"
                    }
                  ],
                  "prefix" : "O0400B6",
                  "text" : "Therapy end date - record the date the most recent therapy regimen (since the most recent entry) ended",
                  "type" : "date",
                  "repeats" : false
                }
              ]
            },
            {
              "linkId" : "103163",
              "prefix" : "O0400C",
              "text" : "Physical Therapy",
              "type" : "group",
              "required" : true,
              "item" : [
                {
                  "linkId" : "103164",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "58220-5",
                      "display" : "Individual minutes - record the total number of minutes this therapy was administered to the resident individually in the last 7 days"
                    }
                  ],
                  "prefix" : "O0400C1",
                  "text" : "Individual minutes - record the total number of minutes this therapy was administered to the resident individually in the last 7 days",
                  "type" : "decimal",
                  "repeats" : false
                },
                {
                  "linkId" : "103165",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "58139-7",
                      "display" : "Concurrent minutes - record the total number of minutes this therapy was administered to the resident concurrently with one other resident in the last 7 days"
                    }
                  ],
                  "prefix" : "O0400C2",
                  "text" : "Concurrent minutes - record the total number of minutes this therapy was administered to the resident concurrently with one other resident in the last 7 days",
                  "type" : "decimal",
                  "repeats" : false
                },
                {
                  "linkId" : "103166",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "58140-5",
                      "display" : "Group minutes - record the total number of minutes this therapy was administered to the resident as part of a group of residents in the last 7 days"
                    }
                  ],
                  "prefix" : "O0400C3",
                  "text" : "Group minutes - record the total number of minutes this therapy was administered to the resident as part of a group of residents in the last 7 days",
                  "type" : "decimal",
                  "repeats" : false
                },
                {
                  "linkId" : "103167",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "86766-3",
                      "display" : "Co-treatment minutes - record the total number of minutes this therapy was administered to the resident in co-treatment sessions in the last 7 days"
                    }
                  ],
                  "prefix" : "O0400C3A",
                  "text" : "Co-treatment minutes - record the total number of minutes this therapy was administered to the resident in co-treatment sessions in the last 7 days",
                  "type" : "decimal",
                  "repeats" : false
                },
                {
                  "linkId" : "103168",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "45764-8",
                      "display" : "Days - record the number of days this therapy was administered for at least 15 minutes a day in the last 7 days"
                    }
                  ],
                  "prefix" : "O0400C4",
                  "text" : "Days - record the number of days this therapy was administered for at least 15 minutes a day in the last 7 days",
                  "type" : "decimal",
                  "repeats" : false
                },
                {
                  "linkId" : "103169",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "55029-3",
                      "display" : "Therapy start date - record the date the most recent therapy regimen (since the most recent entry) started"
                    }
                  ],
                  "prefix" : "O0400C5",
                  "text" : "Therapy start date - record the date the most recent therapy regimen (since the most recent entry) started",
                  "type" : "date",
                  "repeats" : false
                },
                {
                  "linkId" : "103170",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "55030-1",
                      "display" : "Therapy end date - record the date the most recent\r\ntherapy regimen (since the most recent entry) ended"
                    }
                  ],
                  "prefix" : "O0400C6",
                  "text" : "Therapy end date - record the date the most recent\r\ntherapy regimen (since the most recent entry) ended",
                  "type" : "date",
                  "repeats" : false
                }
              ]
            },
            {
              "linkId" : "103171",
              "prefix" : "O0400D",
              "text" : "Respiratory Therapy",
              "type" : "group",
              "required" : true,
              "item" : [
                {
                  "linkId" : "103172",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "45767-1",
                      "display" : "Total minutes - record the total number of minutes this therapy was administered to the resident in the last 7 days"
                    }
                  ],
                  "prefix" : "O0400D1",
                  "text" : "Total minutes - record the total number of minutes this therapy was administered to the resident in the last 7 days",
                  "type" : "decimal",
                  "repeats" : false
                },
                {
                  "linkId" : "103173",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "45766-3",
                      "display" : "Days - record the number of days this therapy was administered for at least 15 minutes a day in the last 7 days"
                    }
                  ],
                  "prefix" : "O0400D2",
                  "text" : "Days - record the number of days this therapy was administered for at least 15 minutes a day in the last 7 days",
                  "type" : "decimal",
                  "repeats" : false
                }
              ]
            },
            {
              "linkId" : "103174",
              "prefix" : "O0400E",
              "text" : "Psychological Therapy (by any licensed mental health professional)",
              "type" : "group",
              "required" : true,
              "item" : [
                {
                  "linkId" : "103175",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "45852-1",
                      "display" : "Total minutes - record the total number of minutes this therapy was administered to the resident in the last 7 days"
                    }
                  ],
                  "prefix" : "O0400E1",
                  "text" : "Total minutes - record the total number of minutes this therapy was administered to the resident in the last 7 days",
                  "type" : "decimal",
                  "repeats" : false
                },
                {
                  "linkId" : "103176",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "45768-9",
                      "display" : "Days - record the number of days this therapy was administered for at least 15 minutes a day in the last 7 days."
