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Property Specification
Data System MDS
Data Specs V1.14.1
Edit Type Format
Severity Fatal
Edit Text Values of Code and Checklist Items:
Only the coded values listed in the "Item Values" table of the Detailed Data Specifications Report may be submitted for this item.
Version Notes

Item List
Item ID Description
ASMT_SYS_CD Assessment system code
ITM_SBST_CD Item subset code
PRODN_TEST_CD Production/test indicator
STATE_CD Facility"s state postal code
A0050 Type of transaction (formerly X0100)
A0200 Type of provider
A0310A Type of assessment: OBRA
A0310B Type of assessment: PPS
A0310C Type of assessment: OMRA
A0310D Swing bed clinical change assessment
A0310E First assessment since most recent entry
A0310F Entry/discharge reporting
A0310G Planned/unplanned discharge
A0410 Submission requirement
A0800 Gender
A1000A Ethnicity: American Indian or Alaska Native
A1000B Ethnicity: Asian
A1000C Ethnicity: Black or African American
A1000D Ethnicity: Hispanic or Latino
A1000E Ethnicity: Native Hawaiian/Pacific Islander
A1000F Ethnicity: White
A1100A Does the resident need or want an interpreter
A1200 Marital status
A1500 Resident evaluated by PASRR
A1510A Level II PASRR conditions: Serious Mental Illness
A1510B Level II PASRR conditions: Mental Retardation
A1510C Level II PASRR conditions: Other related condition
A1550A ID/DD status: Down syndrome
A1550B ID/DD status: Autism
A1550C ID/DD status: Epilepsy
A1550D ID/DD status: other organic ID/DD condition
A1550E ID/DD status: ID/DD with no organic condition
A1550Z ID/DD status: none of the above
A1700 Type of entry
A1800 Entered from
A2100 Discharge status
A2400A Has resident had Medicare-covered stay
B0100 Comatose
B0200 Hearing
B0300 Hearing aid
B0600 Speech clarity
B0700 Makes self understood
B0800 Ability to understand others
B1000 Vision
B1200 Corrective lenses
C0100 BIMS: should resident interview be conducted
C0200 BIMS res interview: repetition of three words
C0300A BIMS res interview: able to report correct year
C0300B BIMS res interview: able to report correct month
C0300C BIMS res interview: can report correct day of week
C0400A BIMS res interview: able to recall "sock"
C0400B BIMS res interview: able to recall "blue"
C0400C BIMS res interview: able to recall "bed"
C0600 Staff asmt mental status: conduct asmt
C0700 Staff asmt mental status: short-term memory OK
C0800 Staff asmt mental status: long-term memory OK
C0900A Staff asmt mental status: recall current season
C0900B Staff asmt mental status: recall location of room
C0900C Staff asmt mental status: recall staff names/faces
C0900D Staff asmt mental status: recall in nursing home
C0900Z Staff asmt mental status: none of above recalled
C1000 Cognitive skills for daily decision making
C1300A Signs of delirium: inattention
C1300B Signs of delirium: disorganized thinking
C1300C Signs of delirium: altered level of consciousness
C1300D Signs of delirium: psychomotor retardation
C1600 Acute onset mental status change
D0100 PHQ: should resident mood interview be conducted
D0200A1 PHQ res: little interest or pleasure - presence
D0200A2 PHQ res: little interest or pleasure - frequency
D0200B1 PHQ res: feeling down, depressed - presence
D0200B2 PHQ res: feeling down, depressed - frequency
D0200C1 PHQ res: trouble with sleep - presence
D0200C2 PHQ res: trouble with sleep - frequency
D0200D1 PHQ res: feeling tired/little energy - presence
D0200D2 PHQ res: feeling tired/little energy - frequency
D0200E1 PHQ res: poor appetite or overeating - presence
