IRF-PAI Data Dictionary - individual assessment
(Data Documentation is sometimes referred to as data dictionaries, file layouts, and data layouts)
ResDAC Disclosure Statement:
This resource is for reference purposes only. Record layouts may vary, users should not use these layouts to develop programming language for specific data files. Please contact ResDAC with questions about the data files.
| Field Name | Data Type | Primary Key |
Short and Long Description |
Code Values |
| ADMSN_CLS_CD | VARCHAR2 (2) | N | (14) Admission Class The patient's admission classification: 1)Initial Rehabilitation; 2)Evaluation; 3)Readmission; 4)Unplanned Discharge; 5)Continuing Rehabilitation. |
01=Initial
Rehab 02=Evaluation 03=Readmission 04=Unplanned Discharge 05=Continuing Rehabilitation |
| ADMSN_DT | DATE (8) | N | (12) Admission Date The date that the patient begins receiving Part A covered Medicare services in an inpatient rehabilitation facility. |
|
| ADMT_FROM_CD | VARCHAR2 (2) | N | (15) Admit From (at date of admission) The living setting from which the patient was admitted to rehabilitation: 01)Home; 02)Board & Care; 03)Transitional Living; 04)Intermediate Care (nursing home); 05)Skilled Nursing Facility (nursing home) 06)Acute Unit of Own Facility; 07)Acute Unit of Another Facility; 08)Chronic Hospital; 09)Rehabilitation Facility; 10)Other; 12)Alternate Level of Care (ALC) Unit; 13)Subacute Setting; 14)Assisted Living Residence. |
01=Home 02=Board '&' Care 03=Transitional Living 04=Intermediate Care 05=Skilled Nursing Facility 06=Acute Unit of Own Facility 07=Acute Unit of Another Facility 08=Chronic Hospital 09=Rehabilitation Facility 10=Other 12=Alternate Level of Care Unit 13=Subacute Setting 14=Assisted Living Residence |
| AGENT_ID | VARCHAR2 (9) | N | Agent Identifier This is the identification of the current software agent used by the facility to handle the computerization of the PAI requirement, if applicable. |
|
| ASMT_BGN_VRSN_DT | DATE (8) | N | Assessment Beginning Version Date Beginning date of the submission file that contains the version of this assessment. |
|
| ASMT_CRCTN_VRSN_NUM | NUMBER (2) | N | Assessment Correction Version Number The number of the assessment. 00 = Original, 01 = First correction, 02 = Second correction, etc. |
|
| ASMT_END_VRSN_DT | DATE (8) | N | Assessment Ending Version Date Ending date of the submission file that contains the version of this assessment. |
|
| ASMT_INTRNL_ID | NUMBER (10) | Y | Assessment Internal Identifier This field is used as a key to uniquely identify an assessment and to tie together all the different tables that compose one assessment record received from a facility. |
|
| ASMT_MOD_CD | VARCHAR2 (1) | N | Assessment Modification Code A code designating the version of the assessment: C = Current, M = Modified, X = Inactive. |
|
| ASMT_RFRNC_DT | DATE (8) | N | (13) Assessment Reference Date The third calendar day of the rehabilitation stay, which represents the last day of the the 3-day admission assessment time period. These three calendar days are the days during which the patient's clinical condition should be assessed. |
|
| BATHG_ADMSN_CD | VARCHAR2 (2) | N | (39Ca) Self-Care: Bathing: Admission A score (0-7) indicating the patient's ability to bathe at admission. Bathing includes washing, rinsing, and drying the body from the neck down in either a tub, shower, or sponge/bed bath. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) 00/=Activity did not occur |
| BATHG_DSCHRG_CD | VARCHAR2 (2) | N | (39Cd) Self-Care: Bathing: Discharge A score (0-7) indicating the patient's ability to bathe at discharge. Bathing includes washing, rinsing, and drying the body from the neck down in either a tub, shower, or sponge/bed bath. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) |
| BATHG_GOAL_CD | VARCHAR2 (2) | N | (39Cg) Self-Care: Bathing: Goal A score (0-7) indicating the desired goal for the patient to achieve for bathing at discharge. Bathing includes washing, rinsing, and drying the body from the neck down in either a tub, shower, or sponge/bed bath. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) /=Blank |
| BED_CHR_WC_ADMSN_CD | VARCHAR2 (2) | N | (39Ia) Transfers - Bed, chair, wheelchair:
Admission A score (0-7) indicating the patient's ability to transfer from a bed to a chair and back, or from a bed to a wheelchair and back, or coming to a standing position if walking is the typical mode of locomotion at admission. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) 00/=Activity did not occur |
| BED_CHR_WC_DSCHRG_CD | VARCHAR2 (2) | N | (39Id) Transfers - Bed, chair, wheelchair:
Discharge A score (0-7) indicating the patient's ability to transfer from a bed to a chair and back, or from a bed to a wheelchair and back, or coming to a standing position if walking is the typical mode of locomotion at discharge. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) |
| BED_CHR_WC_GOAL_CD | VARCHAR2 (2) | N | (39Ig) Transfers - Bed, chair, wheelchair: Goal A score (0-7) indicating the desired goal for the patient to achieve the ability to transfer from a bed to a chair and back, or from a bed to a wheelchair and back, or coming to a standing position if walking is the typical mode of locomotion at discharge. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) /=Blank |
| BIRTH_DT | DATE (8) | N | (6) Birth Date The patient's birthdate. |
|
| BLADR_ACDNT_ADMSN_CD | VARCHAR2 (2) | N | (30a) Bladder Frequency of Accidents: Admission A score (0-7) indicating the frequency of bladder accidents at admission. Bladder accidents refers to the act of wetting linen or clothing with urine, and includes bedpan and urinal spills. |
07=No accidents 06=No accidents, uses device such as catheter 05=One accident in the past 7 days 04=Two accidents in the past 7 days 03=Three accidents in the past 7 days 02=Four accidents in the past 7 days 01=Five or more accidents in the past 7 days |
| BLADR_ACDNT_DSCHRG_CD | VARCHAR2 (2) | N | (30d) Bladder Frequency of Accidents: Discharge A score (0-7) indicating the frequency of bladder accidents at discharge. Bladder accidents refers to the act of wetting linen or clothing with urine, and includes bedpan and urinal spills. |
07=No accidents 06=No accidents, uses device such as catheter 05=One accident in the past 7 days 04=Two accidents in the past 7 days 03=Three accidents in the past 7 days 02=Four accidents in the past 7 days 01=Five or more accidents in the past 7 days |
| BLADR_ASTNC_ADMSN_CD | VARCHAR2 (2) | N | (29a) Bladder Level of Assistance: Admission A score (0-7) indicating the level of assistance needed for the patient's bladder management at admission. Bladder management - level of assistance includes the safe use of equipment or agents for bladder management. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) |
| BLADR_ASTNC_DSCHRG_CD | VARCHAR2 (2) | N | (29d) Bladder Level of Assistance: Discharge A score (0-7) indicating the level of assistance needed for the patient's bladder management at discharge. Bladder management - level of assistance includes the safe use of equipment or agents for bladder management. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) |
| BWL_ACDNT_ADMSN_CD | VARCHAR2 (2) | N | (32a) Bowel Frequency of Accidents: Admission A score (0-7) indicating the frequency of bowel accidents at admission. Bowel accidents refers to the act of soiling linen or clothing with stool, and includes bedpan spills. |
01=Five or more accidents in the past 7 days 02=Four accidents in the past 7 days 03=Three accidents in the past 7 days 04=Two accidents in the past 7 days 05=One accident in the past 7 days 06=No accidents, uses device such as a ostomy 07=No accidents |
