| Data Type | Length | Field Name | Field Description |
|---|---|---|---|
| DATE | 8 | Assessment Beginning Version Date | Beginning date of the submission file that contains the version of this assessment. |
| NUM | 2 | Assessment Correction Version Number | The number of the assessment. 00 = Original, 01 = First correction, 02 = Second correction, etc. |
| DATE | 8 | Assessment Ending Version Date | Ending date of the submission file that contains the version of this assessment. |
| CHAR | 1 | Assessment Modification Code | A code designating the version of the assessment: C = Current, M = Modified, X = Inactive. |
| CHAR | 5 | Calculated HIPPS Code | The value of the HIPPS (Health Insurance Prospective Payment System) code calculated by the state system using the OASIS PPS dll for this assessment. |
| DATE | 8 | Created Date | For OASIS and MDS Assessments, it is the date the record submitted was saved to the state database. Otherwise it is the date that the options were entered into the system. |
| DATE | 8 | Effective Date | For MDS, the effective date is based on the (AA8A) Primary Reason for Assessment field. The effective date will be the R4 Discharge Date for any discharge (RFA 06, 07, 08); the A4A Reentry Date for any re-entry (RFA 09); or the R2B Complete Date for any other type of assessment (RFA 01, 02, 03, 04, 05, 10, 00.) For SB, this date is the same as the Completion Date as is equal to the following dates: 15 (R4) - Discharge Date, 16 (A4a) - Reentry Date and 45b (R2b) - Completion Date. |
| NUM | 9 | Medicare CMI Value for RUG Group | This field contains the Medicare Case Mix Index generated in the RUG calculation for this assessment by the state MDS system. |
| CHAR | 3 | Medicare RUG CMI Set Used | This field contains the Medicare set code that was used in the RUG calculation for this assessment by the state MDS system. |
| CHAR | 3 | Medicare RUG Group | This field contains the Medicare RUG group calculated for this assessment by the state MDS system. |
| CHAR | 2 | Medicare RUG Version | This field contains the Medicare RUG calculator version used for this assessment by the state MDS system. |
| NUM | 15 | Original Assessment Internal ID | Original version (ASMT INT ID) of this assessment where Correction Number is 00. |
| NUM | 10 | Provider Internal Number | This field is used as a key to uniquely identify a provider in the CSP_PRVDR table. |
| CHAR | 2 | Record Type | Record type. This is a calculated field based on the combination of the AA8A PRI RFA and AA8B SPC RFA fields. |
| DATE | 8 | Resident Data Update Timestamp | The last updated date and time of resident data. |
| NUM | 10 | Resident Internal ID | 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. |
| NUM | 2 | Resident Match Criteria | 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. |
| NUM | 15 | SB Assessment Internal ID | The number assigned to identify a swing bed assessment. |
| CHAR | 1 | SB Submission Requirement | Submission Authority for SB-MDS Record |
| NUM | 10 | SB Submission Sequence Number | SB Submission Sequence Number |
| CHAR | 9 | Software ID | This field contains the identification number of the software vendor or agent the provider is using to automate the assessment requirement. |
| CHAR | 5 | 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. |
| CHAR | 2 | State ID | The two-character state abbreviation. |
| DATE | 8 | Submission Date | The date the submission was received by the system. |
| DATE | 8 | 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. |
| DATE | 8 | Updated Date | This is the date the row was last updated in the assessment table in the state system. |
| CHAR | 5 | Version Code 1 | This code represents the version of the form actually completed in the hospital. |
| CHAR | 5 | Version Code 2 | This code represents the version of the data specifications used to create the data record for submission to the National System. |
| CHAR | 1 | (5a)Race: American Indian/Alaskan Native | The patient's race or ethnic category: American Indian or Alaskan Native. |
| CHAR | 1 | (5b)Race: Asian | The patient's race or ethnic category: Asian. |