D0200E2 PHQ res: poor appetite or overeating - frequency
D0200F1 PHQ res: feeling bad about self - presence
D0200F2 PHQ res: feeling bad about self - frequency
D0200G1 PHQ res: trouble concentrating - presence
D0200G2 PHQ res: trouble concentrating - frequency
D0200H1 PHQ res: slow, fidgety, restless - presence
D0200H2 PHQ res: slow, fidgety, restless - frequency
D0200I1 PHQ res: thoughts better off dead - presence
D0200I2 PHQ res: thoughts better off dead - frequency
D0350 PHQ res: safety notification
D0500A1 PHQ staff: little interest or pleasure - presence
D0500A2 PHQ staff: little interest or pleasure - frequency
D0500B1 PHQ staff: feeling down, depressed - presence
D0500B2 PHQ staff: feeling down, depressed - frequency
D0500C1 PHQ staff: trouble with sleep - presence
D0500C2 PHQ staff: trouble with sleep - frequency
D0500D1 PHQ staff: feeling tired/little energy - presence
D0500D2 PHQ staff: feeling tired/little energy - frequency
D0500E1 PHQ staff: poor appetite or overeating - presence
D0500E2 PHQ staff: poor appetite or overeating - frequency
D0500F1 PHQ staff: feeling bad about self - presence
D0500F2 PHQ staff: feeling bad about self - frequency
D0500G1 PHQ staff: trouble concentrating - presence
D0500G2 PHQ staff: trouble concentrating - frequency
D0500H1 PHQ staff: slow, fidgety, restless - presence
D0500H2 PHQ staff: slow, fidgety, restless - frequency
D0500I1 PHQ staff: thoughts better off dead - presence
D0500I2 PHQ staff: thoughts better off dead - frequency
D0500J1 PHQ staff: short-tempered - presence
D0500J2 PHQ staff: short-tempered - frequency
D0650 PHQ staff: safety notification
E0100A Psychosis: hallucinations
E0100B Psychosis: delusions
E0100Z Psychosis: none of the above
E0200A Physical behav symptoms directed toward others
E0200B Verbal behav symptoms directed toward others
E0200C Other behav symptoms not directed toward others
E0300 Overall presence of behavioral symptoms
E0500A Behav symptoms put res at risk for illness/injury
E0500B Behav symptoms interfere with resident care
E0500C Behav symptoms interfere with social activities
E0600A Behav symptoms put others at risk for injury
E0600B Behav symptoms intrude on privacy of others
E0600C Behav symptoms disrupt care or living environment
E0800 Rejection of care: presence and frequency
E0900 Wandering: presence and frequency
E1000A Wandering: risk of getting to dangerous place
E1000B Wandering: intrude on privacy of others
E1100 Change in behavioral or other symptoms
F0300 Conduct res interview for daily/activity prefs
F0400A Res interview: choose clothes to wear
F0400B Res interview: take care of personal belongings
F0400C Res interview: choose tub, bath, shower, sponge
F0400D Res interview: have snacks between meals
F0400E Res interview: choose own bedtime
F0400F Res interview: discuss care with family/friend
F0400G Res interview: use phone in private
F0400H Res interview: lock things to keep them safe
F0500A Res interview: have books, newspaper, mags to read
F0500B Res interview: listen to music
F0500C Res interview: be around animals/pets
F0500D Res interview: keep up with news
F0500E Res interview: do things with groups of people
F0500F Res interview: do favorite activities
F0500G Res interview: go outside when good weather
F0500H Res interview: participate in religious practices
F0600 Primary respondent: daily/activities prefs
F0700 Conduct staff assessment for daily/activity prefs
F0800A Staff assessment: choosing clothes to wear
F0800B Staff assessment: caring for personal belongings
F0800C Staff assessment: receiving tub bath