                    }
                  ],
                  "prefix" : "O0400E2",
                  "text" : "Days - record the number of days this therapy was administered for at least 15 minutes a day in the last 7 days.",
                  "type" : "decimal",
                  "repeats" : false
                }
              ]
            },
            {
              "linkId" : "103177",
              "prefix" : "O0400F",
              "text" : "Recreational Therapy (includes recreational and music therapy)",
              "type" : "group",
              "required" : true,
              "item" : [
                {
                  "linkId" : "103178",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "55035-0",
                      "display" : "Total minutes - record the total number of minutes this therapy was administered to the resident in the last 7 days"
                    }
                  ],
                  "prefix" : "O0400F1",
                  "text" : "Total minutes - record the total number of minutes this therapy was administered to the resident in the last 7 days",
                  "type" : "decimal",
                  "repeats" : false
                },
                {
                  "linkId" : "103179",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "55036-8",
                      "display" : "Days - record the number of days this therapy was administered for at least 15 minutes a day in the last 7 days"
                    }
                  ],
                  "prefix" : "O0400F2",
                  "text" : "Days - record the number of days this therapy was administered for at least 15 minutes a day in the last 7 days",
                  "type" : "decimal",
                  "repeats" : false
                }
              ]
            }
          ]
        },
        {
          "linkId" : "103180",
          "code" : [
            {
              "system" : "http://loinc.org",
              "code" : "86769-7",
              "display" : "Distinct Calendar Days of Therapy. Record the number of calendar days that the resident received Speech-Language Pathology and Audiology Services, Occupational Therapy, or Physical Therapy for at least 15 minutes in the past 7 days."
            }
          ],
          "prefix" : "O0420",
          "text" : "Distinct Calendar Days of Therapy. Record the number of calendar days that the resident received Speech-Language Pathology and Audiology Services, Occupational Therapy, or Physical Therapy for at least 15 minutes in the past 7 days.",
          "type" : "decimal",
          "repeats" : false
        },
        {
          "linkId" : "109459",
          "prefix" : "O0425",
          "text" : "Part A Therapies",
          "type" : "group",
          "required" : true,
          "item" : [
            {
              "linkId" : "109462",
              "prefix" : "O0425A",
              "text" : "Speech-Language Pathology and Audiology Services",
              "type" : "group",
              "required" : true,
              "item" : [
                {
                  "linkId" : "109468",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "90539-8",
                      "display" : "Individual minutes - record the total number of minutes this therapy was administered to the resident individually since the start date of the resident's most recent Medicare Part A stay (A2400B)"
                    }
                  ],
                  "prefix" : "O0425A1",
                  "text" : "Individual minutes - record the total number of minutes this therapy was administered to the resident individually since the start date of the resident's most recent Medicare Part A stay (A2400B)",
                  "type" : "decimal",
                  "repeats" : false
                },
                {
                  "linkId" : "109471",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "90536-4",
                      "display" : "Concurrent minutes - record the total number of minutes this therapy was administered to the resident concurrently with one other resident since the start date of the resident's most recent Medicare Part A stay (A2400B)"
                    }
                  ],
                  "prefix" : "O0425A2",
                  "text" : "Concurrent minutes - record the total number of minutes this therapy was administered to the resident concurrently with one other resident since the start date of the resident's most recent Medicare Part A stay (A2400B)",
                  "type" : "decimal",
                  "repeats" : false
                },
                {
                  "linkId" : "109469",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "90538-0",
                      "display" : "Group minutes - record the total number of minutes this therapy was administered to the resident as part of a group of residents since the start date of the resident's most recent Medicare Part A stay (A2400B)"
                    }
                  ],
                  "prefix" : "O0425A3",
                  "text" : "Group minutes - record the total number of minutes this therapy was administered to the resident as part of a group of residents since the start date of the resident's most recent Medicare Part A stay (A2400B)",
                  "type" : "decimal",
                  "repeats" : false
                },
                {
                  "linkId" : "109470",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "90537-2",
                      "display" : "Co-treatment minutes - record the total number of minutes this therapy was administered to the resident in co-treatment sessions since the start date of the resident's most recent Medicare Part A stay (A2400B)"
                    }
                  ],
                  "prefix" : "O0425A4",
                  "text" : "Co-treatment minutes - record the total number of minutes this therapy was administered to the resident in co-treatment sessions since the start date of the resident's most recent Medicare Part A stay (A2400B)",
                  "type" : "decimal",
                  "repeats" : false
                },
                {
                  "linkId" : "109472",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "90551-3",
