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Property Specification
Data System OSA
Data Specs V3.01.0
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 [V3.01.0]-Added mappings to new items A1005A-Y, A1010A-Z, and A1110B.

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
STATE_PDPM_OBRA_CD State calculation of PDPM for OBRA
A0050 Type of transaction (formerly X0100)
A0200 Type of provider
A0300A State Payment Assessment Purpose
A0300B State Payment Assessment Type
A0410 Submission requirement
A0800 Gender
A1005A Ethnicity: No, not Hispanic, Latino/a, Spanish
A1005B Ethnicity: Yes, Mex, Mex Amer, Chicano/a
A1005C Ethnicity: Yes, Puerto Rican
A1005D Ethnicity: Yes, Cuban
A1005E Ethnicity: Yes, another Hispanic/Latino/Spanish
A1005X Ethnicity: Patient unable to respond
A1005Y Ethnicity: Patient declines to respond
A1010A Race: White
A1010B Race: Black or African American
A1010C Race: American Indian or Alaska Native
A1010D Race: Asian Indian
A1010E Race: Chinese
A1010F Race: Filipino
A1010G Race: Japanese
A1010H Race: Korean
A1010I Race: Vietnamese
A1010J Race: Other Asian
A1010K Race: Native Hawaiian
A1010L Race: Guamanian or Chamorro
A1010M Race: Samoan
A1010N Race: Other Pacific Islander
A1010X Race: Patient unable to respond
A1010Y Race: Patient declines to respond
A1010Z Race: None of the above
A1110B Does the patient need or want an interpreter
A1200 Marital status
B0100 Comatose
B0700 Makes self understood
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
C1000 Cognitive skills for daily decision making
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
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
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
E0800 Rejection of care: presence and frequency
E0900 Wandering: presence and frequency
G0110A1 Bed mobility: self-performance
G0110A2 Bed mobility: support provided
G0110B1 Transfer: self-performance
G0110B2 Transfer: support provided
G0110H1 Eating: self-performance
G0110H2 Eating: support provided
G0110I1 Toilet use: self-performance
G0110I2 Toilet use: support provided
H0200C Urinary toileting program: current program/trial
H0500 Bowel toileting program being used
I2000 Pneumonia
I2100 Septicemia
I2900 Diabetes mellitus (DM)
I4300 Aphasia
I4400 Cerebral palsy
I4900 Hemiplegia or hemiparesis
I5100 Quadriplegia
I5200 Multiple sclerosis
I5300 Parkinson"s disease
I6200 Asthma (COPD) or chronic lung disease
I6300 Respiratory failure
I7900 None of above active diseases within last 7 days
J1100C Short breath/trouble breathing: lying flat
J1100Z Short breath/trouble breathing: none of above
J1550A Problem conditions: fever
J1550B Problem conditions: vomiting
J1550C Problem conditions: dehydrated
J1550D Problem conditions: internal bleeding
J1550Z Problem conditions: none of the above
K0300 Weight loss
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
K0510Z1 Nutrition approach: Not Res: none of the above
K0510Z2 Nutrition approach: Res: none of the above
K0710A3 Prop calories parenteral/tube feed: 7 days
K0710B3 Avg fluid intake per day IV/tube: 7 days
M0210 Resident has 1+ unhealed PU/injuries
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)
M1040Z Other skin probs: none of the above
M1200A Skin/ulcer/injry treat: prssr rduce dvc for chair
M1200B Skin/ulcer/injry treat: prssr reducing dvc for bed
M1200C Skin/ulcer/injry treat: turning/repositioning
M1200D Skin/ulcer/injry treat: nutrition/hydration
M1200E Skin/ulcer/injry treat: prssr ulcer/injry care
M1200F Skin/ulcer/injry treat: surgical wound care
M1200G Skin/ulcer/injry treat: application of dressings
M1200H Skin/ulcer/injry treat: apply ointments/meds
M1200I Skin/ulcer/injry treat: apply dressings to feet
M1200Z Skin/ulcer/injry 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 Treat: Invsv Mech Vent - while not resident
O0100F2 Treat: Invsv Mech Vent - 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
O0100M2 Treatment: isolate/quarantine - while resident
O0100Z1 Treatment: none of above - while not resident
O0100Z2 Treatment: none of above - while resident
O0450A Has therapy resumed
X0150 Correction: type of provider
X0300 Correction: resident gender
X0570A Correction: Optional State Assessment Purpose
X0570B Correction: Optional State Assessment Type
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
X0900Z Correction: modif reasons - other error
X1050A Correction: inact reasons - event did not occur
X1050Z Correction: inact reasons - other reason
Z0200C State case mix: Short Stay Assessment

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Generated: 06/06/2023 01:46:59 PM