| BWL_ACDNT_DSCHRG_CD | VARCHAR2 (2) | N | (32d) Bowel Frequency of Accidents: Discharge A score (0-7) indicating the frequency of bowel accidents at discharge. Bowel accidents refers to the act of soiling linen or clothing with stool, and includes bedpan spills. |
01=Five or more accidents in the past 7 days 02=Four accidents in the past 7 days 03=Three accidents in the past 7 days 04=Two accidents in the past 7 days 05=One accident in the past 7 days 06=No accidents, uses device such as a ostomy 07=No accidents |
| BWL_ASTNC_ADMSN_CD | VARCHAR2 (2) | N | (31a) Bowel Level of Assistance: Admission A score (0-7) indicating the level of assistance needed for the patient's bowel management at admission. Bowel management - level of assistance includes the safe use of equipment or agents for bowel management. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) |
| BWL_ASTNC_DSCHRG_CD | VARCHAR2 (2) | N | (31d) Bowel Level of Assistance: Discharge A score (0-7) indicating the level of assistance needed for the patient's bowel management at discharge. Bowel management - level of assistance includes the safe use of equipment or agents for bowel management. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) |
| CALCTD_AGE_TXT | VARCHAR2 (5) | N | Calculated Age Code A preliminary calculation made prior to determining the CMG group. Age is computed on the basis of the difference between the Admission Date (Item 12) and the Birth Date (Item 6). |
|
| CALCTD_CGNTV_SCALE_TXT | VARCHAR2 (5) | N | Calculated Cognitive Scale Code A preliminary calculation made prior to determining the CMG group. The cognitive score is based upon 5 variables that are taken from Item 39 on the IRF-PAI form. |
|
| CALCTD_CMG_TXT | VARCHAR2 (10) | N | Calculated CMG Code The Case-Mix Group code that is calculated from the data submitted to the NACD. |
|
| CALCTD_CMG_VRSN_TXT | VARCHAR2 (10) | N | Calculated CMG Version Code The version code of the CMG Grouper on the NACD. |
|
| CALCTD_MOTOR_SCALE_TXT | VARCHAR2 (5) | N | Calculated Motor Scale Code A preliminary calculation made prior to determining the CMG group. The motor score is based upon 12 variables that are taken from Item 39 on the IRF-PAI form. |
|
| CMPLCTN_DRNG_REHAB_A_CD | VARCHAR2 (7) | N | (47A) Complications During Rehabilitation Stay (ICD-9
Code) An ICD-9-CM code indicating the complications or comorbidities that began after the rehabilitation stay started. This code identifies conditions which delayed or compromised the effectiveness of the rehabilitation program or represent high-risk medical disorders. |
|
| CMPLCTN_DRNG_REHAB_B_CD | VARCHAR2 (7) | N | (47B) Complications During Rehabilitation Stay (ICD-9
Code) An ICD-9-CM code indicating the complications or comorbidities that began after the rehabilitation stay started. This code identifies conditions which delayed or compromised the effectiveness of the rehabilitation program or represent high-risk medical disorders. |
|
| CMPLCTN_DRNG_REHAB_C_CD | VARCHAR2 (7) | N | (47C) Complications During Rehabilitation Stay (ICD-9
Code) An ICD-9-CM code indicating the complications or comorbidities that began after the rehabilitation stay started. This code identifies conditions which delayed or compromised the effectiveness of the rehabilitation program or represent high-risk medical disorders. |
|
| CMPLCTN_DRNG_REHAB_D_CD | VARCHAR2 (7) | N | (47D) Complications During Rehabilitation Stay (ICD-9
Code) An ICD-9-CM code indicating the complications or comorbidities that began after the rehabilitation stay started. This code identifies conditions which delayed or compromised the effectiveness of the rehabilitation program or represent high-risk medical disorders. |
|
| CMPLCTN_DRNG_REHAB_E_CD | VARCHAR2 (7) | N | (47E) Complications During Rehabilitation Stay (ICD-9
Code) An ICD-9-CM code indicating the complications or comorbidities that began after the rehabilitation stay started. This code identifies conditions which delayed or compromised the effectiveness of the rehabilitation program or represent high-risk medical disorders. |
|
| CMPLCTN_DRNG_REHAB_F_CD | VARCHAR2 (7) | N | (47F) Complications During Rehabilitation Stay (ICD-9
Code) An ICD-9-CM code indicating the complications or comorbidities that began after the rehabilitation stay started. This code identifies conditions which delayed or compromised the effectiveness of the rehabilitation program or represent high-risk medical disorders. |
|
| CMPRHNSN_ADMSN_CD | VARCHAR2 (2) | N | (39Na) Communication - Comprehension: Admission A score (0-7) indicating the patient's ability to comprehend at admission. Comprehension includes understanding of either auditory or visual communication (for example, writing, sign language, gestures). |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) |
| CMPRHNSN_ADTRY_VISL_ADMSN_CD | VARCHAR2 (2) | N | (39Naa) Communication - Auditory/Visual/Both:
Admission A score (0-7) indicating the patient's ability to comprehend at admission. Comprehension includes understanding of either auditory or visual communication (for example, writing, sign language, gestures). The more usual mode of comprehension ('Auditory' or 'Visual') is evaluated; 'Both' indicates auditory and visual are used about equally. |
A=Auditory V=Visual B=Both |
| CMPRHNSN_ADTRY_VISL_DSCHRG_CD | VARCHAR2 (2) | N | (39Ndd) Communication - Auditory/Visual/Both:
Discharge A score (0-7) indicating the patient's ability to comprehend at discharge. Comprehension includes understanding of either auditory or visual communication (for example, writing, sign language, gestures). The more usual mode of comprehension ('Auditory' or 'Visual') is evaluated; 'Both' indicates auditory and visual are used about equally. |
A=Auditory V=Visual B=Both |
| CMPRHNSN_DSCHRG_CD | VARCHAR2 (2) | N | (39Nd) Communication - Comprehension: Discharge A score (0-7) indicating the patient's ability to comprehend at discharge. Comprehension includes understanding of either auditory or visual communication (for example, writing, sign language, gestures). |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) |
| CMPRHNSN_GOAL_CD | VARCHAR2 (2) | N | (39Ng) Communication - Comprehension: Goal A score (0-7) indicating the desired goal for the patient to achieve for comprehension at discharge. Comprehension includes understanding of either auditory or visual communication (for example, writing, sign language, gestures). |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) /=Blank |
| CMRBD_COND_A_CD | VARCHAR2 (7) | N | (24A) Comorbid Conditions (ICD-9 Code) An ICD-9 Code for comorbid conditions. A comorbidity is a specific condition that also affects a patient in addition to the principal diagnosis or impairment that is used to place a patient into a rehabilitation impairment category. |
|
| CMRBD_COND_B_CD | VARCHAR2 (7) | N | (24B) Comorbid Conditions (ICD-9 Code) An ICD-9 Code for comorbid conditions. A comorbidity is a specific condition that also affects a patient in addition to the principal diagnosis or impairment that is used to place a patient into a rehabilitation impairment category. |
|
| CMRBD_COND_C_CD | VARCHAR2 (7) | N | (24C) Comorbid Conditions (ICD-9 Code) An ICD-9 Code for comorbid conditions. A comorbidity is a specific condition that also affects a patient in addition to the principal diagnosis or impairment that is used to place a patient into a rehabilitation impairment category. |
|
| CMRBD_COND_D_CD | VARCHAR2 (7) | N | (24D) Comorbid Conditions (ICD-9 Code) An ICD-9 Code for comorbid conditions. A comorbidity is a specific condition that also affects a patient in addition to the principal diagnosis or impairment that is used to place a patient into a rehabilitation impairment category. |
|
| CMRBD_COND_E_CD | VARCHAR2 (7) | N | (24E) Comorbid Conditions (ICD-9 Code) An ICD-9 Code for comorbid conditions. A comorbidity is a specific condition that also affects a patient in addition to the principal diagnosis or impairment that is used to place a patient into a rehabilitation impairment category. |