                      "display" : "Days - record the number of days this therapy was administered for at least 15 minutes a day since the start date of the resident's most recent Medicare Part A stay (A2400B)"
                    }
                  ],
                  "prefix" : "O0425A5",
                  "text" : "Days - record the number of days this therapy was administered for at least 15 minutes a day since the start date of the resident's most recent Medicare Part A stay (A2400B)",
                  "type" : "decimal",
                  "repeats" : false
                }
              ]
            },
            {
              "linkId" : "109461",
              "prefix" : "O0425B",
              "text" : "Occupational Therapy",
              "type" : "group",
              "required" : true,
              "item" : [
                {
                  "linkId" : "109463",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "90531-5",
                      "display" : "Individual minutes - record the total number of minutes this therapy was administered to the resident individually since the start date of the resident's most recent Medicare Part A stay (A2400B)"
                    }
                  ],
                  "prefix" : "O0425B1",
                  "text" : "Individual minutes - record the total number of minutes this therapy was administered to the resident individually since the start date of the resident's most recent Medicare Part A stay (A2400B)",
                  "type" : "decimal",
                  "repeats" : false
                },
                {
                  "linkId" : "109467",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "90527-3",
                      "display" : "Concurrent minutes - record the total number of minutes this therapy was administered to the resident concurrently with one other resident since the start date of the resident's most recent Medicare Part A stay (A2400B)"
                    }
                  ],
                  "prefix" : "O0425B2",
                  "text" : "Concurrent minutes - record the total number of minutes this therapy was administered to the resident concurrently with one other resident since the start date of the resident's most recent Medicare Part A stay (A2400B)",
                  "type" : "decimal",
                  "repeats" : false
                },
                {
                  "linkId" : "109465",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "90529-9",
                      "display" : "Group minutes - record the total number of minutes this therapy was administered to the resident as part of a group of residents since the start date of the resident's most recent Medicare Part A stay (A2400B)"
                    }
                  ],
                  "prefix" : "O0425B3",
                  "text" : "Group minutes - record the total number of minutes this therapy was administered to the resident as part of a group of residents since the start date of the resident's most recent Medicare Part A stay (A2400B)",
                  "type" : "decimal",
                  "repeats" : false
                },
                {
                  "linkId" : "109466",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "90528-1",
                      "display" : "Co-treatment minutes - record the total number of minutes this therapy was administered to the resident in co-treatment sessions since the start date of the resident's most recent Medicare Part A stay (A2400B)"
                    }
                  ],
                  "prefix" : "O0425B4",
                  "text" : "Co-treatment minutes - record the total number of minutes this therapy was administered to the resident in co-treatment sessions since the start date of the resident's most recent Medicare Part A stay (A2400B)",
                  "type" : "decimal",
                  "repeats" : false
                },
                {
                  "linkId" : "109464",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "90530-7",
                      "display" : "Days - record the number of days this therapy was administered for at least 15 minutes a day since the start date of the resident's most recent Medicare Part A stay (A2400B)"
                    }
                  ],
                  "prefix" : "O0425B5",
                  "text" : "Days - record the number of days this therapy was administered for at least 15 minutes a day since the start date of the resident's most recent Medicare Part A stay (A2400B)",
                  "type" : "decimal",
                  "repeats" : false
                }
              ]
            },
            {
              "linkId" : "109460",
              "prefix" : "O0425C",
              "text" : "Physical Therapy",
              "type" : "group",
              "required" : true,
              "item" : [
                {
                  "linkId" : "109473",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "90535-6",
                      "display" : "Individual minutes - record the total number of minutes this therapy was administered to the resident individually since the start date of the resident's most recent Medicare Part A stay (A2400B)"
                    }
                  ],
                  "prefix" : "O0425C1",
                  "text" : "Individual minutes - record the total number of minutes this therapy was administered to the resident individually since the start date of the resident's most recent Medicare Part A stay (A2400B)",
                  "type" : "decimal",
                  "repeats" : false
                },
                {
                  "linkId" : "109476",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "90532-3",
                      "display" : "Concurrent minutes - record the total number of minutes this therapy was administered to the resident concurrently with one other resident since the start date of the resident's most recent Medicare Part A stay (A2400B)"
                    }
                  ],
                  "prefix" : "O0425C2",
