MDS Data Documentation - individual assessment
(Excel formatted original source document)
(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.
| MDS Data Dictionary - individual assessment | ||||
| CASPER Field Name | Field Description | Data Type | Data Length | Code Values |
| A10A_LIVING_WILL | Identification and Background Information - Advanced Directives - Living Will. | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| A10B_NOT_RECESS | Identification and Background Information - Advanced Directives - Do not resuscitate. | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| A10C_NOT_HOSPTIAL | Identification and Background Information - Advanced Directives - Do not hospitalize. | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| A10D_ORGAN_DONATE | Identification and Background Information - Advanced Directives - Organ donation. | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| A10E_AUTOPSY_REQ | Identification and Background Information - Advanced Directives - Autopsy request. | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| A10F_FEED_RESTRICT | Identification and Background Information - Advanced Directives - Feeding restrictions. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| A10G_MED_RESTRICT | Identification and Background Information - Advanced Directives - Medication restrictions. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| A10H_OTH_TRT_REST | Identification and Background Information - Advanced Directives - Other treatment restrictions. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| A10I_NONE_ABOVE | Identification and Background Information - Advanced Directives - None of Above. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| A2_ROOM_NUM | Identification and Background Information - Room Number | VARCHAR2 | 5 | |
| A3A_ASSESS_REF_DT | Identification and Background Information - Last Day of MDS Observation Period | DATE | 8 | |
| A4A_REENTRY_DT | Identification and Background Information - Date of Reentry | DATE | 8 | |
| A4B_ADMIT_FROM | Identification and Background Information - Admitted from (at Re-entry). 1 - Private home/ apt. with no home health services, 2 - Private home/ apt. with home health services, 3 - Board and care/ assisted living/ group home, 4 - Nursing Home, 5 - Acute care hospital, 6 - Psychiatric hospital, MR/ DD facility, 7 - Rehabilitation Hospital, 8 - Other | NUMBER | 1 | 1=Private home/apt. with no home health services, 2=Private home/apt. with home health services, 3=Board and care/assisted living/group home, 4=Nursing Home, 5=Acute Care Hospital, 6=Psychiatric Hospital, MR/DD facility, 7=Rehabilitation Hospital, 8=Other, -1=Unknown |
| A5_MARTIAL_STATUS | Identification and Background Information - Marital Status. 1 - Never Married, 2 - Married, 3 - Widowed, 4 - Separated, 5 - Divorced | NUMBER | 1 | 1=Never Married, 2=Married, 3=Widowed, 4=Seperated, 5=Divorced, -1=Unknown |
| A6_MEDICAL_REC_NUM | Identification and Background Information - Medical Record No. | VARCHAR2 | 12 | |
| A7A_MCAID_PER_DIEM | Identification and Background Information - Current Payment Sources - Medicaid per diem. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| A7B_MCARE_PER_DIEM | Identification and Background Information - Current Payment Sources - Medicare per diem. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| A7C_MCARE_ANC_P_A | Identification and Background Information - Current Payment Sources - Medicare ancillary part A. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| A7D_MCARE_ANC_P_B | Identification and Background Information - Current Payment Sources - Medicare ancillary part B. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| A7E_CHAMPUS_P_D | Identification and Background Information - Current Payment Sources - CHAMPUS per diem. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| A7F_VA_PER_DIEM | Identification and Background Information - Current Payment Sources - VA per diem. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| A7G_SELF_FAM_PAY | Identification and Background Information - Current Payment Sources - Self or family pays for per diem. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| A7H_MCAID_MCARE | Identification and Background Information - Current Payment Sources - Medicaid resident liability or Medicare copay. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| A7I_PRIVATE_PAY | Identification and Background Information - Current Payment Sources - Private insurance per diem. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| A7J_OTHER | Identification and Background Information - Current Payment Sources - Other per diem. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| A9A_LEGAL_GUARDIAN | Identification and Background Information - Responsibility/ Legal Guardian - Legal guardian. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| A9B_OTH_LGL_OVRSGHT | Identification and Background Information - Responsibility/ Legal Guardian - Other legal oversight. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| A9C_DUR_POA_HTLCRE | Identification and Background Information - Responsibility/ Legal Guardian - Durable power attorney/ health. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| A9D_DUR_POA_FIN | Identification and Background Information - Responsibility/ Legal Guardian - Durable power attorney/ financial. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| A9E_FAM_MEM_RESP | Identification and Background Information - Responsibility/ Legal Guardian - Family member responsible. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| A9F_PAT_RESP_SELF | Identification and Background Information - Responsibility/ Legal Guardian - Patient responsible for self. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| A9G_NONE_ABOVE | Identification and Background Information - Responsibility/ Legal Guardian - None of Above. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| AA1A_FIRST_NM | Resident First Name | VARCHAR2 | 12 | |
| AA1B_MIDDLE_INTIAL | Resident Middle Initial | VARCHAR2 | 1 | |
| AA1C_LAST_NM | Resident Last Name | VARCHAR2 | 18 | |
| AA1D_NAME_SUFFIX | Resident Name Suffix | VARCHAR2 | 3 | |
| AA2_GENDER | Resident's Gender. 1 - Male, 2 - Female | NUMBER | 1 | 1=Male, 2=Female, -1=Unknown |
| AA3_BIRTH_DT | Resident's Birthdate. If only year (YYYY) was submitted the Month is defaulted to 01 and the Day is defaulted to 01. If only the Month and Year are submitted, the day is defaulted to 01. If this field is null, either no date was submitted or an invalid date was submitted. | DATE | 8 | |
| AA4_RACE_ETH | Resident's Race/ Ethnicity. 1 - American Indian/ Alaskan Native,2 - Asian/ Pacific Islander, 3 - Black, not of Hispanic origin, 4 - Hispanic, 5 - White, not of Hispanic origin | NUMBER | 1 | 1=American Indian/Alaskan Native, 2=Asian/Pacific Islander, 3=Black, not of Hispanic origin, 4=Hispanic, 5=White, not of Hispanic origin, -1=Unknown |
| AA5A_SSN_NUM | Social Security Number | VARCHAR2 | 9 | |
| AA5B_PAT_MCARE_NBR | Medicare Number (or comparable number) | VARCHAR2 | 12 | |