|
| CMRBD_COND_F_CD | VARCHAR2 (7) | N | (24F) Comorbid Conditions (ICD-9 Code) An ICD-9 Code for comorbid conditions. A comorbidity is a specific condition that also affects a patient in addition to the principal diagnosis or impairment that is used to place a patient into a rehabilitation impairment category. |
|
| CMRBD_COND_G_CD | VARCHAR2 (7) | N | (24G) Comorbid Conditions (ICD-9 Code) An ICD-9 Code for comorbid conditions. A comorbidity is a specific condition that also affects a patient in addition to the principal diagnosis or impairment that is used to place a patient into a rehabilitation impairment category. |
|
| CMRBD_COND_H_CD | VARCHAR2 (7) | N | (24H) Comorbid Conditions (ICD-9 Code) An ICD-9 Code for comorbid conditions. A comorbidity is a specific condition that also affects a patient in addition to the principal diagnosis or impairment that is used to place a patient into a rehabilitation impairment category. |
|
| CMRBD_COND_I_CD | VARCHAR2 (7) | N | (24I) Comorbid Conditions (ICD-9 Code) An ICD-9 Code for comorbid conditions. A comorbidity is a specific condition that also affects a patient in addition to the principal diagnosis or impairment that is used to place a patient into a rehabilitation impairment category. |
|
| CMRBD_COND_J_CD | VARCHAR2 (7) | N | (24J) Comorbid Conditions (ICD-9 Code) An ICD-9 Code for comorbid conditions. A comorbidity is a specific condition that also affects a patient in addition to the principal diagnosis or impairment that is used to place a patient into a rehabilitation impairment category. |
|
| CMTS_SW | VARCHAR2 (1) | N | (25) Comatose: Admission A code indicating whether the patient is diagnosed as comatose or in a persistent vegetative state at the time of admission. |
0=No 1=Yes =Blank |
| DFCLTY_CLRG_ARWY_ADMSN_SW | VARCHAR2 (1) | N | (50a) Weak Cough and Difficulty Clearing Airway Secretions:
Admission A code which indicates whether the patient reports or is observed to be unable to cough effectively to expel respiratory secretions or sputum from the mouth on at least one occasion at the time of admission. |
0=No 1=Yes =Blank |
| DFCLTY_CLRG_ARWY_DSCHRG_SW | VARCHAR2 (1) | N | (50d) Weak Cough and Difficulty Clearing Airway Secretions:
Discharge A code which indicates whether the patient reports or is observed to be unable to cough effectively to expel respiratory secretions or sputum from the mouth on at least one occasion at the time of discharge. |
0=No 1=Yes =Blank |
| DGNS_TRNSFR_DEATH_CD | VARCHAR2 (7) | N | (46) Diagnosis for Interruption or Death (ICD-9
Code) An ICD-9 Code indicating the reason for the program interruption or death. |
|
| DHYDRTN_ADMSN_SW | VARCHAR2 (1) | N | (28a) Clinical Signs of Dehydration: Admission A code indicating whether the patient exhibits signs of dehydration at time of admission. |
0=No 1=Yes =Blank |
| DHYDRTN_DSCHRG_SW | VARCHAR2 (1) | N | (28d) Clinical Signs of Dehydration: Discharge A code indicating whether the patient exhibits signs of dehydration at time of discharge. |
0=No 1=Yes =Blank |
| DLRS_SW | VARCHAR2 (1) | N | (26) Delirious: Admission A code indicating whether the patient has exhibited symptoms of delirium at time of admission. Delirium may be manifested as disoriented thinking, being easily distracted, disorganized speech, restlessness, lethargy, or altered perceptions or awareness of surroundings. |
0=No 1=Yes =Blank |
| DRSG_LWR_ADMSN_CD | VARCHAR2 (2) | N | (39Ea) Self-Care: Dressing-Lower: Admission A score (0-7) indicating the patient's ability to dress the lower body at admission. Dressing the lower body includes dressing and undressing from the waist down, as well as applying and removing a prosthesis or orthosis when applicable. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) 00/=Activity did not occur |
| DRSG_LWR_DSCHRG_CD | VARCHAR2 (2) | N | (39Ed) Self-Care: Dressing-Lower: Discharge A score (0-7) indicating the patient's ability to dress the lower body at discharge. Dressing the lower body includes dressing and undressing from the waist down, as well as applying and removing a prosthesis or orthosis when applicable. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) |
| DRSG_LWR_GOAL_CD | VARCHAR2 (2) | N | (39Eg) Self-Care: Dressing-Lower: Goal A score (0-7) indicating the desired goal for the patient to achieve to dress the lower body at discharge. Dressing the lower body includes dressing and undressing from the waist down, as well as applying and removing a prosthesis or orthosis when applicable. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) /=Blank |
| DRSG_UPR_ADMSN_CD | VARCHAR2 (2) | N | 39Da) Self-Care: Dressing-Upper: Admission A score (0-7) indicating the patient's ability to dress the upper body at admission. Dressing the upper body includes dressing and undressing above the waist, as well as applying and removing a prosthesis or orthosis when applicable. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) 00/=Activity did not occur |
| DRSG_UPR_DSCHRG_CD | VARCHAR2 (2) | N | (39Dd) Self-Care: Dressing-Upper: Discharge A score (0-7) indicating the patient's ability to dress the upper body at discharge. Dressing the upper body includes dressing and undressing above the waist, as well as applying and removing a prosthesis or orthosis when applicable. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) |
| DRSG_UPR_GOAL_CD | VARCHAR2 (2) | N | (39Dg) Self-Care: Dressing-Upper: Goal A score (0-7) indicating the desired goal for the patient to achieve to dress the upper body at discharge. Dressing the upper body includes dressing and undressing above the waist, as well as applying and removing a prosthesis or orthosis when applicable. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) /=Blank |
| DSCHRG_AGNST_MDCL_ADVC_SW | VARCHAR2 (1) | N | (41) Patient Discharged Against Medical Advice A code indicating whether the patient was discharged against medical advice. |
0=No 1=Yes |
| DSCHRG_DT | VARCHAR2 (2) | N | (40) Discharge Date The date the patient is discharged from the rehabilitation facility. |
|
| DSCHRG_TO_LVG_SETG_CD | VARCHAR2 (2) | N | (44A) Discharge to Living Setting A code indicating the setting to which the patient is discharged. |
01=Home 02=Board and Care 03=Transitional Living 04=Intermediate Care 05=Skilled Nursing Facility 06=Acute unit of own facility 07=Acute unit of another facility 08=Chronic Hospital 09=Rehabiliation Facility 10=Other 11=Died 12=Alternate Level of Care Unit 13=Subacute Setting 14=Assisted Living Residence |
| DSCHRG_TO_LVG_WTH_CD | VARCHAR2 (2) | N | (45) Discharge to Living With A code which indicates with whom the resident will be living if Item 44A (Discharge to Living Setting) is coded 01-Home. |
01=Alone 02=Family/Relatives 03=Friends 04=Attendant 05=Other =Blank |
| DSCHRG_WTH_HOME_HLTH_SRVC_SW | VARCHAR2 (1) | N | (44B) Was Patient Discharged with Home Health
Services? A code indicating whether the patient was discharged with Home Health Services (if the patient was discharged to a community-based setting, i.e., Item 44A is coded 01-Home; 02-Board and Care; 03-Transitional Living; 14-Assisted Living Residence). |
0=No 1=Yes =Blank |
| DSTNC_WC_ADMSN_CD | VARCHAR2 (2) | N | (36a) Distance Traveled in Wheelchair: Admission A code (0-3) indicating the distance the patient traveled in a wheelchair at admission. |
01=Less than 50 feet 02=50 to 149ft 03=150ft 00=Activity does not occur |
| DSTNC_WC_DSCHRG_CD | VARCHAR2 (2) | N | (36d) Distance Traveled in Wheelchair: Discharge A code (0-3) indicating the distance the patient traveled in a wheelchair at discharge. |
01=Less than 50 feet 02=50 to 149ft 03=150ft 00=Activity does not occur |
| DSTNC_WLKD_ADMSN_CD | VARCHAR2 (2) | N | (35a) Distance Walked: Admission A code (0-3) indicating the distance the patient walked at admission. |