                  "text" : "Concurrent minutes - record the total number of minutes this therapy was administered to the resident concurrently with one other resident since the start date of the resident's most recent Medicare Part A stay (A2400B)",
                  "type" : "decimal",
                  "repeats" : false
                },
                {
                  "linkId" : "109474",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "90534-9",
                      "display" : "Group minutes - record the total number of minutes this therapy was administered to the resident as part of a group of residents since the start date of the resident's most recent Medicare Part A stay (A2400B)"
                    }
                  ],
                  "prefix" : "O0425C3",
                  "text" : "Group minutes - record the total number of minutes this therapy was administered to the resident as part of a group of residents since the start date of the resident's most recent Medicare Part A stay (A2400B)",
                  "type" : "decimal",
                  "repeats" : false
                },
                {
                  "linkId" : "109475",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "90533-1",
                      "display" : "Co-treatment minutes - record the total number of minutes this therapy was administered to the resident in co-treatment sessions since the start date of the resident's most recent Medicare Part A stay (A2400B)"
                    }
                  ],
                  "prefix" : "O0425C4",
                  "text" : "Co-treatment minutes - record the total number of minutes this therapy was administered to the resident in co-treatment sessions since the start date of the resident's most recent Medicare Part A stay (A2400B)",
                  "type" : "decimal",
                  "repeats" : false
                },
                {
                  "linkId" : "109477",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "90550-5",
                      "display" : "Days - record the number of days this therapy was administered for at least 15 minutes a day since the start date of the resident's most recent Medicare Part A stay (A2400B)"
                    }
                  ],
                  "prefix" : "O0425C5",
                  "text" : "Days - record the number of days this therapy was administered for at least 15 minutes a day since the start date of the resident's most recent Medicare Part A stay (A2400B)",
                  "type" : "decimal",
                  "repeats" : false
                }
              ]
            }
          ]
        },
        {
          "linkId" : "109479",
          "code" : [
            {
              "system" : "http://loinc.org",
              "code" : "90548-9",
              "display" : "Distinct Calendar Days of Part A Therapy"
            }
          ],
          "prefix" : "O0430",
          "text" : "Distinct Calendar Days of Part A Therapy",
          "type" : "decimal",
          "repeats" : false
        },
        {
          "linkId" : "103184",
          "prefix" : "O0500",
          "text" : "Restorative Nursing Programs",
          "type" : "group",
          "required" : true,
          "item" : [
            {
              "linkId" : "103185",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "86774-7",
                  "display" : "Technique. Range of motion (passive)"
                }
              ],
              "prefix" : "O0500A",
              "text" : "Technique. Range of motion (passive)",
              "type" : "decimal",
              "repeats" : false
            },
            {
              "linkId" : "103186",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "86775-4",
                  "display" : "Technique. Range of motion (active)"
                }
              ],
              "prefix" : "O0500B",
              "text" : "Technique. Range of motion (active)",
              "type" : "decimal",
              "repeats" : false
            },
            {
              "linkId" : "103187",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "86776-2",
                  "display" : "Technique. Splint or brace assistance"
                }
              ],
              "prefix" : "O0500C",
              "text" : "Technique. Splint or brace assistance",
              "type" : "decimal",
              "repeats" : false
            },
            {
              "linkId" : "103188",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "86777-0",
                  "display" : "Training and Skill Practice In: Bed mobility"
                }
              ],
              "prefix" : "O0500D",
              "text" : "Training and Skill Practice In: Bed mobility",
              "type" : "decimal",
              "repeats" : false
            },
            {
              "linkId" : "103189",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "86778-8",
                  "display" : "Training and Skill Practice In: Transfer"
                }
              ],
              "prefix" : "O0500E",
              "text" : "Training and Skill Practice In: Transfer",
              "type" : "decimal",
              "repeats" : false
            },
            {
              "linkId" : "103190",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "86779-6",
                  "display" : "Training and Skill Practice In: Walking"
                }
              ],
              "prefix" : "O0500F",
              "text" : "Training and Skill Practice In: Walking",
              "type" : "decimal",
              "repeats" : false
            },
            {
              "linkId" : "103191",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "86780-4",
                  "display" : "Training and Skill Practice In: Dressing and/or grooming"
                }
              ],
              "prefix" : "O0500G",
              "text" : "Training and Skill Practice In: Dressing and/or grooming",
              "type" : "decimal",
              "repeats" : false
            },
            {
              "linkId" : "103192",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "86781-2",
                  "display" : "Training and Skill Practice In: Eating and/or swallowing"
                }
              ],
              "prefix" : "O0500H",