| AA6A_FAC_MCAID_NBR | State Facility Provider Number | VARCHAR2 | 15 | |
| AA6B_FAC_MCARE_NBR | Federal Facility Provider Number | VARCHAR2 | 12 | |
| AA7_PAT_MCAID_NBR | Medicaid Number | VARCHAR2 | 14 | |
| AA8A_PRI_RFA | Primary Reason for Assessment. 1 - Admission assessment, 2 - Annual assessment, 3 - Significant change in status assessment, 4 - Significant correction to full prior assessment, 5 - Quarterly review assessment, 6 - Discharged-Return not anticipated, 7 - Discharged-Return anticipated, 8 - Discharged prior to completing initial assessment, 9 - Reentry Tracking record, 10 - Significant correction to prior quarterly assessment, 0 - NONE OF ABOVE | VARCHAR2 | 2 | 01=Admission Assessment (required by day 14) , 02=Annual Assessment , 03=Significant change in status assessment , 04=Significant correction of prior full assessment , 05=Quarterly review assessment , 06=Discharged - return not anticipated , 07=Discharged - return anticipated , 08=Discharged prior to completing initial assessment , 09=Reentry , 10=Significant correction of prior quarterly assessment , 00=None of the above , -=Unknown |
| AA8B_SPC_RFA | Special Reason for Assessment. 1 - Medicare 5-day assessment, 2 - Medicare 30-day assessment, 3 - Medicare 60-day assessment, 4 - Medicare 90-day assessment, 5 - Medicare readmission/ return assessment, 6 - Other state required assessment, 7 - Medicare 14-day assessment, 8 - Other Medicare required assessment | VARCHAR2 | 1 | =Space , 01=Medicare 5 day assessment , 02=Medicare 30 day assessment , 03=Medicare 60 day assessment , 04=Medicare 90 day assessment , 05=Medicare readmission/return assessment , 06=Other state required assessment , 07=Medicare 14 day assessment , 08=Other Medicare required assessment , -=Unknown |
| AB10A_MR_DD_NA | Demographic Information - Conditions Related to MR/ DD Status - Non-applicable--no MR/ DD. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| AB10B_MR_DD_DOWNS | Demographic Information - Conditions Related to MR/ DD Status - Down's Syndrome. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| AB10C_MR_DD_AUTISM | Demographic Information - Conditions Related to MR/ DD Status - Autism. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| AB10D_MR_DD_EPI | Demographic Information - Conditions Related to MR/ DD Status - MR/ DD With Organic Condition - Epilespy. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| AB10E_MR_DD_OTH | Demographic Information - Conditions Related to MR/ DD Status - MR/ DD With Organic Condition - Other Organic Condition Related to MR/ DD. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| AB10F_MR_DD_NO_ORG | Demographic Information - Conditions Related to MR/ DD Status - MR/ DD With Organic Condition - MR/ DD with no Organic Condition. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| AB11_BACKGRD_CP_DT | Demographic Information - Date Background Information Completed. | DATE | 8 | |
| AB1_ENTRY_DT | Demographic Information -Date of Entry | DATE | 8 | |
| AB2_ADMIT_FROM | Demographic Information - Admitted from (at Entry). . 1 - Private home/ apt. with no home health services, 2 - Private home/ apt. with home health services, 3 - Board and care/ assisted living/ group home, 4 - Nursing Home, 5 - Acute care hospital, 6 - Psychiatric hospital, MR/ DD facility, 7 - Rehabilitation Hospital, 8 - Other | NUMBER | 1 | 1=Private home/apt. with no home health services, 2=Private home/apt. with home health services, 3=Board and care/assisted living/group home, 4=Nursing Home, 5=Acute Care Hospital, 6=Psychiatric Hospital, MR/DD facility, 7=Rehabilitation Hospital, 8=Other, -1=Unknown |
| AB3_LIVED_ALONE | Demographic Information - Lived Alone (Prior to Entry).0 - No, 1 - Yes, 2 - In other facility | NUMBER | 1 | 0=No, 1=Yes, 2=Other, -1=Unknown |
| AB4_PRIOR_ZIP | Demographic Information - Zip Code of Prior Primary Residence | VARCHAR2 | 5 | |
| AB5A_PRIOR_THIS_NF | Demographic Information - Residential History Prior to Entry - Prior Stay at this Nursing Home. 0 - No, 1 - Yes, '-' - Unknown | NUMBER | 1 | 0=No , 1=Yes , -2=Space , -1=Unknown |
| AB5B_PRIOR_OTH_NF | Demographic Information - Residential History Prior to Entry - Stay in other Nursing Home. 0 - No, 1 - Yes, '-' - Unknown | NUMBER | 1 | 0=No , 1=Yes , -2=Space , -1=Unknown |
| AB5C_OTH_RF | Demographic Information - Residential History Prior to Entry - Other Residential Facility. 0 - No, 1 - Yes, '-' - Unknown | NUMBER | 1 | 0=No , 1=Yes , -2=Space , -1=Unknown |
| AB5D_PRIOR_PSHCH | Demographic Information - Residential History Prior to Entry - MH/ psychiatric Setting. 0 - No, 1 - Yes, '-' - Unknown | NUMBER | 1 | 0=No , 1=Yes , -2=Space , -1=Unknown |
| AB5E_PRIOR_MR_DD | Demographic Information - Residential History Prior to Entry - MR/ DD Setting. 0 - No, 1 - Yes, '-' - Unknown | NUMBER | 1 | 0=No , 1=Yes , -2=Space , -1=Unknown |
| AB5F_NONE_ABOVE | Demographic Information - Residential History Prior to Entry - None of Above. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| AB6_LIFE_OCCUP | Demographic Information - Lifetime Occuption(s) | VARCHAR2 | 21 | |
| AB7_EDUCATION | Demographic Information - Education (Highest Level Completed). 1 - No schooling, 2 - 8th grade/ less, 3 - 9-11 grades, 4 - High school, 5 - Technical or trade school, 6 - Some college, 7 - Bachelor's degree, 8 - Graduate degree | NUMBER | 1 | 1=No Schooling, 2=8th grade/less, 3=9-11 grades, 4=High School, 5=Techical or Trade School, 6=Some College, 7=Bachelor's Degree, 8=Graduate Degree, -1=Unknown |
| AB8A_PRI_LANG | Demographic Information - Primary Language. 0 - English, 1 - Spanish, 2 - French, 3 - Other | NUMBER | 1 | 0=English, 1=Spanish, 2=French, 3=Other, -1=Unknown |
| AB8B_OTH_LANG | Demographic Information - If other (language), specify | VARCHAR2 | 9 | |
| AB9_MH_HISTORY | Demographic Information - Mental Health History. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| AC1A_LATE_NITE | Customary Routine - Cycle of Daily Events - Stays Up Late At Night. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| AC1B_NAPS | Customary Routine - Cycle of Daily Events - Naps Regularly During Day. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| AC1C_OUT_1_WEEK | Customary Routine - Cycle of Daily Events - Goes Out 1+ Days a Week. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| AC1D_STAY_BUSY | Customary Routine - Cycle of Daily Events - Stays Busy with Hobbies/ Fixed Routine. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| AC1E_TIME_ALONE | Customary Routine - Cycle of Daily Events - Spends Most Time Alone or TV. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| AC1F_INDEP_INDOOR | Customary Routine - Cycle of Daily Events - Moves Independently Indoors. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| AC1G_TOBAC_DAILY | Customary Routine - Cycle of Daily Events - Use of Tobacco Daily. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| AC1H_NONE_ABOVE | Customary Routine - Cycle of Daily Events - None of Above. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| AC1I_FOOD_PREF | Customary Routine - Eating Patterns - Distinct Food Preferences. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| AC1J_EAT_BTWN_MEAL | Customary Routine - Eating Patterns - Eats Between Meals Most Days. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| AC1K_ALC_WEEKLY | Customary Routine - Eating Patterns - Use of alcohol/ weekly. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| AC1L_NONE_ABOVE | Customary Routine - Eating Patterns - None of Above. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| AC1M_BEDCTHS_DAY | Customary Routine - ADL Patterns - In Bedclothers Much of Day. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| AC1N_TOLIET_NIGHT | Customary Routine - ADL Patterns - Wakens to Toilet Most Nights. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| AC1O_IRREG_BOWEL | Customary Routine - ADL Patterns - Has Irregular Bowel Movement Pattern. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| AC1P_SHOWERS | Customary Routine - ADL Patterns - Showers for Bathing. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| AC1Q_BATH_PM | Customary Routine - ADL Patterns - Bathing in PM. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| AC1R_NONE_ABOVE | Customary Routine - ADL Patterns - None of Above. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| AC1S_CONTACT_REL | Customary Routine - Involvement Patterns - Daily Contact with Relatives/ Friends. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| AC1T_ATTEND_CHURCH | Customary Routine - Involvement Patterns - Usually Attends Church, Temple, etc.. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| AC1U_STRGHT_FAITH | Customary Routine - Involvement Patterns - Finds Strength in Faith. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| AC1V_ANIMAL | Customary Routine - Involvement Patterns - Daily Animal Companion. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| AC1W_GROUP_ACT | Customary Routine - Involvement Patterns - Involved in Group Activities. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| AC1X_NONE_ABOVE | Customary Routine - Involvement Patterns - None of Above. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| AC1Y_UNKNOWN | Customary Routine - Involvement Patterns - Unknown Customary Routine. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| AST_BEG_VER_DT | Date of the submission file that contains the version of this assessment | DATE | 8 | |
| AST_CORR_VER | Number of the assessment. 00 = Original, 01 = First Correction, 02 = Second Correction, etc. | NUMBER | 2 | |
| AST_END_VER_DT | Date of the submission file that contains the correction or inactivation request of this assessment. | DATE | 8 | |
| AST_MOD_IND | Designates Version of the assessment. C = Current, M = Modified, X = Inactive | VARCHAR2 | 1 | |
| B1_COMATOSE | Cognitive Patterns - Comatose. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| B2A_ST_MEMORY | Cognitive Patterns - Short-term memory OK. 0 - Memory OK, 1 - Memory problem | NUMBER | 1 | -2=Space, 0=Memory OK, 1=Memory Problem, -1=Unknown |
| B2B_LT_MEMORY | Cognitive Patterns - Long-term memory OK. 0 - Memory OK, 1 - Memory problem | NUMBER | 1 | -2=Space, 0=Memory OK, 1=Memory Problem, -1=Unknown |
| B3A_CURNT_SEASON | Cognitive Patterns - Memory/ Recall Ability - Current Season. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| B3B_LOC_OWN_ROOM | Cognitive Patterns - Memory/ Recall Ability - Location of own room. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| B3C_STAFF | Cognitive Patterns - Memory/ Recall Ability - Staff names/ faces. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| B3D_IN_HOME | Cognitive Patterns - Memory/ Recall Ability - That he/ she in nursing home. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| B3E_NONE_ABOVE | Cognitive Patterns - Memory/ Recall Ability - None of Above. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| B4_DAY_DCSN_MAKING | Cognitive Patterns - Cognitive Skills/ Daily Decision Making. 0 - Independent, 1 - Modified Independence, 2 - Moderately Impaired, 3 - Severely Impaired | NUMBER | 1 | -2=Space, 0=Independent - decisions consistent/reasonable, 1=Modified Independence - some difficulty in new situations only, 2=Moderately Impaired - decisions poor; cues/supervision required, 3=Severly Impaired - never/rarely made decisions, -1=Unknown |
| B5A_DISTRACTED | Cognitive Patterns - Indicators of Delirium - Easily distracted. 0 - Behavior not present, 1 - Behavior present, not of recent onset, 2 - Behavior present, over last 7 days appears different from resident's usual functioning | NUMBER | 1 | -2=Space, 0=Behavior not present, 1=Behavior present, not of recent onset, 2=Behavior present, over last 7 days appears different from residents usual functioning (e.g., new onset or worsening), -1=Unknown |
| B5B_ALTER_PERCEPT | Cognitive Patterns - Indicators of Delirium - Periods of altered perception/ awareness. 0 - Behavior not present, 1 - Behavior present, not of recent onset, 2 - Behavior present, over last 7 days appears different from resident's usual functioning | NUMBER | 1 | -2=Space, 0=Behavior not present, 1=Behavior present, not of recent onset, 2=Behavior present, over last 7 days appears different from residents usual functioning (e.g., new onset or worsening), -1=Unknown |
| B5C_DISORG_SPEECH | Cognitive Patterns - Indicators of Delirium - Episodes of disorganized speech. 0 - Behavior not present, 1 - Behavior present, not of recent onset, 2 - Behavior present, over last 7 days appears different from resident's usual functioning | NUMBER | 1 | -2=Space, 0=Behavior not present, 1=Behavior present, not of recent onset, 2=Behavior present, over last 7 days appears different from residents usual functioning (e.g., new onset or worsening), -1=Unknown |
| B5D_RESTLESS | Cognitive Patterns - Indicators of Delirium - Periods of restlessness. 0 - Behavior not present, 1 - Behavior present, not of recent onset, 2 - Behavior present, over last 7 days appears different from resident's usual functioning | NUMBER | 1 | -2=Space, 0=Behavior not present, 1=Behavior present, not of recent onset, 2=Behavior present, over last 7 days appears different from residents usual functioning (e.g., new onset or worsening), -1=Unknown |
| B5E_LETHARGY | Cognitive Patterns - Indicators of Delirium - Periods of lethargy. 0 - Behavior not present, 1 - Behavior present, not of recent onset, 2 - Behavior present, over last 7 days appears different from resident's usual functioning | NUMBER | 1 | -2=Space, 0=Behavior not present, 1=Behavior present, not of recent onset, 2=Behavior present, over last 7 days appears different from residents usual functioning (e.g., new onset or worsening), -1=Unknown |
| B5F_MENTAL_FUNC | Cognitive Patterns - Indicators of Delirium - Mental function varies during day. 0 - Behavior not present, 1 - Behavior present, not of recent onset, 2 - Behavior present, over last 7 days appears different from resident's usual functioning | NUMBER | 1 | -2=Space, 0=Behavior not present, 1=Behavior present, not of recent onset, 2=Behavior present, over last 7 days appears different from residents usual functioning (e.g., new onset or worsening), -1=Unknown |