01=Less than 50 feet 02=50 to 149 feet 03=150 feet 00=Activity does not occur |
| DSTNC_WLKD_DSCHRG_CD | VARCHAR2 (2) | N | (35d) Distance Walked: Discharge A code (0-3) indicating the distance the patient walked at discharge. |
01=Less than 50 feet 02=50 to 149 feet 03=150 feet 00=Activity does not occur |
| EATG_ADMSN_CD | VARCHAR2 (2) | N | (39Aa) Self-Care: Eating: Admission A score (0-7) indicating the patient's ability to eat at admission. Eating includes the ability to use suitable utensils to bring food to the mouth, as well as the ability to chew and swallow the food once the meal is presented in the customary manner on a table or tray. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) 00/=Activity did not occur |
| EATG_DSCHRG_CD | VARCHAR2 (2) | N | (39Ad) Self-Care: Eating: Discharge A score (0-7) indicating the patient's ability to eat at discharge. Eating includes the ability to use suitable utensils to bring food to the mouth, as well as the ability to chew and swallow the food once the meal is presented in the customary manner on a table or tray. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) |
| EATG_GOAL_CD | VARCHAR2 (2) | N | (39Ag) Self-Care: Eating: Goal A score (0-7) indicating the desired goal for the patient to achieve for eating at discharge. Eating includes the ability to use suitable utensils to bring food to the mouth, as well as the ability to chew and swallow the food once the meal is presented in the customary manner on a table or tray. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) /=Blank |
| ETHNCTY_AFRCN_AMRCN_SW | VARCHAR2 (1) | N | (9C) Race: Black or African American The patient's race/ethnicity: Black or African American. |
0=No 1=Yes =Blank |
| ETHNCTY_AMRCN_INDN_AK_NTV_SW | VARCHAR2 (1) | N | (9A) Race: American Indian/Alaskan Native The patient's race/ethnicity: American Indian or Alaska Native. |
0=No 1=Yes =Blank |
| ETHNCTY_ASN_SW | VARCHAR2 (1) | N | (9B) Race: Asian The patient's race/ethnicity: Asian. |
0=No 1=Yes =Blank |
| ETHNCTY_HSPNC_LTN_SW | VARCHAR2 (1) | N | (9D) Ethnicity: Hispanic or Latino The patient's race/ethnicity: Hispanic or Latino. |
0=No 1=Yes =Blank |
| ETHNCTY_NTV_HI_PCFC_ISLNDR_SW | VARCHAR2 (1) | N | (9E) Race: Native Hawaiian or other Pacific
Islander The patient's race/ethnicity: Native Hawaiian or other Pacific Islander. |
0=No 1=Yes =Blank |
| ETHNCTY_WHT_SW | VARCHAR2 (1) | N | (9F) Race: White The patient's race/ethnicity: White. |
0=No 1=Yes =Blank |
| ETLGC_DGNS_CD | VARCHAR2 (7) | N | (22) Etiologic Diagnosis Code (ICD-9 Code) The ICD-99-CM code that indicates the etiologic problem that led to the impairment for which the patient is receiving rehabilitation (Item 21 - Impairment Group). |
|
| EXDT_AMT_ADMSN_CD | VARCHAR2 (2) | N | (52Da) Exudate Amount: Admission A code (0-3) indicating the amount of exudate (drainage) present after removing the dressing and applying any topical agent to the ulcer for the largest pressure ulcer at the time of admission. |
00=None 01=Light 02=Moderate 03=Heavy =Blank |
| EXDT_AMT_DSCHRG_CD | VARCHAR2 (2) | N | (52Dd) Exudate Amount: Discharge A code (0-3) indicating the amount of exudate (drainage) present after removing the dressing and applying any topical agent to the ulcer for the largest pressure ulcer at the time of discharge. |
00=None 01=Light 02=Moderate 03=Heavy =Blank |
| EXPRSN_ADMSN_CD | VARCHAR2 (2) | N | (39Oa) Communication - Expression: Admission A score (0-7) indicating the patient's ability for expression at admission. Expression includes clear vocal or nonvocal expression of language. This item includes either intelligible speech or clear expression of language using writing or a communication device. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) |
| EXPRSN_DSCHRG_CD | VARCHAR2 (2) | N | (39Od) Communication - Expression: Discharge A score (0-7) indicating the patient's ability for expression at discharge. Expression includes clear vocal or nonvocal expression of language. This item includes either intelligible speech or clear expression of language using writing or a communication device. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) |
| EXPRSN_GOAL_CD | VARCHAR2 (2) | N | (39Og) Communication - Expression: Goal A score (0-7) indicating the desired goal for the patient to achieve for expression at discharge. Expression includes clear vocal or nonvocal expression of language. This item includes either intelligible speech or clear expression of language using writing or a communication device. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) /=Blank |
| EXPRSN_VCL_NVCL_ADMSN_CD | VARCHAR2 (2) | N | (39Oaa) Communication - Vocal/Nonvocal/Both:
Admission A score (0-7) indicating the patient's ability for expression at admission. Expression includes clear vocal or nonvocal expression of language. This item includes either intelligible speech or clear expression of language using writing or a communication device. The more usual mode of expression ('Vocal' or 'Nonvocal') is evaluated; 'Both' indicates vocal and nonvocal are used about equally. |
V=Vocal N=Nonvocal B=Both |
| EXPRSN_VCL_NVCL_DSCHRG_CD | VARCHAR2 (2) | N | (39Odd) Communication - Vocal/Nonvocal/Both:
Discharge A score (0-7) indicating the patient's ability for expression at discharge. Expression includes clear vocal or nonvocal expression of language. This item includes either intelligible speech or clear expression of language using writing or a communication device. The more usual mode of expression ('Vocal' or 'Nonvocal') is evaluated; 'Both' indicates vocal and nonvocal are used about equally. |
V=Vocal N=Nonvocal B=Both |
| FAC_MDCR_PRVDR_NUM | VARCHAR2 (12) | N | (1B) Facility Medicare Provider Number Facility Medicare Provider Number assigned by CMS. |
|
| GNDR_CD | VARCHAR2 (1) | N | (8) Gender Code The patient's gender: 1)Male; 2)Female. |
1=Male 2=Female |
| GRMG_ADMSN_CD | VARCHAR2 (2) | N | (39Ba) Self-Care: Grooming: Admission A score (0-7) indicating the patient's ability to groom at admission. Grooming includes oral care, hair grooming (combing or brushing hair), washing the hands, face, and either shaving the face or applying make-up. If the patient neither shaves nor applies make-up, grooming includes only the first four tasks. This item includes obtaining articles necessary for grooming. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) 00/=Activity did not occur |
| GRMG_DSCHRG_CD | VARCHAR2 (2) | N | (39Bd) Self-Care: Grooming: Discharge A score (0-7) indicating the patient's ability to groom at discharge. Grooming includes oral care, hair grooming (combing or brushing hair), washing the hands, face, and either shaving the face or applying make-up. If the patient neither shaves nor applies make-up, grooming includes only the first four tasks. This item includes obtaining articles necessary for grooming. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) |
| GRMG_GOAL_CD | VARCHAR2 (2) | N | (39Bg) Self-Care: Grooming: Goal A score (0-7) indicating the desired goal for the patient to achieve for grooming at discharge. Grooming includes oral care, hair grooming (combing or brushing hair), washing the hands, face, and either shaving the face or applying make-up. If the patient neither shaves nor applies make-up, grooming includes only the first four tasks. This item includes obtaining articles necessary for grooming. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) /=Blank |
| HIGHST_PRSR_ULCR_ADMSN_CD | VARCHAR2 (2) | N | (52Aa) Highest Current Pressure Ulcer stage:
Admission A code (0-5) indicating the highest current pressure ulcer stage at the time of admission. |