              "text" : "Training and Skill Practice In: Eating and/or swallowing",
              "type" : "decimal",
              "repeats" : false
            },
            {
              "linkId" : "103193",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "86782-0",
                  "display" : "Training and Skill Practice In: Amputation/prostheses care"
                }
              ],
              "prefix" : "O0500I",
              "text" : "Training and Skill Practice In: Amputation/prostheses care",
              "type" : "decimal",
              "repeats" : false
            },
            {
              "linkId" : "103194",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "86783-8",
                  "display" : "Training and Skill Practice In: Communication"
                }
              ],
              "prefix" : "O0500J",
              "text" : "Training and Skill Practice In: Communication",
              "type" : "decimal",
              "repeats" : false
            }
          ]
        },
        {
          "linkId" : "103195",
          "code" : [
            {
              "system" : "http://loinc.org",
              "code" : "55040-0",
              "display" : "Physician Examinations. Over the last 14 days, on how many days did the physician (or authorized assistant or practitioner) examine the resident?"
            }
          ],
          "prefix" : "O0600",
          "text" : "Physician Examinations. Over the last 14 days, on how many days did the physician (or authorized assistant or practitioner) examine the resident?",
          "type" : "decimal",
          "repeats" : false
        },
        {
          "linkId" : "103196",
          "code" : [
            {
              "system" : "http://loinc.org",
              "code" : "55041-8",
              "display" : "Physician Orders. Over the last 14 days, on how many days did the physician (or authorized assistant or practitioner) change the resident's orders?"
            }
          ],
          "prefix" : "O0700",
          "text" : "Physician Orders. Over the last 14 days, on how many days did the physician (or authorized assistant or practitioner) change the resident's orders?",
          "type" : "decimal",
          "repeats" : false
        }
      ]
    },
    {
      "linkId" : "103197",
      "prefix" : "P",
      "text" : "Restraints and Alarms",
      "type" : "group",
      "required" : true,
      "item" : [
        {
          "linkId" : "103198",
          "prefix" : "P0100",
          "text" : "Physical Restraints",
          "type" : "group",
          "required" : true,
          "item" : [
            {
              "linkId" : "103199",
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              ],
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                {
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                },
                {
                  "valueCoding" : {
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                },
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              ]
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                {
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                {
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                {
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                {
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                }
              ]
            },
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              "linkId" : "103203",
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                {
                  "system" : "http://loinc.org",
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              ],
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                  "valueCoding" : {
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                },
                {
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              ]
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              "linkId" : "103205",
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                {
                  "system" : "http://loinc.org",
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              ],
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                {
                  "system" : "http://loinc.org",
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              ],
              "prefix" : "P0100H",
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                  "valueCoding" : {
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                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
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                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
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                }
              ]
            }
          ]
        },
        {
          "linkId" : "103207",
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              "linkId" : "103208",
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            {
              "linkId" : "103209",
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                {
                  "system" : "http://loinc.org",
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              ],
              "prefix" : "P0200B",
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                {
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                {
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            {
              "linkId" : "103210",
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                {
                  "system" : "http://loinc.org",
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              "prefix" : "P0200C",
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                {
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                    "system" : "http://loinc.org",
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                }
              ]
            },
            {
              "linkId" : "103211",
              "code" : [
                {