| B6_CHANG_COG_STAT | Cognitive Patterns - Indicators of Delirium - Change in Cognitive Status. 0 - No Change, 1 - Improved, 2 - Deteriorated | NUMBER | 1 | 0=No Change, 1=Improved - receives fewer supports, needs less restrictive level of care, 2=Deteriorated - receives more support, -1=Unknown |
| C1_HEARING | Communications/ Hearing Patterns - Hearing. 0 - Hears Adequately, 1 - Minimal Difficulty, 2 - Hears in Special Situations Only, 3 - Highly Impaired | NUMBER | 1 | -2=Space, 0=Hears Adequately - normal talk, TV, phone, 1=Minimal Difficulty when not in quiet setting, 2=Hears in special situations only - speaker has to adjust tonal quality and speak distinctly, 3=Highly Impaired/absence of useful hearing, -1=Unknown |
| C2A_HEARAID_USED | Communications/ Hearing Patterns - Communication Devices/ Techniques - Hearing aid present/ used. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| C2D_HRAID_NOT_USE | Communications/ Hearing Patterns - Communication Devices/ Techniques - Hearing aid present/ not used regularly. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| C2C_OTHER_RECEP | Communications/ Hearing Patterns - Communication Devices/ Techniques - Other receptive comm. Techniques used. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| C2D_NONE_ABOVE | Communications/ Hearing Patterns - Communication Devices/ Techniques - None of Above. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| C3A_SPEECH | Communications/ Hearing Patterns - Modes of Expression - Speech. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| C3B_WRITE | Communications/ Hearing Patterns - Modes of Expression - Writing messages. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| C3C_SIGN_LANG | Communications/ Hearing Patterns - Modes of Expression - American Sign language/ Braille. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| C3D_GESTURES | Communications/ Hearing Patterns - Modes of Expression - Signs/ gestures/ sounds. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| C3E_COMM_BOARD | Communications/ Hearing Patterns - Modes of Expression - Communication board. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| C3F_OTHER | Communications/ Hearing Patterns - Modes of Expression - Other. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| C3G_NONE_ABOVE | Communications/ Hearing Patterns - Modes of Expression - None of Above. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| C4_IS_UNDERSTOOD | Communications/ Hearing Patterns - Making Self Understood. 0 - Understood, 1 - Usually Understood, 2 - Sometimes Understood, 3 - Rarely/ Never Understood | NUMBER | 1 | -2=Space, 0=Understood, 1=Usually Understood - difficulty finding words or finishing thoughts, 2=Sometimes Understood - ablility is limited to making concrete requests, 3=Rarely/Never Understood, -1=Unknown |
| C5_SPEECH_CLARITY | Communications/ Hearing Patterns - Speech Clarity. 0 - Clear Speech, 1 - Unclear Speech, 2 - No Speech | NUMBER | 1 | -2=Space, 0=Clear Speech - distinct, intelligible words, 1=Unclear Speech - slurred, mumbled words, 2=No Speech - absence of spoken words, -1=Unknown |
| C6_UNDERSTAND_OTH | Communications/ Hearing Patterns - Ability to Understand Others. 0 - Understands, 1 - Usually Understands, 2 - Sometimes Understands, 3 - Rarely/ Never Understands | NUMBER | 1 | -2=Space, 0=Understands, 1=Usually Understands - may miss some part/intent of message, 2=Sometimes Understands - responds adequately to simple, direct communication, 3=Rarely/Never Understands, -1=Unknown |
| C7_CHANGE_IN_COMM | Communications/ Hearing Patterns - Change in Communication/ Hearing. 0 - No Change, 1 - Improved, 2 - Deteriorated | NUMBER | 1 | 0=No Change, 1=Improved - receives fewer supports, needs less restrictive level of care, 2=Deteriorated - receives more support, -1=Unknown |
| CARE_LOCK | CARE PLANNING LOCK DATE | DATE | 8 | |
| CREATED_DATE | This is the date the row was inserted in the assessment table in the state system | DATE | 8 | |
| D1_VISION | Vision Patterns - Vision. 0=Adequate 1=Impaired 2=Moderately Impaired 3=Highly Impaired 4=Severely Impaired (-)=Unknown (sp)=Blank | NUMBER | 1 | -2=Space, 0=Adequate - sees fine detail, including regular print in newpapers/books, 1=Impaired - sees larged print, but not regular print in newpapers/books, 2=Moderately Impaired - limited vision; not able to see newspaper headlines, but can identify ob |
| D2A_SIDE_VISN_PROB | Vision Patterns - Visual Limitations/ Difficulties - Side vision problems. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| D2B_FLASHES_LIGHT | Vision Patterns - Visual Limitations/ Difficulties - Sees halos/ rings/ flashes/ curtains. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| D2C_NONE_ABOVE | Vision Patterns - Visual Limitations/ Difficulties - None of Above. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| D3_VISUAL_APP | Vision Patterns - Visual Appliances. 0=No 1=Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| E1A_NEG_STATE | Mood and Behavior Patterns - Indicators of Depression, Anxiety, Sad Mood - Verbal Expressions of Distress - Negative statements. 0=Indicator not exhibited in last 30 days 1=Indicator of this type exhibited up to five days a week 2=Indicator of this type exhibited daily or almost daily (6, 7 days a week) (-)=Unknown (sp)=Blank | NUMBER | 1 | -2=Space, 0=Indicator not exhibited in last 30 days, 1=Indicator of this type exhibited up to five days a week, 2=Indicator of this type exhibited daily or almost daily (6, 7 days a week), -1=Unknown |
| E1B_REPEAT_QUES | Mood and Behavior Patterns - Indicators of Depression, Anxiety, Sad Mood - Verbal Expressions of Distress - Repetitive questions. 0=Indicator not exhibited in last 30 days 1=Indicator of this type exhibited up to five days a week 2=Indicator of this type exhibited daily or almost daily (6, 7 days a week) (-)=Unknown (sp)=Blank | NUMBER | 1 | -2=Space, 0=Indicator not exhibited in last 30 days, 1=Indicator of this type exhibited up to five days a week, 2=Indicator of this type exhibited daily or almost daily (6, 7 days a week), -1=Unknown |
| E1C_REPEAT_VERB | Mood and Behavior Patterns - Indicators of Depression, Anxiety, Sad Mood - Verbal Expressions of Distress - Repetitive verbalizations. 0=Indicator not exhibited in last 30 days 1=Indicator of this type exhibited up to five days a week 2=Indicator of this type exhibited daily or almost daily (6, 7 days a week) (-)=Unknown (sp)=Blank | NUMBER | 1 | -2=Space, 0=Indicator not exhibited in last 30 days, 1=Indicator of this type exhibited up to five days a week, 2=Indicator of this type exhibited daily or almost daily (6, 7 days a week), -1=Unknown |
