JUN 2012 SNF QIES SURVEY FILE LAYOUT - CASPER…€¦ · JUN 2012 SNF QIES SURVEY FILE LAYOUT -...

JUN 2012 SNF QIES SURVEY FILE LAYOUT - CASPER/QIES SYSTEM 1

DEP Building Extract 20:42 Saturday, June 9, 2012

The CONTENTS Procedure

Data Set Name WORK.QIES1 Observations 160386

Member Type DATA Variables 30

Engine V9 Indexes 0

Created Saturday, June 09, 2012 08:44:00 PM Observation Length 272

Last Modified Saturday, June 09, 2012 08:44:00 PM Deleted Observations 0

Protection Compressed NO

Data Set Type Sorted YES

Label

Data Representation WINDOWS_32

Encoding wlatin1 Western (Windows)

Engine/Host Dependent Information

Data Set Page Size 16384

Number of Data Set Pages 2674

First Data

Max Obs per Page 60

Obs in First Data Page 42

Number of Data Set Repairs 0

File Name C:\DOCUME~1\owner\LOCALS~1\Temp\SAS Temporary

Files\_TD2540\qies1.sas7bdat

Release Created 9.0101M3

Host Created XP_PRO

Alphabetic List of Variables and Attributes

# Variable Type Len Label

29 ADD_DT Char 8 Add Date

16 AUTOMTC_SPRNKLR_RQRD_CD Char 1 Automatic Sprinkler

17 AUTOMTC_SPRNKLR_RQRD_DESC Char 14 Automatic Sprinkler Required Description

6 BLDG_NUM Char 2 Building Number

9 BLDG_TYPE_CD Char 1 Type of Unit (Wing, Building, Floor)

10 BLDG_TYPE_DESC Char 14 Building Type Description

2 CRTFCTN_DT Char 8 Certification Date

3 EVNT_ID Char 7 Event ID

11 ICFMR_EVACTN_SCRE_CNT Num 8 E-Score (Evacuation)

20 LSC_CMPLNC_ACPTBL_POC_SW Char 1 Compliance (A2): Acceptable Plan of Correction

19 LSC_CMPLNC_ALL_PRVSN_SW Char 1 Compliance (A1): With All Provisions

18 LSC_CMPLNC_STUS_SW Char 1 Compliance Status: LSC Building

21 LSC_CMPLNC_WVR_SW Char 1 Compliance (A3): Waivers

22 LSC_FSES_CMPLNC_SW Char 1 Compliance (A4): FSES

7 LSC_SRVY_FORM_CD Char 2 Life Safety Code Form Code

8 LSC_SRVY_FORM_DESC Char 33 LSC Survey Form Description

12 LVL_EVACTN_DFCLTY_CD Char 1 Level of Evacuation Difficulty

13 LVL_EVACTN_DFCLTY_DESC Char 29 Level of Evacuation Difficulty Description

24 POC_DT Char 8 Plan of Correction Date


DEP Building Extract 20:42 Saturday, June 9, 2012




23 PRFMNC_BSD_DSGN_CMPLNC_SW Char 1 Performance Based Design Compliance Switch

1 PRVDR_NUM Char 10 Provider Number

27 REC_STUS_CD Char 1 Record Status Code

28 REC_STUS_DESC Char 16 Record Status Description

14 SEPRT_HZRDS_AREA_CD Char 1 Hazardous Areas Separation

15 SEPRT_HZRDS_AREA_DESC Char 14 Separate Hazardous Area Description

25 SPRNKLR_STUS_CD Char 1 Sprinkler Status Code

26 SPRNKLR_STUS_DESC Char 50 Sprinkler Status Description

4 STATE_CD Char 2 State Abbreviation

5 STATE_DESC Char 20 State Description

30 UPDT_DT Char 8 Update Date

Sort Information

Sortedby PRVDR_NUM

Validated YES

Character Set ANSI