| CHAR | 1 | (5c)Race: Black or African American | The patient's race or ethnic category: Black or African American. |
| CHAR | 1 | (5d)Ethnicity: Hispanic or Latino | The patient's race or ethnic category: Hispanic or Latino. |
| CHAR | 1 | (5e)Race: Native Hawaiian or other Pacific Islander | The patient's race or ethnic category: Native Hawaiian or other Pacific Islander. |
| CHAR | 1 | (5f)Race: White | The patient's race or ethnic category: White. |
| NUM | 1 | (11c) OMRA Assessment | The OMRA (Other Medicare Required Assessment) must be completed only if the patient was in a RUG-III Rehabilitation classification and will continue to need Part A SNF-level services after discontinuing therapy. |
| NUM | 1 | (11d) Clinical Change Assessment | A decline or improvement in a patient's status that will not normally resolve itself without intervention by staff or by implementing standard disease-related clinical interventions, impacts on more than one area of the patient's health status or requires interdisciplinary review or revision of the plan of care. |
| NUM | 1 | (11e) Assessment Required for State | A code used to identify a SB-MDS assessment required by a state Medicaid swing bed program. |
| NUM | 1 | (11f) Assessment Needed Other Reasons | A code used to identify a SB-MDS assessment completed for other payers, such as a Health Maintenance Organization (HMO) or other Medicare Secondary Payer (MSP). |
| DATE | 8 | (12) Prior Acute Care Admission Date | The admission date of the qualifying 3-day hospital stay that occurred before admission to the swing bed for Part A SNF-level services. |
| NUM | 2 | (14a) Admitted From Code | The patient's living arrangements prior to admission and the presence or absence of home health services if the patient was in a private home or apartment. |
| NUM | 2 | (14b) Discharge Status Code | The patient's living arrangements after discharge and the presence or absence of home health services if the patient is in a private home or apartment. |
| NUM | 2 | (14c) Reentry From Code | Indicates the patient's living arrangement prior to reentry for swing bed services. |
| CHAR | 12 | 1a(AA1a)First Name | The patient's first name. |
| CHAR | 1 | 1b(AA1b)Middle Initial | The patient's middle initial. |
| CHAR | 18 | 1c(AA1c)Last Name | The patient's last name. |
| CHAR | 3 | 1d(AA1d)Name Suffix | The patient's name suffix; for example, Jr. or Sr. |
| CHAR | 1 | 2(AA2)Gender | The patient's gender. |
| DATE | 8 | 3(AA3)Birthdate | The patient's birthdate. |
| CHAR | 1 | 4(A5)Marital Status | The patient's current marital status. |
| CHAR | 5 | 6(AB4)ZIP Code of Pre-Hospital Residence | The community address where the patient last resided prior to swing bed admission. |
| CHAR | 9 | 7a(AA5a)Social Security Number | The patient's Social Security Number. |
| CHAR | 12 | 7b(AA5b)Medicare or Railroad Insurance Number | The patient's Medicare or railroad insurance number. |
| CHAR | 14 | 8(AA7)Medicaid Number | The patient's Medicaid number. |
| CHAR | 15 | 9a(AA6a)Hospital State Medicaid Provider Number | The hospital's state Medicaid provider identification number. |
| CHAR | 12 | 9b(AA6b)Hospital Medicare Provider Number | The hospital's Medicare provider number. |
| DATE | 8 | 10a(A3a)Assessment Reference Date | This date refers to a specific end-point for a common observation period in the SB-MDS assessment process. Almost all SB-MDS items refer to the patient's status over a designated time period referring back in time from the Assessment Reference Date (ARD). |
| CHAR | 2 | 11a (AA8a) Primary Reason for Assessment | The primary reason for completing the assessment using the categories of assessment types mandated by Federal regulation. |
| CHAR | 1 | 11b (AA8b) PPS Scheduled Assessments | Indicates which SB-MDS assessment is being completed: 5-Day, 14-Day, 30-Day, 60-Day, 90-Day, Readmission/Return, 14-Day or Other. |
| DATE | 8 | 13(AB1)Admission Date | The date of the initial admission for swing bed services. |
| DATE | 8 | 15(R4)Discharge Date | The date that the patient was discharged from the Swing Bed. |