00=No pressure ulcer 01=Any area of persistent skin redness (Stage 1) 02=Partial loss of skin layers (Stage 2) 03=Deep craters in the skin (Stage 3) 04=Breaks in skin exposing muscle or bone (Stage 4) 05=Not stageable (necrotic eschar predominant; no prior staging available) |
| HIGHST_PRSR_ULCR_DSCHRG_CD | VARCHAR2 (2) | N | (52Ad) Highest Current Pressure Ulcer stage:
Discharge A code (0-5) indicating the highest current pressure ulcer stage at the time of discharge. |
00=No pressure ulcer 01=Any area of persistent skin redness (Stage 1) 02=Partial loss of skin layers (Stage 2) 03=Deep craters in the skin (Stage 3) 04=Breaks in skin exposing muscle or bone (Stage 4) 05=Not stageable (necrotic eschar predominant; no prior staging available) |
| IMPRMNT_GRP_ADMSN_CD | VARCHAR2 (9) | N | (21a) Impairment Group: Admission The Impairment Group Code (IGC) that best describes the primary reason for admission to the rehabilitation program. Each IGC consists of a two-digit number (indicating the major Impairment Group) followed by a decimal point and 1 to 4 additional digits identifying the subgroup. |
ORA-06502: PL/SQL: numeric or value error |
| IMPRMNT_GRP_DSCHRG_CD | VARCHAR2 (9) | N | (21d) Impairment Group: Discharge The Impairment Group Code (IGC) that best describes the patient's primary impairment at discharge from the rehabilitation program. Each IGC consists of a two-digit number (indicating the major Impairment Group) followed by a decimal point and 1 to 4 additional digits identifying the subgroup. |
ORA-06502: PL/SQL: numeric or value error |
| LRGST_PRSR_ULCR_ADMSN_NUM | VARCHAR2 (2) | N | (52Ca) Length Multiplied by Width: Admission A score (0-10) indicating the largest pressure ulcer's open surface area at the time of admission. |
00=0 cm 01=< 0.3 cm 02=0.3 to 0.6 cm 03=0.7 to 1.0 cm 04=1.1 to 2.0 cm 05=2.1 to 3.0 cm 06=3.1 to 4.0 cm 07=4.1 to 8.0 cm 08=8.1 to 12.0 cm 09=12.1 to 24.0 cm 10=> 24 cm =Blank |
| LRGST_PRSR_ULCR_DSCHRG_NUM | VARCHAR2 (2) | N | (52Cd) Length Multiplied by Width: Discharge A score (0-10) indicating the largest pressure ulcer's open surface area at the time of discharge. |
00=0 cm 01=< 0.3 cm 02=0.3 to 0.6 cm 03=0.7 to 1.0 cm 04=1.1 to 2.0 cm 05=2.1 to 3.0 cm 06=3.1 to 4.0 cm 07=4.1 to 8.0 cm 08=8.1 to 12.0 cm 09=12.1 to 24.0 cm 10=> 24 cm =Blank |
| MEMRY_ADMSN_CD | VARCHAR2 (2) | N | (39Ra) Social Cognition - Memory: Admission A score (0-7) indicating the patient's ability to remember at admission. Memory includes skills related to recognizing and remembering while performing daily activities in an institutional or community setting. Memory in this context includes the ability to store and retrieve information, particularly verbal and visual. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) |
| MEMRY_DSCHRG_CD | VARCHAR2 (2) | N | (39Rd) Social Cognition - Memory: Discharge A score (0-7) indicating the patient's ability to remember at discharge. Memory includes skills related to recognizing and remembering while performing daily activities in an institutional or community setting. Memory in this context includes the ability to store and retrieve information, particularly verbal and visual. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) |
| MEMRY_GOAL_CD | VARCHAR2 (2) | N | (39Rg) Social Cognition - Memory: Goal A score (0-7) indicating the desired goal for the patient to achieve for memory at discharge. Memory includes skills related to recognizing and remembering while performing daily activities in an institutional or community setting. Memory in this context includes the ability to store and retrieve information, particularly verbal and visual. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) /=Blank |
| MOST_SVR_PN_RATE_ADMSN_CD | VARCHAR2 (2) | N | (51a) Rate the Highest Level of Pain Reported by the Patient
Within the Assessment Period: Admission A rating (0-10) indicating the highest level of pain reported by the patient within the assessment period regardless of whether taking pain medication at the time of admission. Pain refers to any type of physical pain or discomfort in any part of the body. |
00=00 01=01 02=02 03=03 04=04 05=05 06=06 07=07 08=08 09=09 10=10 |
| MOST_SVR_PN_RATE_DSCHRG_CD | VARCHAR2 (2) | N | (51d) Rate the Highest Level of Pain Reported by the Patient
Within the Assessment Period: Discharge A rating (0-10) indicating the highest level of pain reported by the patient within the assessment period regardless of whether taking pain medication at the time of discharge. Pain refers to any type of physical pain or discomfort in any part of the body. |
00=00 01=01 02=02 03=03 04=04 05=05 06=06 07=07 08=08 09=09 10=10 |
| MRTL_STUS_CD | VARCHAR2 (2) | N | (10) Marital Status The patient's marital status at the time of admission. |
01=Never
Married 02=Married 03=Widowed 04=Separated 05=Divorced |
| ONST_DT | DATE (8) | N | (23) Date of Onset The onset date of the impairment that was coded in Item 21 (Impairment Group). |
|
| ORGNL_ASMT_INTRNL_ID | NUMBER (10) | N | Original Assessment Internal Identifier Original version (ASMT INT ID) of this assessment where Correction Number is 00. |
|
| PAT_1ST_NAME | VARCHAR2 (12) | N | (4) Patient First Name The patient's first name. |
|
| PAT_LAST_NAME | VARCHAR2 (18) | N | (5A) Patient Last Name The patient's last name. |
|
| PAT_MDCD_NUM | VARCHAR2 (14) | N | (3) Patient Medicaid Number The patient's Medicaid Number. |
|
| PAT_MDCR_NUM | VARCHAR2 (13) | N | (2) Patient Medicare Number The patient's Medicare Number (Part A). |
|
| PGM_INTRPTN_SW | VARCHAR2 (1) | N | (42) Program Interruption(s) A code indicating whether the Medicare inpatient is discharged from the inpatient rehabilitation facility and returns to the same inpatient rehabilitation facility within 3 consecutive calendar days. |
0=No 1=Yes |
| PRBLM_SLVG_ADMSN_CD | VARCHAR2 (2) | N | (39Qa) Social Cognition - Problem Solving:
Admission A score (0-7) indicating the patient's ability for problem solving at admission. Problem solving includes skills related to solving problems of daily living. This means making reasonable, safe, and timely decisions regarding financial, social, and personal affairs, as well as the initiation, sequencing, and self-correcting of tasks and activities to solve problems. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) |
| PRBLM_SLVG_DSCHRG_CD | VARCHAR2 (2) | N | (39Qd) Social Cognition - Problem Solving:
Discharge A score (0-7) indicating the patient's ability for problem solving at discharge. Problem solving includes skills related to solving problems of daily living. This means making reasonable, safe, and timely decisions regarding financial, social, and personal affairs, as well as the initiation, sequencing, and self-correcting of tasks and activities to solve problems. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) |
| PRBLM_SLVG_GOAL_CD | VARCHAR2 (2) | N | (39Qg) Social Cognition - Problem Solving: Goal A score (0-7) indicating the desired goal for the patient to achieve for problem solving at dischrage. Problem solving includes skills related to solving problems of daily living. This means making reasonable, safe, and timely decisions regarding financial, social, and personal affairs, as well as the initiation, sequencing, and self-correcting of tasks and activities to solve problems. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) /=Blank |
| PRE_HOSP_LVG_SET_CD | VARCHAR2 (2) | N | (16) Pre-Hospital Living Setting The setting where the patient was living prior to being hospitalized: 01)Home; 02)Board & Care; 03)Transitional Living; 04)Intermediate Care (nursing home); 05)Skilled Nursing Facility (nursing home) 06)Acute Unit of Own Facility; 07)Acute Unit of Another Facility; 08)Chronic Hospital; 09)Rehabilitation Facility; 10)Other; 12)Alternate Level of Care (ALC) Unit; 13)Subacute Setting; 14)Assisted Living Residence. |