F0800D Staff assessment: receiving shower
F0800E Staff assessment: receiving bed bath
F0800F Staff assessment: receiving sponge bath
F0800G Staff assessment: snacks between meals
F0800H Staff assessment: staying up past 8PM
F0800I Staff assessment: discuss care with family/other
F0800J Staff assessment: use phone in private
F0800K Staff assessment: place to lock personal things
F0800L Staff assessment: reading books, newspapers, mags
F0800M Staff assessment: listening to music
F0800N Staff assessment: being around animals/pets
F0800O Staff assessment: keeping up with news
F0800P Staff assessment: doing things with groups
F0800Q Staff assessment: participate favorite activities
F0800R Staff assessment: spend time away from nursng home
F0800S Staff assessment: spend time outdoors
F0800T Staff assessment: participate religious activities
F0800Z Staff assessment: none of above activities
G0110A1 Bed mobility: self-performance
G0110A2 Bed mobility: support provided
G0110B1 Transfer: self-performance
G0110B2 Transfer: support provided
G0110C1 Walk in room: self-performance
G0110C2 Walk in room: support provided
G0110D1 Walk in corridor: self-performance
G0110D2 Walk in corridor: support provided
G0110E1 Locomotion on unit: self-performance
G0110E2 Locomotion on unit: support provided
G0110F1 Locomotion off unit: self-performance
G0110F2 Locomotion off unit: support provided
G0110G1 Dressing: self-performance
G0110G2 Dressing: support provided
G0110H1 Eating: self-performance
G0110H2 Eating: support provided
G0110I1 Toilet use: self-performance
G0110I2 Toilet use: support provided
G0110J1 Personal hygiene: self-performance
G0110J2 Personal hygiene: support provided
G0120A Bathing: self-performance
G0120B Bathing: support provided
G0300A Balance: moving from seated to standing position
G0300B Balance: walking (with assistive device if used)
G0300C Balance: turning around while walking
G0300D Balance: moving on and off toilet
G0300E Balance: surface-to-surface transfer
G0400A ROM limitation: upper extremity
G0400B ROM limitation: lower extremity
G0600A Mobility devices: cane/crutch
G0600B Mobility devices: walker
G0600C Mobility devices: wheelchair (manual or electric)
G0600D Mobility devices: limb prosthesis
G0600Z Mobility devices: none of the above
G0900A Resident believes capable of increased independ
G0900B Staff believes res capable of increased independ
H0100A Appliances: indwelling catheter
H0100B Appliances: external catheter
H0100C Appliances: ostomy
H0100D Appliances: intermittent catheterization
H0100Z Appliances: none of the above
H0200A Urinary toileting program: has been attempted
H0200B Urinary toileting program: response
H0200C Urinary toileting program: current program/trial
H0300 Urinary continence
H0400 Bowel continence
H0500 Bowel toileting program being used
H0600 Constipation
I0100 Cancer (with or without metastasis)
I0200 Anemia
I0300 Atrial fibrillation and other dysrhythmias
I0400 Coronary artery disease (CAD)
I0500 Deep venous thrombosis (DVT), PE, or PTE
I0600 Heart failure
I0700 Hypertension
I0800 Orthostatic hypotension
I0900 Peripheral vascular disease (PVD) or PAD
I1100 Cirrhosis
I1200 Gastroesophageal reflux disease (GERD) or ulcer
I1300 Ulcerative colitis, Chrohn"s, inflam bowel disease
I1400 Benign prostatic hyperplasia (BPH)
I1500 Renal insufficiency, renal failure, ESRD
I1550 Neurogenic bladder
I1650 Obstructive uropathy
I1700 Multidrug resistant organism (MDRO)
I2000 Pneumonia
I2100 Septicemia
I2200 Tuberculosis
I2300 Urinary tract infection (UTI) (LAST 30 DAYS)
I2400 Viral hepatitis (includes type A, B, C, D, and E)