Sort Option NODUPREC


DEP Certification 20:42 Saturday, June 9, 2012




Engine V9 Indexes 0





Label






First Data Page 13

Max Obs per Page 1






Host Created XP_PRO



7 ACPTBL_POC_SW Char 1 Compliance: Plan of Correction

888 ACRDTD_SRVY_CRTFCT_ Char 1 Survey Accreditation Certificate Schedule Code

SCHDL_CD

887 ACRDTD_SRVY_CRTFCT_ Char 45 Accredited Survey Certificate Schedule Description

SCHDL_DESC

889 ACRDTD_SRVY_SCHDL_CD Char 1 Survey Accreditation Schedule Code

890 ACRDTD_SRVY_SCHDL_DESC Char 45 Accredited Survey Schedule Description

891 ACRDTD_SRVY_STUS_SW Char 1 Survey Accreditation Status Switch

892 ACRDTD_SRVY_TEST_VOL_CNT Num 8 Survey Accredited Test Volume Count

381 ACRDTN_EFCTV_DT Char 8 Accreditation Effective Date

382 ACRDTN_EXPRTN_DT Char 8 Accreditation Expiration Date

893 ACRDTN_SCHDL_CD Char 1 Accreditation Schedule Code

894 ACRDTN_SCHDL_DESC Char 45 Accreditation Schedule Description

380 ACRDTN_SRVY_TYPE_CD Char 2 Accreditation Survey Type Code

68 ACRDTN_TYPE_CD Char 1 Accreditation Type Code

69 ACRDTN_TYPE_DESC Char 7 Accreditation Type Description

742 ACTVTY_OFSITE_RSDNT_SW Char 1 Service: Activities-Offsite-Residents Switch

741 ACTVTY_ONST_NRSDNT_SW Char 1 Service: Activities-Onsite-Nonresidents Switch

739 ACTVTY_ONST_RSDNT_SW Char 1 Service: Activities-Onsite-Residents Switch






745 ACTVTY_OTHR_OFSITE_ Char 1 Service: Other Activities-Offsite-Residents Switch

RSDNT_SW

744 ACTVTY_OTHR_ONST_ Char 1 Service: Other Activities-Onsite-Nonresidents Switch

NRSDNT_SW

743 ACTVTY_OTHR_ONST_RSDNT_SW Char 1 Service: Other Activities-Onsite-Residents Switch

843 ACTVTY_PROFNL_CNTRCT_CNT Num 8 Activity Professional Contract Count

841 ACTVTY_PROFNL_FLTM_CNT Num 8 Activity Professional Full-Time Count

842 ACTVTY_PROFNL_PRTM_CNT Num 8 Activity Professional Part-Time Count

846 ACTVTY_STF_OTHR_ Num 8 Activity Staff Other Contract Count

CNTRCT_CNT

844 ACTVTY_STF_OTHR_FLTM_CNT Num 8 Activity Staff Other Full-Time Count

845 ACTVTY_STF_OTHR_PRTM_CNT Num 8 Activity Staff Other Part-Time Count

345 ACUTE_RESP_CARE_CD Char 1 Acute/Respite Care Code

346 ACUTE_RESP_CARE_DESC Char 45 Acute Respite Care Description

508 ACUTE_RNL_DLYS_SRVC_CD Char 1 Services Provided: Acute Renal Dialysis

509 ACUTE_RNL_DLYS_SRVC_DESC Char 39 Services Provided: Acute Renal Dialysis Description

895 ADJSTMT_OVRRD_DT Char 8 Adjustment Override Date

896 ADJSTMT_OVRRD_SW Char 1 Adjustment Override Switch

539 ADMSN_SUSPNSN_DT Char 8 Admission Suspension Date

541 ADMSN_SUSPNSN_PRIOR_DT Char 8 Admission Suspension Prior Date

534 AGRMT_BGN_DT Char 8 LTC Agreement Beginning Date

535 AGRMT_END_DT Char 8 LTC Agreement Ending Date

537 AGRMT_END_PRIOR_DT Char 8 Prior LTC Agreement Ending Date