01=Home 02=Board '&' Care 03=Transitional Living 04=Intermediate Care 05=Skilled Nursing Facility 06=Acute Unit of Own Facility 07=Acute Unit of Another Facility 08=Chronic Hospital 09=Rehabilitation Facility 10=Other 12=Alternate Level of Care Unit 13=Subacute Setting 14=Assisted Living Residence |
| PRE_HOSP_LVG_WTH_CD | VARCHAR2 (2) | N | (17) Pre-Hospital Living With The relationship of any individuals who resided with the patient prior to the patient's hospitalization. This item is used only if code 01 (Home) in Item 16 (Prehospital Living Setting) was coded. |
01=Alone 02=Family/Relatives 03=Friends 04=Attendant 05=Other =Blank |
| PRE_HOSP_VCTNL_CTGRY_CD | VARCHAR2 (2) | N | (18) Pre-Hospital Vocational Category Indicates the vocational status of the patient prior to hospitalization: 1)Employed; 2)Sheltered; 3)Student; 4)Homemaker; 5)Not Working; 6)Retired for Age; 7)Retired for Disability. |
01=Employed 02=Sheltered 03=Student 04=Homemaker 05=Not Working 06=Retired for Age 07=Retired for Disability |
| PRE_HOSP_VCTNL_EFRT_CD | VARCHAR2 (2) | N | (19) Pre-Hospital Vocational Effort The patient's vocational effort prior to hospitalization (if Item 18 - Pre-hospital Vocational Category is coded 1-4): 1)Full-time; 2)Part-time; 3)Adjusted Workload. |
01=Full-time 02=Part-time 03=Adjusted Workload =Blank |
| PRMRY_PMT_SRC_CD | VARCHAR2 (2) | N | (20A) Primary Payment Source A code indicating the primary source of payment for inpatient rehabilitation services. |
02=Medicare non-MCO 51=Medicare MCO 01=Blue Cross 03=Medicaid non-MCO 04=Commercial Insurance 05=MCO HMO 06=Workers Compensation 07=Crippled Childrens Services 08=Developmental Disabilities Services 09=State Vocational Rehabilitation 10=Private Pay 11=Employee Courtesy 12=Unreimbursed 13=CHAMPUS 14=Other 15=None 16=No-Fault Auto Insurance 52=Medicaid MCO |
| PRSR_ULCR_ADMSN_CNT | VARCHAR2 (2) | N | (52Ba) Number of Current Pressure Ulcers:
Admission The number of pressure ulcers, including ulcers that cannot be accurately staged at the time of admission. |
|
| PRSR_ULCR_DSCHRG_CNT | VARCHAR2 (2) | N | (52Bd) Number of Current Pressure Ulcers:
Discharge The number of pressure ulcers, including ulcers that cannot be accurately staged at the time of discharge. |
|
| PRVDR_INTRNL_NUM | NUMBER (10) | N | Provider Internal Number This field is used as a key to uniquely identify a provider in the CSP_PRVDR table. |
|
| RSDNT_CHG_TS | DATE (8) | N | Resident Data Update Timestamp The last updated date and time of resident data. |
|
| RSDNT_INTRNL_ID | NUMBER (10) | N | Resident Internal Identifier A unique number, assigned by the submission system, which identifies a resident. The combination of State Code and Resident Internal ID uniquely identifies the resident in the national repository. |
|
| RSDNT_MATCH_CRTR_CD | NUMBER (2) | N | Resident Match Criteria Code This field is used in determining if a record should be written to the resident history table. It is a number showing which of the resident matching criteria was positive for a match, and is zero if it is a new resident or patient. |
|
| RTRN_1_DT | DATE (8) | N | (43B) First Return Date The date when the patient returns to the inpatient rehabilitation facility in a program interruption situation (Item 42 - a situation where a Medicare inpatient is discharged from the inpatient rehabilitation facility and returns to the same inpatient rehabilitation facility within 3 consecutive calendar days). |
|
| RTRN_2_DT | DATE (8) | N | (43D) Second Return Date The date when the patient returns to the inpatient rehabilitation facility in a program interruption situation (Item 42 - a situation where a Medicare inpatient is discharged from the inpatient rehabilitation facility and returns to the same inpatient rehabilitation facility within 3 consecutive calendar days). |
|
| RTRN_3_DT | DATE (8) | N | (43F) Third Return Date The date when the patient returns to the inpatient rehabilitation facility in a program interruption situation (Item 42 - a situation where a Medicare inpatient is discharged from the inpatient rehabilitation facility and returns to the same inpatient rehabilitation facility within 3 consecutive calendar days). |
|
| SBMTD_CMG_TXT | VARCHAR2 (10) | N | Submitted CMG Code The Case-Mix Group code submitted by the facility. This CMG code is calculated by the software the facility utilizes. |
|
| SBMTD_CMG_VRSN_TXT | VARCHAR2 (10) | N | Submitted CMG Version Code The version code of the CMG Grouper that was used by the facility.s software in the calculation of the submitted CMG code. |
|
| SCL_INTRCTN_ADMSN_CD | VARCHAR2 (2) | N | (39Pa) Social Cognition - Social Interaction:
Admission A score (0-7) indicating the patient's ability for social interaction at admission. Social interaction includes skills related to getting along and participating with others in therapeutic and social situations. It represents how one deals with one's own needs together with the needs of others. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) |
| SCL_INTRCTN_DSCHRG_CD | VARCHAR2 (2) | N | (39Pd) Social Cognition - Social Interaction:
Discharge A score (0-7) indicating the patient's ability for social interaction at discharge. Social interaction includes skills related to getting along and participating with others in therapeutic and social situations. It represents how one deals with one's own needs together with the needs of others. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) |
| SCL_INTRCTN_GOAL_CD | VARCHAR2 (2) | N | (39Pg) Social Cognition - Social Interaction: Goal A score (0-7) indicating the desired goal for the patient to achieve for social interaction at discharge. Social interaction includes skills related to getting along and participating with others in therapeutic and social situations. It represents how one deals with one's own needs together with the needs of others. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) /=Blank |
| SCNDRY_PMT_SRC_CD | VARCHAR2 (2) | N | (20B) Secondary Payment Source A code indicating the secondary source of payment for inpatient rehabilitation services. |
01=Blue Cross =Blank 03=Medicaid non-MCO 04=Commerical Insurance 05=MCO HMO 06=Workers Compensation 07=Crippled Children's Service 08=Developmental Disabilities Service 09=State Vocational Rehabilitation 10=Private Pay 11=Employee Courtesy 12=Unreimbursed 13=CHAMPUS 14=Other 15=None 16=No fault auto insurance 52=Medicaid MCO 02=Medicare non-MCO 51=Medicare MCO |
| SFTWR_ID | VARCHAR2 (9) | N | Software Identifier This field contains the identification number of the software vendor or agent the provider is using to automate the assessment requirement. |
|
| SFTWR_VRSN | VARCHAR2 (10) | N | Software Version This field contains the version number of the vendor software being used by the facility or the facility's agent to automate the assessment submission process. |
|
| SHWR_TRNSFR_ADMSN_CD | VARCHAR2 (2) | N | (34a) Shower Transfer: Admission A score (0-7) indicating the patient's ability to get into and out of a shower at admission. |
00/=Activity did not occur 01/Helper - Complete Dependence=Total Assistance (Subject less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) /=Blank |
| SHWR_TRNSFR_DSCHRG_CD | VARCHAR2 (2) | N | (34d) Shower Transfer: Discharge A score (0-7) indicating the patient's ability to get into and out of a shower at discharge. |
00/=Activity did not occur 01/Helper - Complete Dependence=Total Assistance (Subject less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) /=Blank |
| SOB_EXRTN_ADMSN_SW | VARCHAR2 (1) | N | (48a) Shortness of Breath With Exertion: Admission A code which indicates whether the patient reports one or more episodes of becoming 'breathless' or short of breath (dyspneic), or the patient is observed to be short of breath with mild exertion, such as during bathing or transferring, on at least one occasion at the time of admission. |
0=No 1=Yes =Blank |
