OBRA Admission A=01, B=99, F=99, G=^, H=0
120 values shown.
A0050 · Type of RecordxappliesOpen item
A0100 · Facility Provider NumbersxappliesOpen item
A0200 · Type of ProviderxappliesOpen item
A0310 · Type of AssessmentxappliesOpen item
A0410 · Unit Certification or Licensure DesignationxappliesOpen item
A0500 · Legal Name of ResidentxappliesOpen item
A0600 · Social Security and Medicare NumbersxappliesOpen item
A0700 · Medicaid NumberxappliesOpen item
A0810 · SexxappliesOpen item
A0900 · Birth DatexappliesOpen item
A1005 · EthnicityxappliesOpen item
A1010 · RacexappliesOpen item
A1110 · LanguagexappliesOpen item
A1200 · Marital StatusxappliesOpen item
A1300 · Optional Resident ItemsxappliesOpen item
A1500 · Preadmission Screening and Resident Review (PASRR)xappliesOpen item
A1510 · Level II Preadmission Screening and Resident ReviewxappliesOpen item
A1550 · Conditions Related to IntellectualxappliesOpen item
A1600 · Entry DatexappliesOpen item
A1700 · Type of EntryxappliesOpen item
A1805 · Entered FromxappliesOpen item
A1900 · Admission Date (Date this episode of care in this facilityxappliesOpen item
A2300 · Assessment Reference DatexappliesOpen item
A2400 · Medicare StayxappliesOpen item
B0100 · ComatosexappliesOpen item
B0200 · HearingxappliesOpen item
B0300 · Hearing AidxappliesOpen item
B0600 · Speech ClarityxappliesOpen item
B0700 · Makes Self UnderstoodxappliesOpen item
B0800 · Ability to Understand OthersxappliesOpen item
B1000 · VisionxappliesOpen item
B1200 · Corrective LensesxappliesOpen item
C0100 · Should Brief Interview for Mental Status Be Conducted?xappliesOpen item
C0200 · Repetition of Three WordsxappliesOpen item
C0300 · Temporal Orientation (Orientation to Year, Month,xappliesOpen item
C0400 · RecallxappliesOpen item
C0500 · BIMS Summary ScorexappliesOpen item
C0600 · Should the Staff Assessment for Mental Status Be Conducted?xappliesOpen item
C0700 · Short-term Memory OKxappliesOpen item
C0800 · Long-term Memory OKxappliesOpen item
C0900 · Memory/Recall AbilityxappliesOpen item
C1000 · Cognitive Skills for Daily Decision MakingxappliesOpen item
C1310 · Signs and Symptoms of Delirium (from CAM©)xappliesOpen item
D0100 · Should Resident Mood Interview Be Conducted?xappliesOpen item
D0160 · Total Severity ScorexappliesOpen item
D0600 · Total Severity ScorexappliesOpen item
D0700 · Social IsolationxappliesOpen item
E0100 · Potential Indicators of PsychosisxappliesOpen item
E0200 · Behavioral Symptom—Presence & FrequencyxappliesOpen item
E0300 · Overall Presence of Behavioral SymptomsxappliesOpen item
E0500 · Impact on ResidentxappliesOpen item
E0600 · Impact on OthersxappliesOpen item
E0800 · Rejection of Care—Presence & FrequencyxappliesOpen item
E0900 · Wandering—Presence & FrequencyxappliesOpen item
E1000 · Wandering—ImpactxappliesOpen item
E1100 · Change in Behavior or Other SymptomsxappliesOpen item
F0300 · Should Interview for Daily and Activity Preferences BexappliesOpen item
F0400 · Interview for Daily PreferencesxappliesOpen item
F0500 · Interview for Activity PreferencesxappliesOpen item
F0600 · Daily and Activity Preferences Primary RespondentxappliesOpen item
F0700 · Should the Staff Assessment of Daily and ActivityxappliesOpen item