                  "system" : "http://loinc.org",
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              "prefix" : "P0200D",
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              "linkId" : "103212",
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                {
                  "system" : "http://loinc.org",
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              "linkId" : "103213",
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                  "system" : "http://loinc.org",
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                    "system" : "http://loinc.org",
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          "linkId" : "103215",
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              "linkId" : "103216",
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                {
                  "system" : "http://loinc.org",
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                {
                  "valueCoding" : {
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                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
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                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA27973-9",
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                }
              ]
            },
            {
              "linkId" : "103218",
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                {
                  "system" : "http://loinc.org",
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              ],
              "prefix" : "Q0100C",
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                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
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                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
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                }
              ]
            }
          ]
        },
        {
          "linkId" : "103219",
          "prefix" : "Q0300",
          "text" : "Resident's Overall Expectation",
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          "required" : true,
          "item" : [
            {
              "linkId" : "103220",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "55057-4",
                  "display" : "Select one for resident's overall goal established during assessment process"
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              ],
              "prefix" : "Q0300A",
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              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA30462-8",
                    "display" : "Discharge to the community"
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                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA30463-6",
                    "display" : "Remain in this facility"
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                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA30464-4",
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                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11107-2",
                    "display" : "Unknown or uncertain"
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              ]
            },
            {
              "linkId" : "103221",
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                  "system" : "http://loinc.org",
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              ],
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                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11019-9",
                    "display" : "Resident"
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                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA11116-3",
                    "display" : "If not resident, then family or significant other"
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                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA12652-6",
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                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
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          ]
        },
        {
          "linkId" : "103222",
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            {
              "system" : "http://loinc.org",
              "code" : "58146-2",
              "display" : "Discharge Plan. Is active discharge planning already occurring for the resident to return to the community?"
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          ],
          "prefix" : "Q0400A",
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          "answerOption" : [
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              "valueCoding" : {
                "system" : "http://loinc.org",
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            {
              "valueCoding" : {
                "system" : "http://loinc.org",
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                "display" : "Yes"
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          ]
        },
        {
          "linkId" : "103223",
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              "system" : "http://loinc.org",
              "code" : "86795-2",
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          ],
          "prefix" : "Q0490",
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          "answerOption" : [
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              "valueCoding" : {
                "system" : "http://loinc.org",
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            {
              "valueCoding" : {
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        {
          "linkId" : "103224",
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            {
              "system" : "http://loinc.org",
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              "display" : "Return to Community. Do you want to talk to someone about the possiblity of leaving this facility and returning to live and receive services in the community?"