| DATE | 8 | 16(A4a)Reentry Date | The date the patient returns to the Swing Bed program from a discharge status-return anticipated. |
| CHAR | 1 | 17(B1)Comatose | Indicates a pathological state in which neither arousal (wakefulness, alertness) nor awareness (cognition of self and environment) is present. |
| CHAR | 1 | 18(B2a)Short Term Memory | Indicates the patient's functional capacity to remember recent or short-term events. |
| CHAR | 1 | 19(B4)Cognitive Skills | Indicates the patient's actual performance in making everyday decisions about tasks or activities of daily living. |
| CHAR | 1 | 20(C4)Making Self Understood | Indicates the patient's ability to express or communicate requests, needs, opinions, urgent problems, and social conversation, whether in speech, writing, sign language, or a combination of these. |
| CHAR | 1 | 21(E1l)Sad, Pained, Worried Facial Expressions | Indicates the frequency of the patient's sad, pained or worried facial expressions. |
| CHAR | 1 | 21a(E1a)Negative Statements | Indicates the frequency of negative statements the patient expressed. Examples are: "Nothing matters."; "I'd rather be dead."; "What's the use?"; "Let me die." |
| CHAR | 1 | 21b(E1b)Repetitive Questions | Indicates the frequency of repetitive verbalizations the patient made. Examples include: "Where do I go?"; What do I do?" |
| CHAR | 1 | 21c(E1c)Repetitive Verbalizations | Indicates the frequency of repetitive verbalizations the patient made. Examples include calling out for help, "God help me." |
| CHAR | 1 | 21d(E1d)Persistent Anger With Self/Others | Indicates the frequency of persistent anger the patient expressed with self or others. Examples include being easily annoyed, anger at placement in swing bed; anger at care received. |
| CHAR | 1 | 21e(E1e)Self Depreciation | Indicates the frequency of self depreciation the patient expressed. Examples include: "I am nothing."; "I am of no use to anyone." |
| CHAR | 1 | 21f(E1f)Expression of Unrealistic Fears | Indicates the frequency of unrealistic fears the patient expressed. Examples are fear of being abandoned, left alone, being with others. |
| CHAR | 1 | 21g(E1g)Recurrent Statements of Terrible Future | Indicates the frequency of recurrent statement of a terrible future the patient expressed. Examples include belief that he or she is about to die, have a heart attack. |
| CHAR | 1 | 21h(E1h)Repetitive Health Complaints | Indicates the frequency of repetitive health complaints the patient expressed. Examples include persistently seeking medical attention, obsessive concerns with body functions. |
| CHAR | 1 | 21i(E1i)Repetitive Anxious Complaints/Concerns | Indicates the frequency of repetitive anxious complaints (non-health related) the patient expressed. Examples include: persistently seeking attention or reassurance regarding schedules, meals, laundry, clothing, relationship issues. |
| CHAR | 1 | 21j(E1j)Unpleasant Mood in Morning | Indicates the frequency the patient expressed an unpleasant mood in the morning. |
| CHAR | 1 | 21k(E1k)Insomnia/Change in Sleeping Pattern | Indicates the frequency of the patient's insomnia or a change in sleeping pattern. Examples include difficulty falling asleep, fewer or more hours of sleep than usual, waking up too early and unable to fall back to sleep. |
| CHAR | 1 | 21m(E1m)Crying, Tearfulness | Indicates the frequency of the patient's crying or tearfulness. |
| CHAR | 1 | 21n(E1n)Repetitive Physical Movements | Indicates the frequency of the patient's repetitive physical movements. Examples include: pacing, hand wringing, restlessness, fidgeting, picking. |
| CHAR | 1 | 21o(E1o)Withdrawal From Activities of Interest | Indicates the frequency of the patient's withdrawal from activities of interest. Examples include having no interest in long standing activities or being with family or friends. |
| CHAR | 1 | 21p(E1p)Reduced Social Interaction | Indicates the frequency of the patient's reduced social interaction. Examples include being less talkative, more isolated. |
| CHAR | 1 | 22a(E4aA)Wandering: Frequency | Indicates the frequency of the patient's wandering (locomotion with no discernible, rational purpose). Wandering may be manifested by walking or by wheelchair. |