| E1D_PRST_ANGER | Mood and Behavior Patterns - Indicators of Depression, Anxiety, Sad Mood - Verbal Expressions of Distress - Persistent anger with self/ others. 0=Indicator not exhibited in last 30 days 1=Indicator of this type exhibited up to five days a week 2=Indicator of this type exhibited daily or almost daily (6, 7 days a week) (-)=Unknown (sp)=Blank | NUMBER | 1 | -2=Space, 0=Indicator not exhibited in last 30 days, 1=Indicator of this type exhibited up to five days a week, 2=Indicator of this type exhibited daily or almost daily (6, 7 days a week), -1=Unknown |
| E1E_SELF_DEPER | Mood and Behavior Patterns - Indicators of Depression, Anxiety, Sad Mood - Verbal Expressions of Distress - Self deprecation. 0=Indicator not exhibited in last 30 days 1=Indicator of this type exhibited up to five days a week 2=Indicator of this type exhibited daily or almost daily (6, 7 days a week) (-)=Unknown (sp)=Blank | NUMBER | 1 | -2=Space, 0=Indicator not exhibited in last 30 days, 1=Indicator of this type exhibited up to five days a week, 2=Indicator of this type exhibited daily or almost daily (6, 7 days a week), -1=Unknown |
| E1F_UNREAL_FEARS | Mood and Behavior Patterns - Indicators of Depression, Anxiety, Sad Mood - Verbal Expressions of Distress - Expression of What Appears to be Unrealistic Fears. 0=Indicator not exhibited in last 30 days 1=Indicator of this type exhibited up to five days a week 2=Indicator of this type exhibited daily or almost daily (6, 7 days a week) (-)=Unknown (sp)=Blank | NUMBER | 1 | -2=Space, 0=Indicator not exhibited in last 30 days, 1=Indicator of this type exhibited up to five days a week, 2=Indicator of this type exhibited daily or almost daily (6, 7 days a week), -1=Unknown |
| E1G_TERRIBLE_FEEL | Mood and Behavior Patterns - Indicators of Depression, Anxiety, Sad Mood - Verbal Expressions of Distress - Recurrent Statements that Something is About to Happen. 0=Indicator not exhibited in last 30 days 1=Indicator of this type exhibited up to five days a week 2=Indicator of this type exhibited daily or almost daily (6, 7 days a week) (-)=Unknown (sp)=Blank | NUMBER | 1 | -2=Space, 0=Indicator not exhibited in last 30 days, 1=Indicator of this type exhibited up to five days a week, 2=Indicator of this type exhibited daily or almost daily (6, 7 days a week), -1=Unknown |
| E1H_HLTH_COMPLAIN | Mood and Behavior Patterns - Indicators of Depression, Anxiety, Sad Mood - Verbal Expressions of Distress - Repetitive Health Complaints. 0=Indicator not exhibited in last 30 days 1=Indicator of this type exhibited up to five days a week 2=Indicator of this type exhibited daily or almost daily (6, 7 days a week) (-)=Unknown (sp)=Blank | NUMBER | 1 | -2=Space, 0=Indicator not exhibited in last 30 days, 1=Indicator of this type exhibited up to five days a week, 2=Indicator of this type exhibited daily or almost daily (6, 7 days a week), -1=Unknown |
| E1I_ANX_COMP | Mood and Behavior Patterns - Indicators of Depression, Anxiety, Sad Mood - Verbal Expressions of Distress - Repetitive Anxious Complaints/ Concerns - Non-Health Related. 0=Indicator not exhibited in last 30 days 1=Indicator of this type exhibited up to five days a week 2=Indicator of this type exhibited daily or almost daily (6, 7 days a week) (-)=Unknown (sp)=Blank | NUMBER | 1 | -2=Space, 0=Indicator not exhibited in last 30 days, 1=Indicator of this type exhibited up to five days a week, 2=Indicator of this type exhibited daily or almost daily (6, 7 days a week), -1=Unknown |
| E1J_UNPLEAS_MORN | Mood and Behavior Patterns - Indicators of Depression, Anxiety, Sad Mood - Sleep Cycle Issues - Unpleasant Mood in Morning. 0=Indicator not exhibited in last 30 days 1=Indicator of this type exhibited up to five days a week 2=Indicator of this type exhibited daily or almost daily (6, 7 days a week) (-)=Unknown (sp)=Blank | NUMBER | 1 | -2=Space, 0=Indicator not exhibited in last 30 days, 1=Indicator of this type exhibited up to five days a week, 2=Indicator of this type exhibited daily or almost daily (6, 7 days a week), -1=Unknown |
| E1K_INSOMINA | Mood and Behavior Patterns - Indicators of Depression, Anxiety, Sad Mood - Sleep Cycle Issues - Insomnia/ change in sleeping pattern. 0=Indicator not exhibited in last 30 days 1=Indicator of this type exhibited up to five days a week 2=Indicator of this type exhibited daily or almost daily (6, 7 days a week) (-)=Unknown (sp)=Blank | NUMBER | 1 | -2=Space, 0=Indicator not exhibited in last 30 days, 1=Indicator of this type exhibited up to five days a week, 2=Indicator of this type exhibited daily or almost daily (6, 7 days a week), -1=Unknown |
| E1L_WORRIED_FACE | Mood and Behavior Patterns - Indicators of Depression, Anxiety, Sad Mood - Sad/ Apathetic/ Anxious Appearance - Sad/ Pained/ Worried Facial Expressions. 0=Indicator not exhibited in last 30 days 1=Indicator of this type exhibited up to five days a week 2=Indicator of this type exhibited daily or almost daily (6, 7 days a week) (-)=Unknown (sp)=Blank | NUMBER | 1 | -2=Space, 0=Indicator not exhibited in last 30 days, 1=Indicator of this type exhibited up to five days a week, 2=Indicator of this type exhibited daily or almost daily (6, 7 days a week), -1=Unknown |
| E1M_CRYING | Mood and Behavior Patterns - Indicators of Depression, Anxiety, Sad Mood - Sad/ Apathetic/ Anxious Appearance - Crying/ Tearfulness. 0=Indicator not exhibited in last 30 days 1=Indicator of this type exhibited up to five days a week 2=Indicator of this type exhibited daily or almost daily (6, 7 days a week) (-)=Unknown (sp)=Blank | NUMBER | 1 | -2=Space, 0=Indicator not exhibited in last 30 days, 1=Indicator of this type exhibited up to five days a week, 2=Indicator of this type exhibited daily or almost daily (6, 7 days a week), -1=Unknown |
| E1N_REPEAT_MOVES | Mood and Behavior Patterns - Indicators of Depression, Anxiety, Sad Mood - Sad/ Apathetic/ Anxious Appearance - Repetitive Physical Movements. 0=Indicator not exhibited in last 30 days 1=Indicator of this type exhibited up to five days a week 2=Indicator of this type exhibited daily or almost daily (6, 7 days a week) (-)=Unknown (sp)=Blank | NUMBER | 1 | -2=Space, 0=Indicator not exhibited in last 30 days, 1=Indicator of this type exhibited up to five days a week, 2=Indicator of this type exhibited daily or almost daily (6, 7 days a week), -1=Unknown |
| E1O_WITHDRAWN | Mood and Behavior Patterns - Indicators of Depression, Anxiety, Sad Mood - Loss of Interest - Withdrawal From Activities of Interest. 0=Indicator not exhibited in last 30 days 1=Indicator of this type exhibited up to five days a week 2=Indicator of this type exhibited daily or almost daily (6, 7 days a week) (-)=Unknown (sp)=Blank | NUMBER | 1 | -2=Space, 0=Indicator not exhibited in last 30 days, 1=Indicator of this type exhibited up to five days a week, 2=Indicator of this type exhibited daily or almost daily (6, 7 days a week), -1=Unknown |