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          ],
          "prefix" : "Q0500B",
          "text" : "Return to Community. Do you want to talk to someone about the possiblity of leaving this facility and returning to live and receive services in the community?",
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          "answerOption" : [
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              "valueCoding" : {
                "system" : "http://loinc.org",
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            {
              "valueCoding" : {
                "system" : "http://loinc.org",
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                "display" : "Yes"
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            },
            {
              "valueCoding" : {
                "system" : "http://loinc.org",
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                "display" : "Unknown or uncertain"
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            }
          ]
        },
        {
          "linkId" : "103225",
          "prefix" : "Q0550",
          "text" : "Resident's Preference to Avoid Being Asked Question Q0500B Again",
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          "required" : true,
          "item" : [
            {
              "linkId" : "103226",
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                {
                  "system" : "http://loinc.org",
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              ],
              "prefix" : "Q0550A",
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              "answerOption" : [
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                  "valueCoding" : {
                    "system" : "http://loinc.org",
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                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
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                    "display" : "Yes"
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                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA21297-9",
                    "display" : "Information not available"
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                }
              ]
            },
            {
              "linkId" : "103227",
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              ],
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              "repeats" : false,
              "answerOption" : [
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA32-8",
                    "display" : "No"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
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                    "display" : "Yes"
                  }
                }
              ]
            }
          ]
        },
        {
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          "type" : "group",
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                {
                  "system" : "http://loinc.org",
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            },
            {
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                {
                  "system" : "http://loinc.org",
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                }
              ],
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            },
            {
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              "code" : [
                {
                  "system" : "http://loinc.org",
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              ],
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            }
          ]
        },
        {
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          "item" : [
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              "code" : [
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                }
              ],
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            },
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                }
              ],
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                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28177-6",
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                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28178-4",
                    "display" : "Item coding error"
                  }
                },
                {
                  "valueCoding" : {
                    "system" : "http://loinc.org",
                    "code" : "LA28180-0",
                    "display" : "Other error requiring modification"
                  }
                }
              ]
            },
            {
              "linkId" : "103263",
              "code" : [
                {
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                }
              ],
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              "repeats" : true,
              "answerOption" : [
                {
                  "valueCoding" : {
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                  }
                },
                {
                  "valueCoding" : {
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                    "display" : "Other error requiring inactivation"
                  }
                }
              ]
            },
            {
              "linkId" : "103264",
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              "text" : "RN Assessment Coordinator Attestation of Completion",
              "type" : "group",
              "required" : true,
              "item" : [
                {
                  "linkId" : "103265",
                  "code" : [
                    {
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                      "code" : "87219-2",
                      "display" : "Attesting individual's first name"
                    }
                  ],
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                  "type" : "string",
                  "repeats" : false
                },
                {
                  "linkId" : "103266",
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                    {
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                    }
                  ],
                  "prefix" : "X1100B",
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                  "type" : "string",
                  "repeats" : false
                },
                {
                  "linkId" : "103267",
                  "code" : [
                    {
                      "system" : "http://loinc.org",
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                  ],
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                  "text" : "Attesting individual's title",
                  "type" : "string",
                  "repeats" : false
                },
                {
                  "linkId" : "103268",
                  "code" : [
                    {
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                  ],
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              ]
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          ]
        }
      ]
    },
    {
      "linkId" : "110082",
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      "type" : "group",
      "required" : true,
      "item" : [
        {
          "linkId" : "110044",
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          "type" : "group",
          "required" : true,
          "item" : [
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              "linkId" : "103271",
              "code" : [
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                }
              ],
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              "type" : "string",
              "repeats" : false
            },
            {
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                  "system" : "http://loinc.org",
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              ],
              "prefix" : "Z0100B",
              "text" : "Version code",
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              "repeats" : false
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          ]
        },
        {
          "linkId" : "112461",
          "prefix" : "Z0200",
          "text" : "State Medicaid Billing (if required by the state)",
          "type" : "group",
          "required" : true,
          "item" : [
            {
              "linkId" : "103278",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "55068-1",
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                }
              ],
              "prefix" : "Z0200A",
              "text" : "Case Mix group",
              "type" : "string",
              "repeats" : false
            },
            {
              "linkId" : "112458",
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                  "system" : "http://loinc.org",
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              ],
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              "repeats" : false
            }
          ]
        },
        {
          "linkId" : "112462",
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          "text" : "Alternate State Medicaid Billing (if required by the state)",
          "type" : "group",
          "required" : true,
          "item" : [
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              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "58212-2",
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                }
              ],
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              "text" : "Case Mix group",
              "type" : "string",
              "repeats" : false
            },
            {
              "linkId" : "112459",
              "code" : [
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                  "system" : "http://loinc.org",
                  "code" : "55081-4",
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              ],
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              "repeats" : false
            }
          ]
        },
        {
          "linkId" : "112463",
          "prefix" : "Z0300",
          "text" : "Insurance Billing",
          "type" : "group",
          "required" : true,
          "item" : [
            {
              "linkId" : "103284",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "55071-5",
                  "display" : "Billing code"
                }
              ],
              "prefix" : "Z0300A",
              "text" : "Billing code",
              "type" : "string",
              "repeats" : false
            },
            {
              "linkId" : "112460",
              "code" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "55081-4",
                  "display" : "Billing version"
                }
              ],
              "prefix" : "Z0300B",
              "text" : "Billing version",
              "type" : "string",
              "repeats" : false
            }
          ]
        }
      ]
    }
  ]
}

```