I2500 Wound infection (other than foot)
I2900 Diabetes mellitus (DM)
I3100 Hyponatremia
I3200 Hyperkalemia
I3300 Hyperlipidemia (e.g., hypercholesterolemia)
I3400 Thyroid disorder
I3700 Arthritis
I3800 Osteoporosis
I3900 Hip fracture
I4000 Other fracture
I4200 Alzheimer"s disease
I4300 Aphasia
I4400 Cerebral palsy
I4500 Cerebrovascular accident (CVA), TIA, or stroke
I4800 Non-Alzheimer"s dementia
I4900 Hemiplegia or hemiparesis
I5000 Paraplegia
I5100 Quadriplegia
I5200 Multiple sclerosis
I5250 Huntington"s disease
I5300 Parkinson"s disease
I5350 Tourette"s syndrome
I5400 Seizure disorder or epilepsy
I5500 Traumatic brain injury (TBI)
I5600 Malnutrition (protein, calorie), risk of malnutrit
I5700 Anxiety disorder
I5800 Depression (other than bipolar)
I5900 Manic depression (bipolar disease)
I5950 Psychotic disorder (other than schizophrenia)
I6000 Schizophrenia
I6100 Post-traumatic stress disorder (PTSD)
I6200 Asthma (COPD) or chronic lung disease
I6300 Respiratory failure
I6500 Cataracts, glaucoma, or macular degeneration
I7900 None of above active diseases within last 7 days
J0100A Pain: received scheduled pain med regimen
J0100B Pain: received PRN pain medications
J0100C Pain: received non-medication intervention
J0200 Should pain assessment interview be conducted
J0300 Res pain interview: presence
J0400 Res pain interview: frequency
J0500A Res pain interview: made it hard to sleep
J0500B Res pain interview: limited daily activities
J0600B Res pain interview: verbal descriptor scale
J0700 Should staff assessment for pain be conducted
J0800A Staff pain asmt: non-verbal sounds
J0800B Staff pain asmt: vocal complaints of pain
J0800C Staff pain asmt: facial expressions
J0800D Staff pain asmt: protective movements/postures
J0800Z Staff pain asmt: none of these signs observed
J0850 Staff pain asmt: frequency of pain
J1100A Short breath/trouble breathing: with exertion
J1100B Short breath/trouble breathing: sitting at rest
J1100C Short breath/trouble breathing: lying flat
J1100Z Short breath/trouble breathing: none of above
J1300 Current tobacco use
J1400 Prognosis: life expectancy of less than 6 months
J1550A Problem conditions: fever
J1550B Problem conditions: vomiting
J1550C Problem conditions: dehydrated
J1550D Problem conditions: internal bleeding
J1550Z Problem conditions: none of the above
J1700A Fall history: fall during month before admission
J1700B Fall history: fall 2-6 months before admission
J1700C Fall history: fracture from fall 6 month pre admit
J1800 Falls since admit/prior asmt: any falls
J1900A Falls since admit/prior asmt: no injury
J1900B Falls since admit/prior asmt: injury (not major)
J1900C Falls since admit/prior asmt: major injury
K0100A Swallow disorder: loss liquids/solids from mouth
K0100B Swallow disorder: holds food in mouth/cheeks
K0100C Swallow disorder: cough/choke with meals/meds
K0100D Swallow disorder: difficulty or pain swallowing
K0100Z Swallow disorder: none of the above
K0300 Weight loss
K0310 Weight Gain
K0510A1 Nutrition approach: Not Res: parenteral/IV feeding
K0510A2 Nutrition approach: Res: parenteral /IV feeding
K0510B1 Nutrition approach: Not Res: feeding tube
K0510B2 Nutrition approach: Res: feeding tube
K0510C1 Nutrition approach: Not Res: mechanic altered diet
K0510C2 Nutrition approach: Res: mechanic altered diet
K0510D1 Nutrition approach: Not Res: therapeutic diet
K0510D2 Nutrition approach: Res: therapeutic diet
K0510Z1 Nutrition approach: Not Res: none of the above
K0510Z2 Nutrition approach: Res: none of the above