| E1P_LESS_INTERACT | Mood and Behavior Patterns - Indicators of Depression, Anxiety, Sad Mood - Loss of Interest - Reduced Social Interaction. 0=Indicator not exhibited in last 30 days 1=Indicator of this type exhibited up to five days a week 2=Indicator of this type exhibited daily or almost daily (6, 7 days a week) (-)=Unknown (sp)=Blank | NUMBER | 1 | -2=Space, 0=Indicator not exhibited in last 30 days, 1=Indicator of this type exhibited up to five days a week, 2=Indicator of this type exhibited daily or almost daily (6, 7 days a week), -1=Unknown |
| E2_MOOD_PERSIST | Mood and Behavior Patterns - Mood Persistence. 0=No mood indicators 1=Indicators present, easily altered 2=Indicators present, not easily altered (-)=Unknown (sp)=Blank | NUMBER | 1 | -2=Space, 0=No Mood Indicators, 1=Indicators Present, easily altered, 2=Indicators Present, not easily altered, -1=Unknown |
| E3_MOOD_CHANGE | Mood and Behavior Patterns - Change in Mood. 0=No change 1=Improved 2=Deteriorated (-)=Unknown (sp)=Blank | NUMBER | 1 | 0=No Change, 1=Improved - receives fewer supports, needs less restrictive level of care, 2=Deteriorated - receives more support, -1=Unknown |
| E4AA_WANDERS | Mood and Behavior Patterns - Behavioral Symptoms - Wandering - Behavior symptom frequency. 0=Behavior not exhibited in last 7 days 1=Behavior of this type occurred 1 to 3 days in last 7 days 2=Behavior of this type occurred 4 to 6 days, but less than daily 3=Behavior of this type occurred daily (-)=Unknown (sp)=Blank | NUMBER | 1 | -2=Space, 0=Behavior not exhibited in last 7 days, 1=Behavior of this type occurred 1 to 3 days in last 7 days, 2=Behavior of this type occurred 4 to 6 days, but less than daily, 3=Behavior of this type occurred daily, -1=Unknown |
| E4AB_WANDERS_ALT | Mood and Behavior Patterns - Behavioral Symptoms - Wandering - Behavior symptom alterability. 0=Behavior not present OR behavior was easily altered 1= Behavior was not easily altered (-)=Unknown (sp)=Blank | NUMBER | 1 | -2=Space, 0=Behavior not present OR behavior easily altered, 1=Behavior was not easily altered, -1=Unknown |
| E4BA_VRBL_ABUSIVE | Mood and Behavior Patterns - Behavioral Symptoms -Verbally Abusive Behavioral Symptoms - Behavior symptom frequency. 0=Behavior not exhibited in last 7 days 1=Behavior of this type occurred 1 to 3 days in last 7 days 2=Behavior of this type occurred 4 to 6 days, but less than daily 3=Behavior of this type occurred daily (-)=Unknown (sp)=Blank | NUMBER | 1 | -2=Space, 0=Behavior not exhibited in last 7 days, 1=Behavior of this type occurred 1 to 3 days in last 7 days, 2=Behavior of this type occurred 4 to 6 days, but less than daily, 3=Behavior of this type occurred daily, -1=Unknown |
| E4BB_VRBL_ABUS_ALT | Mood and Behavior Patterns - Behavioral Symptoms -Verbally Abusive Behavioral Symptoms - Behavior symptom alterability. 0=Behavior not present OR behavior was easily altered 1= Behavior was not easily altered (-)=Unknown (sp)=Blank | NUMBER | 1 | -2=Space, 0=Behavior not present OR behavior easily altered, 1=Behavior was not easily altered, -1=Unknown |
| E4CA_PHYS_ABUSIVE | Mood and Behavior Patterns - Behavioral Symptoms -Physically Abusive Behavioral Symptoms - Behavior symptom frequency. 0=Behavior not exhibited in last 7 days 1=Behavior of this type occurred 1 to 3 days in last 7 days 2=Behavior of this type occurred 4 to 6 days, but less than daily 3=Behavior of this type occurred daily (-)=Unknown (sp)=Blank | NUMBER | 1 | -2=Space, 0=Behavior not exhibited in last 7 days, 1=Behavior of this type occurred 1 to 3 days in last 7 days, 2=Behavior of this type occurred 4 to 6 days, but less than daily, 3=Behavior of this type occurred daily, -1=Unknown |
| E4CB_PHYS_ABUS_ALT | Mood and Behavior Patterns - Behavioral Symptoms -Physically Abusive Behavioral Symptoms - Behavior symptom alterability. 0=Behavior not present OR behavior was easily altered 1= Behavior was not easily altered (-)=Unknown (sp)=Blank | NUMBER | 1 | -2=Space, 0=Behavior not present OR behavior easily altered, 1=Behavior was not easily altered, -1=Unknown |
| E4DA_DIS_BEHAVIOR | Mood and Behavior Patterns - Behavioral Symptoms -Socially Inappropriate/ Disruptive Behavioral Symptoms - Behavior symptom frequency. 0=Behavior not exhibited in last 7 days 1=Behavior of this type occurred 1 to 3 days in last 7 days 2=Behavior of this type occurred 4 to 6 days, but less than daily 3=Behavior of this type occurred daily (-)=Unknown (sp)=Blank | NUMBER | 1 | -2=Space, 0=Behavior not exhibited in last 7 days, 1=Behavior of this type occurred 1 to 3 days in last 7 days, 2=Behavior of this type occurred 4 to 6 days, but less than daily, 3=Behavior of this type occurred daily, -1=Unknown |
| E4DB_DIS_BEHAV_ALT | Mood and Behavior Patterns - Behavioral Symptoms -Socially Inappropriate/ Disruptive Behavioral Symptoms - Behavior symptom alterability. 0=Behavior not present OR behavior was easily altered 1= Behavior was not easily altered (-)=Unknown (sp)=Blank | NUMBER | 1 | -2=Space, 0=Behavior not present OR behavior easily altered, 1=Behavior was not easily altered, -1=Unknown |
| E4EA_RESIST_CARE | Mood and Behavior Patterns - Behavioral Symptoms - Resists Care - Behavior symptom frequency. 0=Behavior not exhibited in last 7 days 1=Behavior of this type occurred 1 to 3 days in last 7 days 2=Behavior of this type occurred 4 to 6 days, but less than daily 3=Behavior of this type occurred daily (-)=Unknown (sp)=Blank | NUMBER | 1 | -2=Space, 0=Behavior not exhibited in last 7 days, 1=Behavior of this type occurred 1 to 3 days in last 7 days, 2=Behavior of this type occurred 4 to 6 days, but less than daily, 3=Behavior of this type occurred daily, -1=Unknown |
| E4EB_RESIST_ALT | Mood and Behavior Patterns - Behavioral Symptoms - Resists Care - Behavior symptom alterability. 0=Behavior not present OR behavior was easily altered 1= Behavior was not easily altered (-)=Unknown (sp)=Blank | NUMBER | 1 | -2=Space, 0=Behavior not present OR behavior easily altered, 1=Behavior was not easily altered, -1=Unknown |
| E5_CHANGE_BEHAVE | Mood and Behavior Patterns - Change in Behavior Symptoms. 0=No change 1=Improve 2=Deteriorated (-)=Unknown (sp)=Blank | NUMBER | 1 | 0=No Change, 1=Improved - receives fewer supports, needs less restrictive level of care, 2=Deteriorated - receives more support, -1=Unknown |
| EFFECTIVE_DATE | This is the R4_DISCHARGE_DT for any discharge, A4A_REENTRY_DT for any re-entry and R2B_COMPLETE_DT for any other type of assessment. | DATE | 8 | |