536 AGRMT_EXTNSN_DT Char 8 LTC Agreement Extension Date

538 AGRMT_EXTNSN_PRIOR_DT Char 8 Prior LTC Agreement Extension Date

695 AIDS_BED_CNT Num 8 Special Care Beds - AIDS

418 ALCHL_DRUG_SRVC_CD Char 1 Services Provided: Alcohol and/or Drug

419 ALCHL_DRUG_SRVC_DESC Char 39 Services Provided: Alcohol and or Drug Description

38 ALL_CTN_CRCTD_SW Char 1 All Citations Corrected Switch

696 ALZHMR_BED_CNT Num 8 Special Care Beds - Alzheimers

110 ANSTHSA_ENTRY_SW Char 1 ASC Record: Anesthesia Entries

420 ANSTHSA_SRVC_CD Char 1 Services Provided: Anesthesia

421 ANSTHSA_SRVC_DESC Char 39 Services Provided: Anesthesia Description

379 AOA_ACRDTN_STUS_SW Char 1 AOA Accreditation Status Switch

378 AO_CD Char 2 AO Code

39 APLCTN_RCVD_DT Char 8 Application Received Date

897 APLCTN_SGND_DT Char 8 Date Application Signed

898 APLCTN_SGND_SW Char 1 Application Signature Switch

309 APLNC_EQUIP_SRVC_CD Char 1 Service: Appliance and Equipment

310 APLNC_EQUIP_SRVC_DESC Char 39 Appliance And Equipment HHA Service Description

711 APRVD_NRS_AIDE_TRNG_SW Char 1 Approved Aid Training/Evaluation Program

899 AQAS_SRVY_ONST_TRGR_CD Char 2 Onsite Survey Trigger Code

900 AQAS_SRVY_ONST_TRGR_DESC Char 40 AQAS Survey Onsite Trigger Description

901 AQAS_SRVY_SENT_DT Char 8 AQAS Survey Sent Date

902 AQAS_SRVY_SW Char 1 AQAS Survey Switch






422 AUDLGY_SRVC_CD Char 1 Services Provided: Audiology

423 AUDLGY_SRVC_DESC Char 39 Services Provided: Audiology Description

521 BED_CNT Num 8 Beds-Total

533 BED_PER_ROOM_WVR_SW Char 1 Compliance: Beds Per Room Waiver

903 BLOOD_PROD_CLCTD_SW Char 1 Blood or Blood Products Collected

771 BLOOD_SRVC_OFSITE_ Char 1 Service: Blood Administered-Offsite-Resident

RSDNT_SW

770 BLOOD_SRVC_ONST_NRSDNT_SW Char 1 Service: Blood Administered-Onsite-Nonresident

769 BLOOD_SRVC_ONST_RSDNT_SW Char 1 Service: Blood Administered-Onsite-Resident

296 BRNCH_CNT Num 8 Branches

295 BRNCH_OPRTN_SW Char 1 Branch Operation Switch

424 BURN_CARE_UNIT_SRVC_CD Char 1 Services Provided: Burn Care Unit

425 BURN_CARE_UNIT_SRVC_DESC Char 39 Services Provided: Burn Care Unit Description

408 CAH_PSYCH_DPU_SW Char 1 CAH Psychological DPU Switch

409 CAH_REHAB_DPU_SW Char 1 CAH Rehabilitation DPU Switch

410 CAH_SB_DPU_SW Char 1 CAH Swing Bed DPU Switch

504 CARF_IP_REHAB_SRVC_CD Char 1 Services Provided: CARF Inpatient Rehabilitation Code

505 CARF_IP_REHAB_SRVC_DESC Char 39 Services Provided: CARF Inpatient

Rehabilitation Description

706 CCRC_FAC_SW Char 1 Facility Part of a CCRC

488 CHLD_ADLSCNT_ Char 1 Services Provided: Psychiatric Child/Adolescent

PSYCH_SRVC_CD

489 CHLD_ADLSCNT_PSYCH_ Char 39 Services Provided: Child Adolescent

SRVC_DESC Psychiatric Description