| CHAR | 1 | 22b(E4bA)Verbally Abusive Behavioral Symptoms: Frequency | Indicates the frequency of the patient's verbally abusive behavior. Other patients or staff were threatened, screamed at, or cursed at. |
| CHAR | 1 | 22c(E4cA)Physically Abusive Behavioral Symptoms: Frequency | Indicates the frequency of the patient's verbally abusive behavior. Other patients or staff were threatened, screamed at, or cursed at. |
| CHAR | 1 | 22d(E4dA)Socially Inappropriate/Disruptive Behavior: Frequency | Indicates the frequency of the patient's socially inappropriate or disruptive behavior. Examples include disruptive sounds, excessive noise, screams, self-abusive acts, sexual behavior or disrobing in public, smearing or throwing food or feces, hoarding, rummaging through others' belongings. |
| CHAR | 1 | 22e(E4eA)Resists Care: Frequency | Indicates the patient's frequency in resisting care. Examples include resisting taking medications/injections, ADL assistance or help with eating. This category does not include instances where the patient has made an informed choice not to follow a course of care. |
| CHAR | 1 | 23aA(G1aA)Bed Mobility - Self Performance | Indicates how the patient without assistance moves to and from a lying position, turns side to side, and positions body while in bed. |
| CHAR | 1 | 23aB(G1aB)Bed Mobility - Support Provided | Indicates how the patient with support provided moves to and from a lying position, turns side to side, and positions body while in bed. |
| CHAR | 1 | 23bA(G1bA)Transfer - Self Performance | Indicates how the patient without assistance moves between surfaces. Examples include: moving from bed, chair, wheelchair to standing position. |
| CHAR | 1 | 23bB(G1bB)Transfer - Support Provided | Indicates how the patient with support provided moves between surfaces. Examples include: moving from bed, chair, wheelchair to standing position. |
| CHAR | 1 | 23cA(G1hA)Eating - Self Performance | Indicates how the patient without assistance eats and drinks, regardless of skill. |
| CHAR | 1 | 23cB(G1hB)Eating - Support Provided | Indicates how the patient with support provided eats and drinks, regardless of skill. |
| CHAR | 1 | 23dA(G1iA)Toilet Use - Self Performance | Indicates how the patient without assistance uses the toilet room, commode, bedpan, or urinal, transfers on/off toilet, cleanses, changes pad, manages ostomy or catheter, and adjusts clothes. |
| CHAR | 1 | 23dB(G1iB)Toilet Use - Support Provided | Indicates how the patient with support provided uses the toilet room, commode, bedpan, or urinal, transfers on/off toilet, cleanses, changes pad, manages ostomy or catheter, and adjusts clothes. |
| CHAR | 1 | 24a(H3a)Any Scheduled Toileting Plan | A plan whereby staff members at scheduled times each day either take the patient to the toilet room, or give the patient a urinal, or remind the patient to go to the toilet. Includes habit training and/or prompted voiding. |
| CHAR | 1 | 24b(H3b)Bladder Retraining Program | A retraining program where the patient is taught to consciously delay urinating or resist the urgency to void. Patients are encouraged to void on a schedule rather than according to their urge to void. This form of training is used to manage urinary incontinence due to bladder instability. |
| CHAR | 1 | 25a(I1a)Diabetes Mellitus | Indicates the diagnosis of Diabetes Mellitus (includes insulin-dependent Diabetes Mellitus (IDDM) and dietcontrolled Diabetes (NIDDM or AODM). |
| CHAR | 1 | 25b(I1r)Aphasia | Indicates the diagnosis of aphasia - a speech or language disorder caused by disease or injury to the brain resulting in difficulty expressing thoughts (spoken or written) or understanding spoken or written language. |
| CHAR | 1 | 25c(I1s)Cerebral Palsy | Indicates the diagnosis of Cerebral Palsy - a paralysis related to developmental brain defects or birth trauma. |
| CHAR | 1 | 25d(I1v)Hemiplegia/Hemiparesis | Indicates a diagnosis of hemiplegia/hemiparesis - paralysis/partial paralysis (temporary or permanent impairment of sensation, function, motion) of both limbs on one side of the body - usually caused by cerebral hemorrhage, thrombosis, embolism, or tumor. |