| F1A_ACTIVE_OTHERS | Psychosocial Well-Being - Sense of Initiative/ Involvement - At ease interacting with others. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| F1B_PLAN_ACTIVITY | Psychosocial Well-Being - Sense of Initiative/ Involvement - At ease doing planned/ structured activities. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| F1C_SELF_ACTIVITY | Psychosocial Well-Being - Sense of Initiative/ Involvement - At ease doing self-initiated activities. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| F1D_OWN_GOALS | Psychosocial Well-Being - Sense of Initiative/ Involvement - Establishes own goals. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| F1E_DAY_ACTIVITY | Psychosocial Well-Being - Sense of Initiative/ Involvement - Purses involvement in life of facility. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| F1F_ACPT_INVITE | Psychosocial Well-Being - Sense of Initiative/ Involvement - Accepts invitations to most group activities. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| F1G_NONE_ABOVE | Psychosocial Well-Being - Sense of Initiative/ Involvement - None of Above. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| F2A_CONFLICT_STAFF | Psychosocial Well-Being - Unsettled Relationships - Covert/ Open Conflict with or Repeated Criticism of Staff. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| F2B_CONFLCT_RMMATE | Psychosocial Well-Being - Unsettled Relationships - Unhappy with roommate. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| F2C_CONFLT_OTH_RES | Psychosocial Well-Being - Unsettled Relationships - Unhappy with other residents. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| F2D_EXPRS_ANGER | Psychosocial Well-Being - Unsettled Relationships - Openly Expresses Conflict/ Anger With Family/ Friends. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| F2E_NO_CNTCT_FAM | Psychosocial Well-Being - Unsettled Relationships - Absence of Personal Contact With Family/ Friends. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| F2F_RECENT_LOSS | Psychosocial Well-Being - Unsettled Relationships - Recent Loss of Close Family Member/ Friend. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| F2G_NOT_ADJUST | Psychosocial Well-Being - Unsettled Relationships - Does not easily adjust to routine change. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| F2H_NONE_ABOVE | Psychosocial Well-Being - Unsettled Relationships - None of Above. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| F3A_PAST_ROLES | Psychosocial Well-Being - Past Roles - Strong identification with past roles. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| F3B_SADNESS | Psychosocial Well-Being - Past Roles - Expresses Sadness/ Anger/ Empty Feeling Over Lost Roles/ Status. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| F3C_DIFFERENCE | Psychosocial Well-Being - Past Roles - Resident Perceives That Daily Routine (Customary Routine, Activities) Is Very Different from Prior Pattern in the Community. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| F3D_NONE_ABOVE | Psychosocial Well-Being - Past Roles - None of above. 0 - No, 1 - Yes | NUMBER | 1 | 0=No, 1=Yes, -1=Unknown |
| FAC_INT_ID | Unique key for National Facility Table when combined with State_id | NUMBER | null | |
| G1AA_SELF_BED | Psychosocial Functioning and Structural Problems - Bed Mobility - ADL Self-Performance. 0=Independent 1=Supervision 2=Limited Assistance 3=Extensive Assistance 4=Total Dependence 8=Activity did not occur (-)=Unknown | NUMBER | 1 | 0=Independent - No help or oversight -OR- Help/oversight provided only 1 or 2 times during last 7 days, 1=Supervision - Oversight, encouragement or cueing provided 3 or more times during last 7 days -OR- Supervision (3 or more times) plus physical assistance provided only 1 or 2 times during last 7 days, 2=Limited Assistance - Resident highly involved in activity, received physical help in guided maneuvering of limbs or other nonweight bearing assistance 3 or more times -OR- More help provided only 1 or 2 times during last 7 days, 3=Extensive Assistance - While resident performed part of activity, over last 7 day period, help of following type(s) provided 3 or more times: -Weight-bearing support -Full staff performance during part (but not all) of last 7 days, 4=Total Dependence - Full stuff performance of activity during entire 7 days, 8=Activity did no occur during entire 7 days, -1=Unknown |
| G1AB_SUPP_BED | Psychosocial Functioning and Structural Problems - Bed Mobility - ADL Support Provided. 0=No setup or physical help from staff 1=Setup help only 2=One person physical assist 3=Two+ persons physical assist 8=ADL activity itself did not occur during entire 7 days (-)=Unknown | NUMBER | 1 | 0=No setup or physical help from staff, 1=Setup help only, 2=One person physical assist, 3=Two+ person physical assist, 8=ADL activity itself did not occur during entire 7 days, -1=Unknown |
| G1BA_SELF_TRANS | Physical Functioning and Structural Problems - Transfer - ADL Self-Performance. 0=Independent 1=Supervision 2=Limited Assistance 3=Extensive Assistance 4=Total Dependence 8=Activity did not occur (-)=Unknown | NUMBER | 1 | 0=Independent - No help or oversight -OR- Help/oversight provided only 1 or 2 times during last 7 days, 1=Supervision - Oversight, encouragement or cueing provided 3 or more times during last 7 days -OR- Supervision (3 or more times) plus physical assistance provided only 1 or 2 times during last 7 days, 2=Limited Assistance - Resident highly involved in activity, received physical help in guided maneuvering of limbs or other nonweight bearing assistance 3 or more times -OR- More help provided only 1 or 2 times during last 7 days, 3=Extensive Assistance - While resident performed part of activity, over last 7 day period, help of following type(s) provided 3 or more times: -Weight-bearing support -Full staff performance during part (but not all) of last 7 days, 4=Total Dependence - Full stuff performance of activity during entire 7 days, 8=Activity did no occur during entire 7 days, -1=Unknown |
| G1BB_SUPP_TRANS | Physical Functioning and Structural Problems - Transfer - ADL Support Provided. 0=No setup or physical help from staff 1=Setup help only 2=One person physical assist 3=Two+ persons physical assist 8=ADL activity itself did not occur during entire 7 days (-)=Unknown | NUMBER | 1 | 0=No setup or physical help from staff, 1=Setup help only, 2=One person physical assist, 3=Two+ person physical assist, 8=ADL activity itself did not occur during entire 7 days, -1=Unknown |
| G1CA_SELF_WLK_RM | Physical Functioning and Structural Problems - Walk In Room - ADL Self-Performance. 0=Independent 1=Supervision 2=Limited Assistance 3=Extensive Assistance 4=Total Dependence 8=Activity did not occur (-)=Unknown | NUMBER | 1 | 0=Independent - No help or oversight -OR- Help/oversight provided only 1 or 2 times during last 7 days, 1=Supervision - Oversight, encouragement or cueing provided 3 or more times during last 7 days -OR- Supervision (3 or more times) plus physical assistance provided only 1 or 2 times during last 7 days, 2=Limited Assistance - Resident highly involved in activity, received physical help in guided maneuvering of limbs or other nonweight bearing assistance 3 or more times -OR- More help provided only 1 or 2 times during last 7 days, 3=Extensive Assistance - While resident performed part of activity, over last 7 day period, help of following type(s) provided 3 or more times: -Weight-bearing support -Full staff performance during part (but not all) of last 7 days, 4=Total Dependence - Full stuff performance of activity during entire 7 days, 8=Activity did no occur during entire 7 days, -1=Unknown |