430 CHMTHRPY_SRVC_CD Char 1 Services Provided: Chemotherapy

431 CHMTHRPY_SRVC_DESC Char 39 Services Provided: Chemotherapy Description

290 CHOW_SW Char 1 Change of Ownership Switch

432 CHRPRCTIC_SRVC_CD Char 1 Services Provided: Chiropractic

433 CHRPRCTIC_SRVC_DESC Char 39 Services Provided: Chiropractic Description

904 CLIA_67_LCNSD_SW Char 1 Previously Regulated Switch

905 CLIA_EXMPT_STATE_CD Char 2 CLIA-Exempt State Abbreviation

906 CLIA_EXMPT_STATE_DESC Char 20 CLIA Exempt State Description

907 CLIA_MDCR_NUM Char 12 CLIA Medicare Number

908 CLNCL_CNSLTNT_HIGH_A_CNT Num 8 Clinical Consultant - High (A)

909 CLNCL_CNSLTNT_HIGH_B_CNT Num 8 Clinical Consultant - High (B)

910 CLNCL_CNSLTNT_MODRT_A_CNT Num 8 Clinical Consultant - Moderate (A)

911 CLNCL_CNSLTNT_MODRT_B_CNT Num 8 Clinical Consultant - Moderate (B)

456 CL_SRVC_CD Char 1 Services Provided: Clinical Laboratory

457 CL_SRVC_DESC Char 39 Services Provided: Clinical Laboratory Description

765 CL_SRVC_OFSITE_RSDNT_SW Char 1 Service: Clinical Laboratory-Offsite-Resident

764 CL_SRVC_ONST_NRSDNT_SW Char 1 Service: Clinical Laboratory-Onsite-Nonresident

763 CL_SRVC_ONST_RSDNT_SW Char 1 Service: Clinical Laboratory-Onsite-Resident

554 CMNTY_BSD_SW Char 1 Community Based Switch

5 CMPLNC_STUS_CD Char 1 Compliance: Status

6 CMPLNC_STUS_DESC Char 17 Compliance Status Description






337 CNSLNG_SRVC_CD Char 1 Service: Counseling

338 CNSLNG_SRVC_DESC Char 39 Counseling Hospice Service Description

357 CNSLR_EMPLEE_CNT Num 8 Counselors - Staff

358 CNSLR_VLNTR_CNT Num 8 Counselors - Volunteer

600 CNSUS_ABUSE_INVSTGTN_CNT Num 8 Investigated: # Clients Abused

327 CNSUS_ADMSN_READMSN_CNT Num 8 Census: Admissions - Readmissions

326 CNSUS_ADMSN_UNDUP_CNT Num 8 Census: Admissions-Unduplicated

674 CNSUS_ADVNC_DRCTV_CNT Num 8 Census: Other Advance Directive

563 CNSUS_AGE_BTWN_22_45_CNT Num 8 Census: Total Clients 22-45

564 CNSUS_AGE_BTWN_46_65_CNT Num 8 Census: Total Clients 46-65

565 CNSUS_AGE_OVR_65_CNT Num 8 Census: Total Clients Over 65

562 CNSUS_AGE_UNDER_22_CNT Num 8 Census: Total Clients Under 22

596 CNSUS_ASGND_LGL_GRDN_CNT Num 8 Census: Over 18 with Legal Guardian

634 CNSUS_ASTNC_MBLTY_CNT Num 8 Census: Mobility - Ambulation with Assistance

594 CNSUS_ATNDG_DAY_PGM_CNT Num 8 Census: Clients Attending Day Programs

574 CNSUS_AUTSTC_CNT Num 8 Census: Autistic

393 CNSUS_AVG_DAILY_CNT Num 8 Average Daily Census

611 CNSUS_BATHG_ASTD_CNT Num 8 Census: Bathing - Assisted

612 CNSUS_BATHG_DPNDNT_CNT Num 8 Census: Bathing - Dependent

610 CNSUS_BATHG_INDPNDNT_CNT Num 8 Census: Bathing - Independent

631 CNSUS_BED_FST_CNT Num 8 Census: Mobility - Bedfast

590 CNSUS_BHVR_CNTL_DRUG_CNT Num 8 Census: Drugs to Control Behavior