| CHAR | 1 | 25e(I1w)Multiple Sclerosis | Indicates a diagnosis of Multiple Sclerosis - a chronic disease affecting the central nervous system with remissions and relapses of weakness, uncoordination, paresthesis, speech disturbances and visual disturbances. |
| CHAR | 1 | 25f(I1z)Quadriplegia | Indicates a diagnosis of quadriplegia - paralysis (temporary or permanent impairment of sensation, function, motion) of all four limbs. Usually caused by cerebral hemorrhage, thrombosis, embolism, tumor, or spinal cord injury. |
| CHAR | 1 | 26a(I2e)Pneumonia | Indicates a diagnosis of pneumonia - inflammation of the lungs; most commonly of bacterial or viral origin. |
| CHAR | 1 | 26b(I2g)Septicemia | Indicates a diagnosis of septicemia - morbid condition associated with bacterial growth in the blood. |
| CHAR | 1 | 27a(J1c)Dehydrated - Output Exceeds Input | Indicates the patient is dehydrated - output exceeds input. |
| CHAR | 1 | 27b(J1e)Delusions | Indicates the patient has delusions - fixed, false beliefs not shared by others that the patient holds even when there is obvious proof or evidence to the contrary. |
| CHAR | 1 | 27c(J1h)Fever | Indicates the patient has a fever - a fever is present when the patient's temperature is 2.4 degrees greater than the baseline temperature. Many frail elders have normally low rectal baseline temperatures. |
| CHAR | 1 | 27d(J1i)Hallucinations | Indicates the patient has hallucinations - false perceptions that occur in the absence of any real stimuli. An hallucination may be auditory (hearing voices), visual (seeing people, animals), tactile (feeling bugs crawling over skin), olfactory (smelling poisonous fumes), or gustatory (having strange tastes). |
| CHAR | 1 | 27e(J1j)Internal Bleeding | Indicates the patient has internal bleeding - bleeding may be frank (such as bright red blood) or occult. |
| CHAR | 1 | 27f(J1o)Vomiting | Indicates the patient has a vomiting problem condition. |
| CHAR | 1 | 28(K3a)Unplanned Weight Loss | Indicates variations in the patient's weight over time: 5% or more lost in the last 30 days; 10% or more lost in the last 180 days. |
| CHAR | 1 | 29a(K5a)Parenteral IV | Indicates the patient is given intravenous (IV) fluids or hyperalimentation continuously or intermittently. |
| CHAR | 1 | 29b(K5b)Feeding Tube | Indicates the presence of any type of tube that can deliver food/nutritional substances/fluids/medications directly into the gastrointestinal system. |
| CHAR | 1 | 30a(K6a)Parenteral or Enteral Intake | A record of the proportion of calories received and the average fluid intake, through parenteral or tube feeding in the last seven days. |
| CHAR | 1 | 30b(K6b)Average Fluid Intake In Last 7 Days | The actual amount of fluid the patient received by IV or tube feeding in the last seven days. |
| CHAR | 1 | 31a(M1a)Ulcers - Stage 1 | A count of the number of stage 1 ulcers, regardless of cause, on any part of the body. Stage 1 is defined as a persistent area of skin redness (without a break in the skin) that does not disappear when pressure is relieved. |
| CHAR | 1 | 31b(M1b)Ulcers - Stage 2 | A count of the number of stage 2 ulcers, regardless of cause, on any part of the body. Stage 2 is defined as a partial thickness loss of skin layers that presents clinically as an abrasion, blister, or shallow crater. |
| CHAR | 1 | 31c(M1c)Ulcers - Stage 3 | A count of the number of stage 3 ulcers, regardless of cause, on any part of the body. Stage 3 is defined as a full thickness of skin is lost, exposing the subcutaneous tissues. Presents as a deep crater with or without undermining adjacent tissue. |
| CHAR | 1 | 31d(M1d)Ulcers - Stage 4 | A count of the number of stage 4 ulcers, regardless of cause, on any part of the body. Stage 4 is defined as a full thickness of skin and subcutaneous tissue is lost, exposing muscle or bone. |
| CHAR | 1 | 32(M2a)Pressure Ulcer | A determination of the highest stage for pressure ulcers that were present in the last 7 days. |