| SOB_EXRTN_DSCHRG_SW | VARCHAR2 (1) | N | (48d) Shortness of Breath With Exertion: Discharge A code which indicates whether the patient reports one or more episodes of becoming 'breathless' or short of breath (dyspneic), or the patient is observed to be short of breath with mild exertion, such as during bathing or transferring, on at least one occasion at the time of discharge. |
0=No 1=Yes =Blank |
| SOB_REST_ADMSN_SW | VARCHAR2 (1) | N | (49a) Shortness of Breath At Rest: Admission A code which indicates whether the patient reports one or more episodes of becoming 'breathless' or short of breath (dyspneic), or the patient is observed to be short of breath while at rest (e.g., while sitting, talking) on at least one occasion at the time of admission. |
0=No 1=Yes =Blank |
| SOB_REST_DSCHRG_SW | VARCHAR2 (1) | N | (49d) Shortness of Breath At Rest: Discharge A code which indicates whether the patient reports one or more episodes of becoming 'breathless' or short of breath (dyspneic), or the patient is observed to be short of breath while at rest (e.g., while sitting, talking) on at least one occasion at the time of discharge. |
0=No 1=Yes =Blank |
| SPHNCTR_BLADR_ADMSN_CD | VARCHAR2 (2) | N | (39Ga) Sphincter Control - Bladder: Admission A score (0-7) indicating the level of assistance needed for the patient's bladder management at admission. Bladder management - level of assistance includes the safe use of equipment or agents for bladder management. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) |
| SPHNCTR_BLADR_DSCHRG_CD | VARCHAR2 (2) | N | (39Gd) Sphincter Control - Bladder: Discharge A score (0-7) indicating the level of assistance needed for the patient's bladder management at discharge. Bladder management - level of assistance includes the safe use of equipment or agents for bladder management. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) |
| SPHNCTR_BLADR_GOAL_CD | VARCHAR2 (2) | N | (39Gg) Sphincter Control - Bladder: Goal A score (0-7) indicating indicating the desired goal for the patient to achieve for bladder management at discharge. Bladder management - level of assistance includes the safe use of equipment or agents for bladder management. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) /=Blank |
| SPHNCTR_BWL_ADMSN_CD | VARCHAR2 (2) | N | (39Ha) Sphincter Control - Bowel: Admission A score (0-7) indicating the level of assistance needed for the patient's bowel management at admission. Bowel management - level of assistance includes use of equipment or agents for bowel management. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) |
| SPHNCTR_BWL_DSCHRG_CD | VARCHAR2 (2) | N | (39Hd) Sphincter Control - Bowel: Discharge A score (0-7) indicating the level of assistance needed for the patient's bowel management at discharge. Bowel management - level of assistance includes use of equipment or agents for bowel management. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) |
| SPHNCTR_BWL_GOAL_CD | VARCHAR2 (2) | N | (39Hg) Sphincter Control - Bowel: Goal A score (0-7) indicating the desired goal for the level of assistance needed for the patient's bowel management at discharge. Bowel management - level of assistance includes use of equipment or agents for bowel management. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) /=Blank |
| SSN_NUM | VARCHAR2 (9) | N | (7) Social Security Number The patient's Social Security Number. |
|
| STATE_CD | VARCHAR2 (2) | N | State Code This field holds the two-digit state abbreviation, two-digit region code or 'US'. If the row of data is state or facility level, the two-digit state code will be in this column. If the row of data is regional, the two-digit regional code will be in this column. If the row of data is national level, 'US' will be in this column. |
|
| STNDG_BAL_PRBLM_ADMSN_SW | VARCHAR2 (1) | N | (53a) Standing Balance Problem: Admission A code indicating whether the patient reports at least one episode of dizziness, vertigo, or light-headedness while sitting or standing at the time of admission. |
0=No 1=Yes =Blank |
| STNDG_BAL_PRBLM_DSCHRG_SW | VARCHAR2 (1) | N | (53d) Standing Balance Problem: Discharge A code indicating whether the patient reports at least one episode of dizziness, vertigo, or light-headedness while sitting or standing at the time of discharge. |
0=No 1=Yes =Blank |
| STR_ADMSN_CD | VARCHAR2 (2) | N | (39Ma) Locomotion - Stairs: Admission A score (0-7) indicating the patient's ability to go up and down 12 to 14 stairs (one flight) indoors in a safe manner at admission. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) 00/=Activity did not occur |
| STR_DSCHRG_CD | VARCHAR2 (2) | N | (39Md) Locomotion - Stairs: Discharge A score (0-7) indicating the patient's ability to go up and down 12 to 14 stairs (one flight) indoors in a safe manner at discharge. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) |
| STR_GOAL_CD | VARCHAR2 (2) | N | (39Mg) Locomotion - Stairs: Goal A score (0-7) indicating the desired goal for the patient's ability to go up and down 12 to 14 stairs (one flight) indoors in a safe manner at discharge. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) /=Blank |
| SUBMSN_DT | DATE (8) | N | Submission Date The date the submission was received by the system. |
|
| SUBMSN_SQNC_NUM | NUMBER (10) | N | Submission Sequence Number Submission Sequence Number |
|
| SWLWG_ADMSN_CD | VARCHAR2 (2) | N | (27a) Swallowing Status: Admission A code (1-3) used to describe the patient's swallowing status at time of admission. |
01=Tube / Parenteral Feeding: tube / parenteral feeding used
wholly or partially as a means of sustenance 02=Modified Food Consistency / Supervision: subject requires modified food consistency and/or needs supervision for safety 03=Reguar Food: solids and liquids swallowed safely without supervision or modified food consistency |
| SWLWG_DSCHRG_CD | VARCHAR2 (2) | N | (27d) Swallowing Status: Discharge A code (1-3) describing the patient's swallowing status at time of discharge. |
01=Tube / Parenteral Feeding: tube / parenteral feeding used
wholly or partially as a means of sustenance 02=Modified Food Consistency / Supervision: subject requires modified food consistency and/or needs supervision for safety 03=Reguar Food: solids and liquids swallowed safely without supervision or modified food consistency |
| TISUE_TYPE_ADMSN_CD | VARCHAR2 (2) | N | (52Ea) Tissue Type: Admission A code (0-4) that indicates the type of tissue that occupies the majority of the ulcer bed of the largest pressure ulcer at the time of admission. |
00=Closed/resurfaced: /The wound is completely covered with
epithelium (new skin) 01=Epithelial tissue: Fors superficial ulcers, new pink or shiny tissue (skin) that grows in from the edges or as islands on the ulcer surface 02=Granulation tissue: Pink or beefy red tissue with a shiny, moist, granular appearance 03=Slough: Yellow or white tissue that adheres to the ulcer bed in strings or thick clumps or is mucinous 04=Necrotic tissue (eschar): Black, brown, or tan tissue that adheres firmly to the wound bed or ulcer edges =Blank |
| TISUE_TYPE_DSCHRG_CD | VARCHAR2 (2) | N | (52Ed) Tissue Type: Discharge A code (0-4) that indicates the type of tissue that occupies the majority of the ulcer bed of the largest pressure ulcer at the time of discharge. |
00=Closed/resurfaced: /The wound is completely covered with
epithelium (new skin) 01=Epithelial tissue: Fors superficial ulcers, new pink or shiny tissue (skin) that grows in from the edges or as islands on the ulcer surface 02=Granulation tissue: Pink or beefy red tissue with a shiny, moist, granular appearance 03=Slough: Yellow or white tissue that adheres to the ulcer bed in strings or thick clumps or is mucinous 04=Necrotic tissue (eschar): Black, brown, or tan tissue that adheres firmly to the wound bed or ulcer edges =Blank |