644 CNSUS_BHVR_MGMT_PGM_CNT Num 8 Census: Mental Status - Behavioral Management Program

629 CNSUS_BLADR_TRNG_PGM_CNT Num 8 Census: Continence - Bladder Training Program

587 CNSUS_BLND_CNT Num 8 Census: Blind

630 CNSUS_BWL_TRNG_PGM_CNT Num 8 Census: Continence - Bowel Training Program

652 CNSUS_CHMTHRPY_CNT Num 8 Census: Special Care - Chemotherapy

632 CNSUS_CHRBND_CNT Num 8 Census: Mobility - Chairbound

576 CNSUS_CNTLD_EPLPSY_CNT Num 8 Census: Epilepsy - Controlled

635 CNSUS_CNTRCT_ADMSN_CNT Num 8 Census: Mobility - Contractures on Admission

640 CNSUS_CNTRCT_CNT Num 8 Census: Mobility - with Contractures

575 CNSUS_CRBRL_PLSY_CNT Num 8 Census: Cerebral Palsy

595 CNSUS_CRT_ORDRD_ADMSN_CNT Num 8 Census: Court Ordered Admissions

625 CNSUS_CTHTR_ADMSN_CNT Num 8 Census: Continence - Catheters Present on Admission

624 CNSUS_CTHTR_CNT Num 8 Census: Continence - Catheters

584 CNSUS_DEAF_CNT Num 8 Census: Deaf

331 CNSUS_DEATH_DSCHRG_CNT Num 8 Census: Discharges - Death

605 CNSUS_DEATH_OTHR_CNT Num 8 Census: Deaths - Number Deaths Other

604 CNSUS_DEATH_RSTRNT_CNT Num 8 Census: Deaths - Number Related to Restraints

603 CNSUS_DEATH_UNSUL_CNT Num 8 Census: Deaths - Number Unusual Incidents

653 CNSUS_DLYS_CNT Num 8 Census: Special Care - Dialysis

642 CNSUS_DMNT_CNT Num 8 Census: Mental Status - Dementia

639 CNSUS_DPRSN_CNT Num 8 Census: Mental Status - Depression

614 CNSUS_DRS_ASTD_CNT Num 8 Census: Dressing - Assisted

615 CNSUS_DRS_DPNDNT_CNT Num 8 Census: Dressing - Dependent






613 CNSUS_DRS_INDPNDNT_CNT Num 8 Census: Dressing - Independent

330 CNSUS_DSCHRG_GOAL_MET_CNT Num 8 Census: Discharges - Goals Met

556 CNSUS_DSCRT_LVG_UNIT_CNT Num 8 Discrete Living Units

622 CNSUS_EATG_ASTD_CNT Num 8 Census: Eating - Assisted

663 CNSUS_EATG_ASTV_DVC_CNT Num 8 Census: Eating - Assistive Devices

626 CNSUS_EATG_DPNDNT_CNT Num 8 Census: Eating - Dependent

623 CNSUS_EATG_INDPNDNT_CNT Num 8 Census: Eating - Independent

578 CNSUS_EPLPSY_CNT Num 8 Census: Total Epilepsy

567 CNSUS_FEML_CNT Num 8 Census: Total Females

583 CNSUS_HARD_HEARG_CNT Num 8 Census: Hard of Hearing

585 CNSUS_HEARG_IMPRMNT_CNT Num 8 Census: Hearing Impairment

650 CNSUS_HOSPC_CARE_CNT Num 8 Census: Special Care - Hospice Benefit

328 CNSUS_HOSP_DSCHRG_CNT Num 8 Census: Discharge - Hospital

586 CNSUS_IMPRD_VSN_CNT Num 8 Census: Impaired Vision

627 CNSUS_INCNTNT_BLADR_CNT Num 8 Census: Continence - Bladder Incontenence

628 CNSUS_INCNTNT_BWL_CNT Num 8 Census: Continence - Bowel Incontenence

633 CNSUS_INDPNDNT_MBLTY_CNT Num 8 Census: Mobility - Ambulatory

675 CNSUS_INFLNZ_IMNZTN_CNT Num 8 Census: Influenza Immunization

654 CNSUS_INTRVNS_THRPY_CNT Num 8 Census: Special Care - IV Therapy