| CHAR | 1 | 33a(M4b)Burns (Second or Third Degree) | The presence of second or third degree burns from any cause (heat, chemicals) in any stage of healing. |
| CHAR | 1 | 33b(M4c)Open Lesions Other Than Ulcers, Rashes, Cuts | The presence of open lesions other than ulcers, rashes, cuts. Examples include lesions such as cancer lesions. |
| CHAR | 1 | 33c(M4g)Surgical Wounds | The presence of healing and non-healing, open or closed surgical incisions, skin grafts or drainage sites on any part of the body. This category does not include healed surgical sites or stomas. |
| CHAR | 1 | 34a(M5a)Pressure Relieving Device(s) for Chair | Indicates the patient has received pressure relieving device(s) for the chair to manage skin problems in the past seven days. Includes gel, air or other cushioning placed on a chair or wheelchair. |
| CHAR | 1 | 34b(M5b)Pressure Relieving Device(s) for Bed | Indicates the patient has received pressure relieving device(s) for the bed to manage skin problems in the past seven days. Includes air fluidized, low air loss therapy beds, flotation, water, or bubble mattress or pad placed on the bed. |
| CHAR | 1 | 34c(M5c)Turning/Repositioning Program | Indicates the patient has received turning/repositioning program to manage skin problems in the past seven days. Includes a continuous, consistent program for changing the patient's position and realigning the body. |
| CHAR | 1 | 34d(M5d)Nutrition/Hydration Intervention | Indicates the patient has received nutrition or hydration intervention to prevent or treat specific skin conditions in the past seven days. Includes wheat-free diet to prevent allergic dermatitis, high calorie diet with added supplements to prevent skin breakdown, high protein supplements for wound healing. |
| CHAR | 1 | 34e(M5e)Ulcer Care | Indicates the patient has received any intervention for treating an ulcer at any ulcer stage in the past seven days. Includes use of dressings, chemical or surgical debridement, wound irrigations, and hydrotherapy. |
| CHAR | 1 | 34f(M5f)Surgical Wound Care | Indicates the patient has received any intervention for treating or protecting any type of surgical wound in the last seven days. Includes topical cleansing, wound irrigation, application of antimicrobial ointments, dressings of any type, suture removal, and warm soaks or heat application. |
| CHAR | 1 | 34g(M5g)Application of Dressings | Indicates the patient has had dressings applied with or without topical medications to treat a skin condition in the past seven days. Includes dry gauze dressings, dressings moistened with saline or other solutions, transparent dressings, hydrogel dressings, and dressings with hydrocolloid or hydroactive particles. |
| CHAR | 1 | 34h(M5h)Application of Ointments/Medications | Indicates the patient has had ointments or medications applied to treat a skin condition in the past seven days. Includes cortisone, antifungal preparations, chemotherapeutic agents, etc. |
| CHAR | 1 | 35a(M6b)Infection of the Foot | Indicates the patient has a foot infection during the past seven days. Examples include cellulitis, purulent drainage. |
| CHAR | 1 | 35b(M6c)Open Lesions of the Foot | Indicates the patient has open foot lesions during the past seven days. Includes cuts, ulcers, and fissures. |
| CHAR | 1 | 35c(M6f)Application of Dressing (Foot) | Indicates the patient has dressings with or without topical medications applied on the foot during the past seven days. Includes dry gauze dressings, dressings moistened with saline or other solutions, transparent dressings, hydrogel dressings, and dressings with hydrocolloid or hydroactive particles. |
| CHAR | 1 | 36a(N1a)Time Awake - Morning | Identifies those periods of a typical morning (over the last seven days) when the patient was awake all or most of the time (no more than one hour nap during any such period). |
| CHAR | 1 | 36b(N1b)Time Awake - Afternoon | Identifies those periods of a typical afternoon (over the last seven days) when the patient was awake all or most of the time (no more than one hour nap during any such period). |