| TOILTG_ADMSN_CD | VARCHAR2 (2) | N | (39Fa) Self-Care: Toileting: Admission A score (0-7) indicating the patient's ability to maintain perineal hygiene and adjusting clothing before and after using a toilet, commode, bedpan, or urinal at admission. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) 00/=Activity did not occur |
| TOILTG_DSCHRG_CD | VARCHAR2 (2) | N | (39Fd) Self-Care: Toileting: Discharge A score (0-7) indicating the patient's ability to maintain perineal hygiene and adjusting clothing before and after using a toilet, commode, bedpan, or urinal at discharge. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) |
| TOILTG_GOAL_CD | VARCHAR2 (2) | N | (39Fg) Self-Care: Toileting: Goal A score (0-7) indicating the the desired goal for the patient to achieve the ability to maintain perineal hygiene and adjusting clothing before and after using a toilet, commode, bedpan, or urinal at discharge. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) /=Blank |
| TOILT_ADMSN_CD | VARCHAR2 (2) | N | (39Ja) Transfers - Toilet: Admission A score (0-7) indicating the patient's ability to safely get on and off a toilet at admission. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) 00/=Activity did not occur |
| TOILT_DSCHRG_CD | VARCHAR2 (2) | N | (39Jd) Transfers - Toilet: Discharge A score (0-7) indicating the patient's ability to safely get on and off a toilet at discharge. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) |
| TOILT_GOAL_CD | VARCHAR2 (2) | N | (39Jg) Transfers - Toilet: Goal A score (0-7) indicating the desired goal for the patient to achieve to safely get on and off a toilet at discharge. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) /=Blank |
| TOT_FALL_DRNG_REHAB_STAY_NUM | NUMBER (3) | N | (54) Total Number of Falls During the Rehabilitation Stay:
Discharge The total number of falls during the rehabilitation stay recorded at the time of discharge. |
|
| TOT_PUSH_SCRE_ADMSN_NUM | VARCHAR2 (2) | N | (52Fa) Total PUSH Score: Admission The sum of the scores of the three items (52C + 52D + 52E) to derive the total PUSH tool score at the time of admission. |
|
| TOT_PUSH_SCRE_DSCHRG_NUM | VARCHAR2 (2) | N | (52Fd) Total PUSH Score: Discharge The sum of the scores of the three items (52C + 52D + 52E) to derive the total PUSH tool score at the time of discharge. |
|
| TRGT_DT | DATE (8) | N | Target Date For MDS, the target date is the R4 Discharge Date for any discharge, the A4A Reentry Date for any re-entry and the A3A Assessment Reference Date for any other type of assessment. For IRF-PAI, the Target Date is 12: Admission Date. For SB the Target Date is the same as the Event Date and is equal to the following dates: 10a (A3a) - Assessment Reference Date, 15 (R4) - Discharge Date and 16 (A4a) - Reentry Date. |
|
| TRNSFR_1_DT | DATE (8) | N | (43A) First Interruption Date The date when the patient leaves the inpatient rehabilitation facility in a program interruption situation (Item 42 - a situation where a Medicare inpatient is discharged from the inpatient rehabilitation facility and returns to the same inpatient rehabilitation facility within 3 consecutive calendar days). |
|
| TRNSFR_2_DT | DATE (8) | N | (43C) Second Interruption Date The second date when the patient leaves the inpatient rehabilitation facility in a program interruption situation (Item 42 - a situation where a Medicare inpatient is discharged from the inpatient rehabilitation facility and returns to the same inpatient rehabilitation facility within 3 consecutive calendar days). |
|
| TRNSFR_3_DT | DATE (8) | N | (43E) Third Interruption Date The third date when the patient leaves the inpatient rehabilitation facility in a program interruption situation (Item 42 - a situation where a Medicare inpatient is discharged from the inpatient rehabilitation facility and returns to the same inpatient rehabilitation facility within 3 consecutive calendar days). |
|
| TUB_SHWR_ADMSN_CD | VARCHAR2 (2) | N | (39Ka) Transfers - Tub, Shower: Admission A score (0-7) indicating the patient's ability to get into and out of a tub or shower at admission. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) 00/=Activity did not occur |
| TUB_SHWR_DSCHRG_CD | VARCHAR2 (2) | N | (39Kd) Transfers - Tub, Shower: Discharge A score (0-7) indicating the patient's ability to get into and out of a tub or shower at discharge. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) |
| TUB_SHWR_GOAL_CD | VARCHAR2 (2) | N | (39Kg) Transfers - Tub, Shower: Goal A score (0-7) indicating the desired goal for the patient to achieve to get into and out of a tub or shower at discharge. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) /=Blank |
| TUB_TRNSFR_ADMSN_CD | VARCHAR2 (2) | N | (33a) Tub Transfer: Admission A score (0-7) indicating the patient's ability to get into and out of a tub at admission. |
00/=Activity did not occur 01/Helper - Complete Dependence=Total Assistance (Subject less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) /=Blank |
| TUB_TRNSFR_DSCHRG_CD | VARCHAR2 (2) | N | (33d) Tub Transfer: Discharge A score (0-7) indicating the patient's ability to get into and out of a tub at discharge. |
00/=Activity did not occur 01/Helper - Complete Dependence=Total Assistance (Subject less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) /=Blank |
| VRSN_CD1 | VARCHAR2 (5) | N | Version Code 1 This code represents the version of the SB-MDS 2.0 form actually completed in the hospital. Use 1.0A for the SB-MDS form dated 03/01/02. |
|
| VRSN_CD2 | VARCHAR2 (5) | N | Version Code 2 This code represents the version of the SB-MDS data specifications used to create the data record for submission to the National System. |
|
| WC_ADMSN_CD | VARCHAR2 (2) | N | (38a) Wheelchair: Admission A score (0-7) indicating the patient's ability to use a wheelchair on a level surface once seated at admission. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) 00/=Activity did not occur |
| WC_DSCHRG_CD | VARCHAR2 (2) | N | (38d) Wheelchair: Discharge A score (0-7) indicating the patient's ability to use a wheelchair on a level surface once seated at discharge. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) 00/=Activity did not occur |
| WLK_ADMSN_CD | VARCHAR2 (2) | N | (37a) Walk: Admission A score (0-7) indicating the patient's ability to walk on a level surface at admission. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) 00/=Activity did not occur |
| WLK_DSCHRG_CD | VARCHAR2 (2) | N | (37d) Walk: Discharge A score (0-7) indicating the patient's ability to walk on a level surface at discharge. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) 00/=Activity did not occur |
| WLK_WC_ADMSN_CD | VARCHAR2 (2) | N | (39La) Locomotion - Walk/wheelchair: Admission A score (0-7) indicating the patient's ability to walk or use a wheelchair on a level surface at admission. This item indicates the most frequent mode of locomotion the patient uses - 'walk' or 'wheelchair'. |
01/Helper - Complete Dependence=Total Assistance (Subject
less than 25%) 02/Helper - Complete Dependence=Maximal Assistance (Subject = 25% or more) 03/Helper - Modified Dependence=Moderate Assistance (Subject = 50% or more) 04/Helper - Modified Dependence=Minimal Assistance (Subject = 75% or more) 05/Helper - Modified Dependence=Supervision (Subject = 100%) 06/No Helper=Modified Independence (Device) 07/No Helper=Complete Independence (Timely, Safely) 00/=Activity did not occur |
| WLK_WC_BOTH_ADMSN_CD | VARCHAR2 (2) | N | (39Laa) Locomotion - Walk/wheelchair/both:
Admission A score (0-7) indicating the patient's ability to both walk and use a wheelchair at admission. This item indicates that the patient uses 'both' means of locomotion about equally. |
W=Walk C=Wheelchair B=Both |
| WLK_WC_BOTH_DSCHRG_CD | VARCHAR2 (2) |