566 CNSUS_MALE_CNT Num 8 Census: Total Males

579 CNSUS_MBL_NAMBLTRY_CNT Num 8 Census: Mobile - Nonambulatory

661 CNSUS_MCHNCL_ALTRD_ Num 8 Census: Special Care - Mechanically Altered Diet

DIET_CNT

608 CNSUS_MDCD_CNT Num 8 Census: Medicaid

589 CNSUS_MDCL_CARE_PLAN_CNT Num 8 Census: Medical Care Plan

607 CNSUS_MDCR_CNT Num 8 Census: Medicare

643 CNSUS_MENTL_BHVR_CNT Num 8 Census: Mental Status - Behavioral Symptoms

569 CNSUS_MILD_MR_CNT Num 8 Census: Mild Mental Retardation

570 CNSUS_MODRT_MR_CNT Num 8 Census: Moderate Mental Retardation

638 CNSUS_MR_CNT Num 8 Census: Mental Status - Mental Retardation

581 CNSUS_NAMBLTRY_CNT Num 8 Census: Total Nonambulatory

601 CNSUS_NGLCT_INVSTGTN_CNT Num 8 Census: Neglect Allegations Investigated

580 CNSUS_NMBL_NAMBLTRY_CNT Num 8 Census: Nonambulatory - Nonmobile

673 CNSUS_NON_ORAL_ Num 8 Census: Other- Non-Oral Communication Devices

COMMUN_DVC_CNT

672 CNSUS_NO_COMMUN_CNT Num 8 Census: Other - Communication

561 CNSUS_OBSRVD_ATNDG_ Num 8 Day Program Sites Observed

DAY_PGM_CNT

558 CNSUS_OLDST_RSDNT_AGE_NUM Num 8 Age - Oldest Client

657 CNSUS_OSTMY_CARE_CNT Num 8 Census: Special Care - Ostomy Care

609 CNSUS_OTHR_MDCD_MDCR_CNT Num 8 Census: Other Residents

591 CNSUS_PHYS_RSTRNT_CNT Num 8 Census: Physical Restraints

676 CNSUS_PNEUMO_VCN_CNT Num 8 Census: Pneumococcal Vaccine

670 CNSUS_PN_MGMT_PGM_CNT Num 8 Census: Medications - Pain Management Program

593 CNSUS_PN_STMLI_CNT Num 8 Census: Painful or Noxious Stimuli






572 CNSUS_PRFND_MR_CNT Num 8 Census: Profound Mental Retardation

647 CNSUS_PRSR_SORE_ADMSN_CNT Num 8 Census: Skin Integrity - Pressure Sores on Admission

648 CNSUS_PRVNTV_SKN_CARE_CNT Num 8 Census: Skin Integrity - Preventive Care

641 CNSUS_PSYCH_CNT Num 8 Census: Mental Status - Psychiatric Diagnosis

666 CNSUS_RCVG_ANTI_ANXTY_CNT Num 8 Census: Medications - Antianxiety

669 CNSUS_RCVG_ANTI_BTC_CNT Num 8 Census: Medications - Antibiotics

667 CNSUS_RCVG_ANTI_ Num 8 Census: Medications - Antidepressant

DPRSNT_CNT

665 CNSUS_RCVG_ANTI_ Num 8 Census: Medications - Antipsychotic

PSYCHTC_CNT

668 CNSUS_RCVG_HYPNTC_CNT Num 8 Census: Medications - Hypnotic

659 CNSUS_RCVG_INJCTN_CNT Num 8 Census: Special Care - Injections

645 CNSUS_RCVG_MNTL_ Num 8 Census: Mental Status - Health Rehabilitation

HLTH_REHAB_CNT

664 CNSUS_RCVG_PSYCHACTV_ Num 8 Census: Medications - Psychoactive

DRUG_CNT

651 CNSUS_RDTN_THRPY_CNT Num 8 Census: Special Care - Radiation

662 CNSUS_REHAB_CNT Num 8 Census: Special Care - Rehabilitation Services

568 CNSUS_RSDNT_CNT Num 8 Census: Total Residents/Clients

655 CNSUS_RSPRTRY_TRTMT_CNT Num 8 Census: Special Care - Respiratory Treatment