K0710A1 Prop calories parenteral/tube feed: not resident
K0710A2 Prop calories parenteral/tube feed: while resident
K0710A3 Prop calories parenteral/tube feed: 7 days
K0710B1 Avg fluid intake per day IV/tube: not resident
K0710B2 Avg fluid intake per day IV/ tube: while resident
K0710B3 Avg fluid intake per day IV/tube: 7 days
L0200A Dental: broken or loosely fitting denture
L0200B Dental: no natural teeth or tooth fragment(s)
L0200C Dental: abnormal mouth tissue
L0200D Dental: cavity or broken natural teeth
L0200E Dental: inflamed/bleeding gums or loose teeth
L0200F Dental: pain, discomfort, difficulty chewing
L0200G Dental: unable to examine
L0200Z Dental: none of the above
M0100A Risk determination: has ulcer, scar, or dressing
M0100B Risk determination: formal assessment
M0100C Risk determination: clinical assessment
M0100Z Risk determination: none of the above
M0150 Is resident at risk of developing pressure ulcer
M0210 Resident has Stage 1 or higher pressure ulcers
M0700 Tissue type for ulcer at most advanced stage
M0900A Pressure ulcers on prior assessment
M1040A Other skin probs: infection of the foot
M1040B Other skin probs: diabetic foot ulcer(s)
M1040C Other skin probs: other open lesion(s) on the foot
M1040D Other skin probs: lesions not ulcers, rashes, cuts
M1040E Other skin probs: surgical wound(s)
M1040F Other skin probs: burns (second or third degree)
M1040G Skin Tear(s)
M1040H Moisture Associated Skin Damage (MASD)
M1040Z Other skin probs: none of the above
M1200A Skin/ulcer treat: pressure reduce device for chair
M1200B Skin/ulcer treat: pressure reducing device for bed
M1200C Skin/ulcer treat: turning/repositioning
M1200D Skin/ulcer treat: nutrition/hydration
M1200E Skin/ulcer treat: pressure ulcer care
M1200F Skin/ulcer treat: surgical wound care
M1200G Skin/ulcer treat: application of dressings
M1200H Skin/ulcer treat: apply ointments/medications
M1200I Skin/ulcer treat: apply dressings to feet
M1200Z Skin/ulcer treat: none of the above
O0100A1 Treatment: chemotherapy - while not resident
O0100A2 Treatment: chemotherapy - while resident
O0100B1 Treatment: radiation - while not resident
O0100B2 Treatment: radiation - while resident
O0100C1 Treatment: oxygen therapy - while not resident
O0100C2 Treatment: oxygen therapy - while resident
O0100D1 Treatment: suctioning - while not resident
O0100D2 Treatment: suctioning - while resident
O0100E1 Treatment: tracheostomy care - while not resident
O0100E2 Treatment: tracheostomy care - while resident
O0100F1 Treatment: vent/respirator - while not resident
O0100F2 Treatment: vent/respirator - while resident
O0100G1 Treatment: BiPAP/CPAP - while not resident
O0100G2 Treatment: BIPAP/CPAP - while resident
O0100H1 Treatment: IV medications - while not resident
O0100H2 Treatment: IV medications - while resident
O0100I1 Treatment: transfusions - while not resident
O0100I2 Treatment: transfusions - while resident
O0100J1 Treatment: dialysis - while not resident
O0100J2 Treatment: dialysis - while resident
O0100K1 Treatment: hospice care - while not resident
O0100K2 Treatment: hospice care - while resident
O0100L2 Treatment: respite care - while resident
O0100M1 Treatment: isolate/quarantine - while not resident
O0100M2 Treatment: isolate/quarantine - while resident
O0100Z1 Treatment: none of above - while not resident
O0100Z2 Treatment: none of above - while resident
O0250A Was influenza vaccine received
O0250C If influenza vaccine not received, state reason
O0300A Is pneumococcal vaccination up to date
O0300B If pneumococcal vacc not received, state reason
O0450A Has therapy resumed