| CHAR | 1 | 36c(N1c)Time Awake - Evening | Identifies those periods of a typical evening (over the last seven days) when the patient was awake all or most of the time (no more than one hour nap during any such period). |
| CHAR | 1 | 37(O3)Injections | A determination of the number of days during the past seven days that the patient received any type of medication, antigen, vaccines (including influenza and pneumovax), and/or PPD tests, by subcutaneous, intramuscular or intradermal injection. |
| CHAR | 1 | 38aa(P1aa)Special Care - Chemotherapy | Indicates the patient received any type of chemotherapy given by any route. |
| CHAR | 1 | 38ab(P1ab)Special Care - Dialysis | Indicates the patient received dialysis. Includes peritoneal and renal dialysis. |
| CHAR | 1 | 38ac(P1ac)Special Care - IV Medication | Indicates the patient received IV medication. Includes any drug or biological given by intravenous push or drip through a central or peripheral port. |
| CHAR | 1 | 38ad(P1ag)Special Care - Oxygen Therapy | Indicates the patient received oxygen therapy. Includes continuous or intermittent oxygen via mask, cannula, etc. |
| CHAR | 1 | 38ae(P1ah)Special Care - Radiation | Indicates the patient received radiation. Includes radiation therapy or having a radiation implant. |
| CHAR | 1 | 38af(P1ai)Special Care - Suctioning | Indicates the patient received suctioning. Includes nasopharyngeal or tracheal aspiration. |
| CHAR | 1 | 38ag(P1aj)Special Care - Tracheostomy Care | Indicates the patient received tracheostomy care. Includes cleansing of tracheostomy and cannula. |
| CHAR | 1 | 38ah(P1ak)Special Care - Transfusions | Indicates the patient received transfusions. Includes transfusions of blood or any blood products which are administered directly into the bloodstream. |
| CHAR | 1 | 38ai(P1al)Special Care - Ventilator or Respirator | Indicates the patient received ventilator or respirator treatment. Includes any type of electrically or pneumatically powered closed system mechanical ventilatory support devices. |
| CHAR | 1 | 38baA(P1baA)Speech Language Pathology & Audiology - Days | Indicates the number of days of speech language pathology and audiology therapy the patient received in the last seven days. |
| CHAR | 4 | 38baB(P1baB)Speech Language Pathology & Audiology - Minutes | Indicates the total number of minutes of speech language pathology and audiology therapy the patient received during the past seven days. |
| CHAR | 1 | 38bbA(P1bbA)Occupational Therapy Days | Indicates the number of days of occupational therapy received by the patient for the past seven days. |
| CHAR | 4 | 38bbB(P1bbB)Occupational Therapy Minutes | Indicates the total number of minutes of occupational therapy received by the patient for the past seven days. |
| CHAR | 1 | 38bcA(P1bcA)Physical Therapy Days | Indicates the number of days of physical therapy received by the patient for the past seven days. |
| CHAR | 4 | 38bcB(P1bcB)Physical Therapy Minutes | Indicates the total number of minutes of physical therapy received by the patient for the past seven days. |
| CHAR | 1 | 38bdA(P1bdA)Respiratory Therapy Days | Indicates the number of days of respiratory therapy received by the patient for the past seven days. |
| CHAR | 4 | 38bdB(P1bdB)Respiratory Therapy Minutes | The total number of minutes of respiratory therapy received by the patient for the past seven days. |
| CHAR | 1 | 39a(P3a)Nursing Rehab: Range of Motion (Passive) | Indicates the extent to which the patient received passive range of motion nursing rehabilitation intervention. Range of motion exercise is a program of passive movements to maintain flexibility and useful motion in the joints of the body. The caregiver moves the body part around a fixed point or joint through the patient's available range of motion. |
| CHAR | 1 | 39b(P3b)Nursing Rehab: Range of Motion (Active) | Indicates the extent to which the patient received active range of motion nursing rehabilitation intervention. Range of motion exercise is a program of exercises performed by the patient, with cueing or supervision by staff, that are planned, scheduled, and documented. |