F0800 · Staff Assessment of Daily and Activity PreferencesxappliesOpen item
GG0115 · Functional Limitation in Range of MotionxappliesOpen item
GG0120 · Mobility DevicesxappliesOpen item
GG0130 · Self-Care and GG0170: Mobility subsection addedxappliesOpen item
H0100 · AppliancesxappliesOpen item
H0200 · Urinary Toileting ProgramxappliesOpen item
H0300 · Urinary ContinencexappliesOpen item
H0400 · Bowel ContinencexappliesOpen item
H0500 · Bowel Toileting ProgramxappliesOpen item
H0600 · Bowel PatternsxappliesOpen item
J0100 · Pain ManagementxappliesOpen item
J0200 · Should Pain Assessment Interview Be Conducted?xappliesOpen item
J0300 · Pain PresencexappliesOpen item
J0410 · Pain FrequencyxappliesOpen item
J0510 · Pain Effect on SleepxappliesOpen item
J0520 · Pain Interference with Therapy ActivitiesxappliesOpen item
J0530 · Pain Interference with Day-to-Day ActivitiesxappliesOpen item
J0600 · Pain IntensityxappliesOpen item
J0700 · Should the Staff Assessment for Pain be Conducted?xappliesOpen item
J0800 · Indicators of PainxappliesOpen item
J0850 · Frequency of Indicator of Pain or Possible PainxappliesOpen item
J1100 · Shortness of Breath (dyspnea)xappliesOpen item
J1300 · Current Tobacco UsexappliesOpen item
J1400 · PrognosisxappliesOpen item
J1550 · Problem ConditionsxappliesOpen item
J1700 · Fall History on Admission/Entry or ReentryxappliesOpen item
J1800 · Any Falls Since Admission/Entry or Reentry or PriorxappliesOpen item
J1900 · Number of Falls Since Admission/Entry or Reentry or PriorxappliesOpen item
K0100 · Swallowing DisorderxappliesOpen item
K0200 · Height and WeightxappliesOpen item
K0300 · Weight LossxappliesOpen item
K0310 · Weight GainxappliesOpen item
L0200 · DentalxappliesOpen item
M0100 · Determination of Pressure Ulcer/Injury RiskxappliesOpen item
M0150 · Risk of Pressure Ulcers/InjuriesxappliesOpen item
M0210 · Unhealed Pressure Ulcers/InjuriesxappliesOpen item
M1030 · Number of Venous and Arterial UlcersxappliesOpen item
M1040 · Other Ulcers, Wounds and Skin ProblemsxappliesOpen item
M1200 · Skin and Ulcer/Injury TreatmentsxappliesOpen item
N0300 · InjectionsxappliesOpen item
N0350 · InsulinxappliesOpen item
N0450 · Antipsychotic Medication ReviewxappliesOpen item
O0250 · Influenza VaccinexappliesOpen item
O0300 · Pneumococcal VaccinexappliesOpen item
O0350 · Resident’s COVID-19 vaccination is up to datexappliesOpen item
O0500 · Restorative Nursing ProgramsxappliesOpen item
P0100 · Physical RestraintsxappliesOpen item
P0200 · AlarmsxappliesOpen item
Q0110 · Participation in Assessment and Goal SettingxappliesOpen item
Q0310 · Resident’s Overall GoalxappliesOpen item
Q0400 · Discharge PlanxappliesOpen item
Q0500 · Return to CommunityxappliesOpen item
Q0550 · Resident’s Preference to Avoid Being Asked QuestionxappliesOpen item
Q0610 · ReferralxappliesOpen item
Q0620 · Reason Referral to Local Contact Agency (LCA) NotxappliesOpen item
Z0100 · Medicare Part A BillingxappliesOpen item
Z0200 · State Medicaid Billing (if required by the state)xappliesOpen item
Z0250 · Alternate State Medicaid Billing (if required by the state)xappliesOpen item
Z0300 · Insurance BillingxappliesOpen item