P0100A Restraints used in bed: bed rail
P0100B Restraints used in bed: trunk restraint
P0100C Restraints used in bed: limb restraint
P0100D Restraints used in bed: other
P0100E Restraints in chair/out of bed: trunk restraint
P0100F Restraints in chair/out of bed: limb restraint
P0100G Restraints in chair/out of bed: chair stops rising
P0100H Restraints in chair/out of bed: other
Q0100A Resident participated in assessment
Q0100B Family/signif other participated in assessment
Q0100C Guardian/legal rep participated in assessment
Q0300A Resident"s overall goal
Q0300B Information source for resident"s goal
Q0400A Active discharge planning for return to community
Q0490 Resident"s preference to avoid being asked
Q0500B Do you want to talk about returning to community
Q0550A Reasking resident preference
Q0550B Reasking resident preference source
Q0600 Referral been made to Local Contact Agency
V0100A Prior OBRA reason for assessment
V0100B Prior PPS reason for assessment
V0200A01A CAA-Delirium: triggered
V0200A01B CAA-Delirium: plan
V0200A02A CAA-Cognitive loss/dementia: triggered
V0200A02B CAA-Cognitive loss/dementia: plan
V0200A03A CAA-Visual function: triggered
V0200A03B CAA-Visual function: plan
V0200A04A CAA-Communication: triggered
V0200A04B CAA-Communication: plan
V0200A05A CAA-ADL functional/rehab potential: triggered
V0200A05B CAA-ADL functional/rehab potential: plan
V0200A06A CAA-Urinary incont/indwell catheter: triggered
V0200A06B CAA-Urinary incont/indwell catheter: plan
V0200A07A CAA-Psychosocial well-being: triggered
V0200A07B CAA-Psychosocial well-being: plan
V0200A08A CAA-Mood state: triggered
V0200A08B CAA-Mood state: plan
V0200A09A CAA-Behavioral symptoms: triggered
V0200A09B CAA-Behavioral symptoms: plan
V0200A10A CAA-Activities: triggered
V0200A10B CAA-Activities: plan
V0200A11A CAA-Falls: triggered
V0200A11B CAA-Falls: plan
V0200A12A CAA-Nutritional status: triggered
V0200A12B CAA-Nutritional status: plan
V0200A13A CAA-Feeding tubes: triggered
V0200A13B CAA-Feeding tubes: plan
V0200A14A CAA-Dehydration/fluid maintenance: triggered
V0200A14B CAA-Dehydration/fluid maintenance: plan
V0200A15A CAA-Dental care: triggered
V0200A15B CAA-Dental care: plan
V0200A16A CAA-Pressure ulcer: triggered
V0200A16B CAA-Pressure ulcer: plan
V0200A17A CAA-Psychotropic drug use: triggered
V0200A17B CAA-Psychotropic drug use: plan
V0200A18A CAA-Physical restraints: triggered
V0200A18B CAA-Physical restraints: plan
V0200A19A CAA-Pain: triggered
V0200A19B CAA-Pain: plan
V0200A20A CAA-Return to community referral: triggered
V0200A20B CAA-Return to community referral: plan
X0150 Correction: type of provider
X0300 Correction: resident gender
X0600A Correction: OBRA reason for assessment
X0600B Correction: PPS reason for assessment
X0600C Correction: OMRA assessment
X0600D Correction: Swing bed clinical change asmt
X0600F Correction: entry/discharge reporting
X0900A Correction: modif reasons - transcription error
X0900B Correction: modif reasons - data entry error
X0900C Correction: modif reasons - software error
X0900D Correction: modif reasons - item coding error
X0900E Correction: modif reasons - resume therapy date
X0900Z Correction: modif reasons - other error
X1050A Correction: inact reasons - event did not occur
X1050Z Correction: inact reasons - other reason
Z0100C Medicare Part A: Medicare short stay asmt

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NOTICE: These materials are in the public domain and cannot be copyrighted.
Generated: 05/08/2014
MDS 3.0 dataspecs V1.14.1 | http://www.careplans.com