| CHAR | 1 | 39c(P3c)Nursing Rehab: Splint/Brace Assistance | Indicates the extent to which the patient received splint or brace assistance. Assistance can be of two types: 1) where staff provide verbal and physical guidance and direction that teaches the patient how to apply, manipulate, and care for a brace or splint, or 2) where staff have a scheduled program of applying removing a splint or brace. |
| CHAR | 1 | 39d(P3d)Nursing Rehab: Bed Mobility | Indicates the extent to which the patient participated in activities to improve or maintain his self-performance in moving to and from a lying position, turning side to side, and positioning him or herself in bed. |
| CHAR | 1 | 39e(P3e)Nursing Rehab: Transfer | Indicates the extent to which the patient participated in activities to improve or maintain his self-performance in moving between surfaces or planes either with or without assistive devices. |
| CHAR | 1 | 39f(P3f)Nursing Rehab: Walking | Indicates the extent to which the patient participated in activities to improve or maintain his self-performance in walking, with or without assistive devices. |
| CHAR | 1 | 39g(P3g)Nursing Rehab: Dressing or Grooming | Indicates the extent to which the patient participated in activities to improve or maintain his self-performance in dressing and undressing, bathing and washing, and performing other personal hygiene tasks. |
| CHAR | 1 | 39h(P3h)Nursing Rehab: Eating or Swallowing | Indicates the extent to which the patient participated in activities to improve or maintain his self-performance in feeding himself food and fluids, or activities used to improve or maintain his ability to ingest nutrition and hydration by mouth. |
| CHAR | 1 | 39i(P3i)Nursing Rehab: Amputation/Prosthesis Care | Indicates the extent to which the patient participated in activities to improve or maintain his self-performance in putting on and removing a prosthesis, caring for the prosthesis, and providing appropriate hygiene at the site where the prosthesis attaches to the body. |
| CHAR | 1 | 39j(P3j)Nursing Rehab: Communication | Indicates the extent to which the patient participated in activities to improve or maintain his self-performance in using newly acquired communication skills or assisting him in using residual communication skills and adaptive devices. |
| CHAR | 2 | 40(P7)Physician Visits | Indicates the number of days during the last 14-day period a physician has examined the patient. |
| CHAR | 2 | 41(P8)Physician Orders | Indicates the number of days during the last 14-day period in which a physician has changed the patient's orders. |
| CHAR | 1 | 42a(T1b)Ordered Therapies | Indicates if the physician ordered any of the therapy services to begin in the first 14 days of stay: physical therapy, occupational therapy or speech pathology services. |
| CHAR | 2 | 42b(T1c)Ordered Therapies - Days | Estimated number of days at least one therapy service is expected to be delivered through the patient's fifteenth day of admission. |
| CHAR | 4 | 42c(T1d)Ordered Therapies - Minutes | Estimated total number of minutes of therapy the patient is expected to receive through his fifteenth day of admission. |
| CHAR | 5 | 43-Medicare (T3)Case Mix Group - Medicare | The software will calculate the RUG-III classification for the Medicare program using the 44-Group Version 5.12 RUG-III Classification. |
| CHAR | 5 | 43-State(T3)Case Mix Group - State | If the state requires the completion of the SB-MDS assessment for Medicaid swing bed payment, and the State uses a version of the RUG-III system, the Medicaid RUG-III group may be coded on the SB-MDS. RAVEN-SB does not include a State Medicaid classification program, and will NOT calculate the RUG-III group needed for state payment. |
| CHAR | 5 | 44HIPPS Code | The HIPPS (Health Insurance Prospective Payment System) codes are 5-character codes used solely for billing the Medicare Part A stay under the SNF PPS. The codes reflect the 3-character RUG-III group into which the patient is classified, and a two-character assessment indicator. |
| DATE | 8 | 45b(R2b)Signature Completion Date | The date RN Assessment Coordinator signed the assessment as complete. |