637 CNSUS_RSTRNT_ORDR_ Num 8 Census: Mobility - Restraints with Admission Order

ADMSN_CNT

636 CNSUS_RSTRNT_ORDR_CNT Num 8 Census: Mobility - Physically Restrained

646 CNSUS_SKN_PRSR_SORE_CNT Num 8 Census: Skin Integrity - Pressure Sores

649 CNSUS_SKN_RSH_CNT Num 8 Census: Skin Integrity - With Rash

560 CNSUS_SMPL_ATNDG_ Num 8 Clients Attend Day Programs - Sample

DAY_PGM_CNT

597 CNSUS_SPCFD_CHRCTRSTC_ Num 8 Census: Other - 1 Total

1_CNT


2_CNT


3_CNT

582 CNSUS_SPCH_LANG_ Num 8 Census: Speech / Language Impairment

IMPRMNT_CNT

658 CNSUS_SUCTN_CARE_CNT Num 8 Census: Special Care - Suctioning

571 CNSUS_SVR_MR_CNT Num 8 Census: Severe Mental Retardation

592 CNSUS_TIME_OUT_ROOM_CNT Num 8 Census: Time Out Rooms

620 CNSUS_TOILT_ASTD_CNT Num 8 Census: Toilet Use - Assisted

621 CNSUS_TOILT_DPNDNT_CNT Num 8 Census: Toilet Use - Dependent

619 CNSUS_TOILT_INDPNDNT_CNT Num 8 Census: Toilet Use - Independent

602 CNSUS_TOT_ABUSE_NGLCT_CNT Num 8 Census: Investigated - Total Investigated

606 CNSUS_TOT_DEATH_CNT Num 8 Census: Deaths - Total Deaths

573 CNSUS_TOT_MR_CNT Num 8 Census: Total Mental Retardation

656 CNSUS_TRCHOSTMY_CARE_CNT Num 8 Census: Special Care - Tracheostomy






617 CNSUS_TRNSFR_ASTD_CNT Num 8 Census: Transfer - Assisted

618 CNSUS_TRNSFR_DPNDNT_CNT Num 8 Census: Transfer - Dependent

616 CNSUS_TRNSFR_INDPNDNT_CNT Num 8 Census: Transfer - Independent

660 CNSUS_TUBE_FEED_CNT Num 8 Census: Special Care - Tube Feeding

577 CNSUS_UNCNTLD_EPLPSY_CNT Num 8 Census: Epilepsy - Uncontrolled

671 CNSUS_UNPLND_WT_ Num 8 Census: Other - Unplanned Weight Gain / Loss

LOSS_GAIN_CNT

588 CNSUS_VISL_IMPRMNT_CNT Num 8 Census: Total Visual Impairment

557 CNSUS_YNGST_AGE_NUM Num 8 Age - Youngest Client

41 CNTCT_1ST_NAME Char 20 Contact First Name

44 CNTCT_CITY_NAME Char 25 Contact City Name

49 CNTCT_EMAIL Char 60 Contact Email

47 CNTCT_FAX_NUM Char 10 Contact Fax Number

42 CNTCT_LAST_NAME Char 20 Contact Last Name

48 CNTCT_PHNE_NUM Char 10 Contact Phone Number

40 CNTCT_SLTTN Char 3 Contact Salutation

45 CNTCT_STATE_ABRVTN_CD Char 2 Contact State Abbreviation Code

43 CNTCT_ST_ADR Char 50 Contact Street Address

46 CNTCT_ZIP_CD Char 5 Contact ZIP Code

182 CNVNTNL_HOME_HD_NUM Num 8 Conventional Home HD Number

520 COLCTN_STUS_SW Char 1 Co-Location Status Switch

426 CRDC_CTHTRZTN_LAB_SRVC_CD Char 1 Services Provided: Cardiac Catheterization Lab

427 CRDC_CTHTRZTN_ Char 39 Services Provided: Cardiac Catheterization

LAB_SRVC_DESC Lab Description

97 CRDC_DFBRLTR_EQUIP_SW Char 1 ASC Equipment: Cardiac Defibrillator

98 CRDC_MNTRG_EQUIP_SW Char 1 ASC Equipment: Cardiac Monitoring

80 CRDVSCLR_SRGRY_SW Char 1 Specialty: Cardiovascular

399 CRNA_CNT Num 8 Certified Registered Nurse Anesthetists (CRNA)