| G1CB_SUPP_WLK_RM | Physical Functioning and Structural Problems - Walk In Room - ADL Support Provided. 0=No setup or physical help from staff 1=Setup help only 2=One person physical assist 3=Two+ persons physical assist 8=ADL activity itself did not occur during entire 7 days (-)=Unknown | NUMBER | 1 | 0=No setup or physical help from staff, 1=Setup help only, 2=One person physical assist, 3=Two+ person physical assist, 8=ADL activity itself did not occur during entire 7 days, -1=Unknown |
| G1DA_SELF_WLK_CORR | Physical Functioning and Structural Problems - Walk In Corridor - ADL Self-Performance. 0=Independent 1=Supervision 2=Limited Assistance 3=Extensive Assistance 4=Total Dependence 8=Activity did not occur (-)=Unknown | NUMBER | 1 | 0=Independent - No help or oversight -OR- Help/oversight provided only 1 or 2 times during last 7 days, 1=Supervision - Oversight, encouragement or cueing provided 3 or more times during last 7 days -OR- Supervision (3 or more times) plus physical assistance provided only 1 or 2 times during last 7 days, 2=Limited Assistance - Resident highly involved in activity, received physical help in guided maneuvering of limbs or other nonweight bearing assistance 3 or more times -OR- More help provided only 1 or 2 times during last 7 days, 3=Extensive Assistance - While resident performed part of activity, over last 7 day period, help of following type(s) provided 3 or more times: -Weight-bearing support -Full staff performance during part (but not all) of last 7 days, 4=Total Dependence - Full stuff performance of activity during entire 7 days, 8=Activity did no occur during entire 7 days, -1=Unknown |
| G1DB_SUPP_WLK_CORR | Physical Functioning and Structural Problems - Walk In Corridor - ADL Support Provided. 0=No setup or physical help from staff 1=Setup help only 2=One person physical assist 3=Two+ persons physical assist 8=ADL activity itself did not occur during entire 7 days (-)=Unknown | NUMBER | 1 | 0=No setup or physical help from staff, 1=Setup help only, 2=One person physical assist, 3=Two+ person physical assist, 8=ADL activity itself did not occur during entire 7 days, -1=Unknown |
| G1EA_SELF_LOC_UNIT | Physical Functioning and Structural Problems - Locomotion on Unit - ADL Self-Performance. 0=Independent 1=Supervision 2=Limited Assistance 3=Extensive Assistance 4=Total Dependence 8=Activity did not occur (-)=Unknown | NUMBER | 1 | 0=Independent - No help or oversight -OR- Help/oversight provided only 1 or 2 times during last 7 days, 1=Supervision - Oversight, encouragement or cueing provided 3 or more times during last 7 days -OR- Supervision (3 or more times) plus physical assistance provided only 1 or 2 times during last 7 days, 2=Limited Assistance - Resident highly involved in activity, received physical help in guided maneuvering of limbs or other nonweight bearing assistance 3 or more times -OR- More help provided only 1 or 2 times during last 7 days, 3=Extensive Assistance - While resident performed part of activity, over last 7 day period, help of following type(s) provided 3 or more times: -Weight-bearing support -Full staff performance during part (but not all) of last 7 days, 4=Total Dependence - Full stuff performance of activity during entire 7 days, 8=Activity did no occur during entire 7 days, -1=Unknown |
| G1EB_SUPP_LOC_UNIT | Physical Functioning and Structural Problems - Locomotion on Unit - ADL Support Provided. 0=No setup or physical help from staff 1=Setup help only 2=One person physical assist 3=Two+ persons physical assist 8=ADL activity itself did not occur during entire 7 days (-)=Unknown | NUMBER | 1 | 0=No setup or physical help from staff, 1=Setup help only, 2=One person physical assist, 3=Two+ person physical assist, 8=ADL activity itself did not occur during entire 7 days, -1=Unknown |
| G1FA_SELF_LOC_OFFU | Physical Functioning and Structural Problems - Locomotion Off Unit - ADL Self-Performance. 0=Independent 1=Supervision 2=Limited Assistance 3=Extensive Assistance 4=Total Dependence 8=Activity did not occur (-)=Unknown | NUMBER | 1 | 0=Independent - No help or oversight -OR- Help/oversight provided only 1 or 2 times during last 7 days, 1=Supervision - Oversight, encouragement or cueing provided 3 or more times during last 7 days -OR- Supervision (3 or more times) plus physical assistance provided only 1 or 2 times during last 7 days, 2=Limited Assistance - Resident highly involved in activity, received physical help in guided maneuvering of limbs or other nonweight bearing assistance 3 or more times -OR- More help provided only 1 or 2 times during last 7 days, 3=Extensive Assistance - While resident performed part of activity, over last 7 day period, help of following type(s) provided 3 or more times: -Weight-bearing support -Full staff performance during part (but not all) of last 7 days, 4=Total Dependence - Full stuff performance of activity during entire 7 days, 8=Activity did no occur during entire 7 days, -1=Unknown |
| G1FB_SUPP_LOC_OFFU | Physical Functioning and Structural Problems - Locomotion Off Unit - ADL Support Provided. 0=No setup or physical help from staff 1=Setup help only 2=One person physical assist 3=Two+ persons physical assist 8=ADL activity itself did not occur during entire 7 days (-)=Unknown | NUMBER | 1 | 0=No setup or physical help from staff, 1=Setup help only, 2=One person physical assist, 3=Two+ person physical assist, 8=ADL activity itself did not occur during entire 7 days, -1=Unknown |
| G1GA_SELF_DRESS | Physical Functioning and Structural Problems - Dressing - ADL Self-Performance. 0=Independent 1=Supervision 2=Limited Assistance 3=Extensive Assistance 4=Total Dependence 8=Activity did not occur (-)=Unknown | NUMBER | 1 | 0=Independent - No help or oversight -OR- Help/oversight provided only 1 or 2 times during last 7 days, 1=Supervision - Oversight, encouragement or cueing provided 3 or more times during last 7 days -OR- Supervision (3 or more times) plus physical assistance provided only 1 or 2 times during last 7 days, 2=Limited Assistance - Resident highly involved in activity, received physical help in guided maneuvering of limbs or other nonweight bearing assistance 3 or more times -OR- More help provided only 1 or 2 times during last 7 days, 3=Extensive Assistance - While resident performed part of activity, over last 7 day period, help of following type(s) provided 3 or more times: -Weight-bearing support -Full staff performance during part (but not all) of last 7 days, 4=Total Dependence - Full stuff performance of activity during entire 7 days, 8=Activity did no occur during entire 7 days, -1=Unknown |
| G1GB_SUPP_DRESS | Physical Functioning and Structural Problems - Dressing - ADL Support Provided. 0=No setup or physical help from staff 1=Setup help only 2=One person physical assist 3=Two+ persons physical assist 8=ADL activity itself did not occur during entire 7 days (-)=Unknown | NUMBER | 1 | 0=No setup or physical help from staff, 1=Setup help only, 2=One person physical assist, 3=Two+ person physical assist, 8=ADL activity itself did not occur during entire 7 days, -1=Unknown |