446 CRNRY_CARE_UNIT_SRVC_CD Char 1 Services Provided: ICU Cardiac (non-surgical)

447 CRNRY_CARE_UNIT_SRVC_DESC Char 39 Services Provided: ICU Cardiac (non-surgical) Description

4 CRTFCTN_AGE_NUM Num 8 Certification Age Number


14 CRTFCTN_FLAG_CD Char 1 Flag / Sample Code

15 CRTFCTN_FLAG_DESC Char 33 Certification Flag Description

113 CRTFCTN_TRK_ID Char 4 Certification Tracking ID

251 CRTFCT_NEED_RQRD_IND Char 1 Certificate Need Required Indicator

522 CRTFD_BED_CNT Num 8 Beds - Total Certified

876 CRTFD_NRS_PRCTNR_CNT Num 8 Nurse Practitioners - Certified

434 CT_SCAN_SRVC_CD Char 1 Services Provided: CT Scanner

435 CT_SCAN_SRVC_DESC Char 39 Services Provided: CT Scanner Description

912 CYTOTCHLGS_B_1_CNT Num 8 Cytotechnologist - (B)(1)










266 DAILY_HOME_HD_PTNTS_NUM Num 8 Daily Home Hemodialysis Patient Number

265 DAYS_OPRTN_MWF_IND Char 1 Days Operation Mon, Wed, Fri Indicator

264 DAYS_OPRTN_TTS_IND Char 1 Days of Operation Tues, Thurs & Sat Indicator

440 DCTD_ER_SRVC_CD Char 1 Services Provided: Emergency Dept(Dedicated)

441 DCTD_ER_SRVC_DESC Char 39 Services Provided: Emergency Dept (Dedicated) Description

70 DEMD_STUS_SW Char 1 Deemed Status Switch

498 DGNSTC_RDLGY_SRVC_CD Char 1 Services Provided: Radiology (Diagnostic)

499 DGNSTC_RDLGY_SRVC_DESC Char 39 Services Provided: Diagnostic Radiology Description

768 DGNSTC_XRAY_OFSITE_ Char 1 Service: X-ray Off-Site Residents

RSDNT_SW

767 DGNSTC_XRAY_ONST_ Char 1 Service: X-ray On-Site Nonresidents

NRSDNT_SW

766 DGNSTC_XRAY_ONST_RSDNT_SW Char 1 Service: X-ray On-Site Residents

211 DIETN_CNT Num 8 Dietitians

813 DIETN_CNTRCT_CNT Num 8 Dietitians - Contract

811 DIETN_FLTM_CNT Num 8 Dietitians - Full-Time

812 DIETN_PRTM_CNT Num 8 Dietitians - Part-Time

697 DLYS_BED_CNT Num 8 Special Care Beds - Dialysis

200 DLYS_PTNT_CNT Num 8 Total Dialysis Patients

203 DLYS_STN_CNT Num 8 Stations - Total

114 DME_STF_PRVDD_SW Char 1 DME Staff Provided Code

436 DNTL_SRVC_CD Char 1 Services Provided: Dental

437 DNTL_SRVC_DESC Char 39 Services Provided: Dental Description

753 DNTL_SRVC_OFSITE_RSDNT_SW Char 1 Service: Dental Off-Site Residents

752 DNTL_SRVC_ONST_NRSDNT_SW Char 1 Service: Dental On-Site Nonresidents

751 DNTL_SRVC_ONST_RSDNT_SW Char 1 Service: Dental On-Site Residents

855 DNTST_CNTRCT_CNT Num 8 Dentists - Contract

853 DNTST_FLTM_CNT Num 8 Dentists - Full-Time

854 DNTST_PRTM_CNT Num 8 Dentists - Part-Time

385 DNV_ACRDTN_STUS_SW Char 1 DNV Accreditation Status Switch

917 DRCTLY_AFLTD_LAB_CNT Num 8 Number of Labs Directly Affiliated

918 DRCTR_1ST_NAME Char 21 Directors First Name

919 DRCTR_HIGH_B_1_CNT Num 8 Directors - High (B)(1)






925 DRCTR_LAST_NAME Char 25 Directors Last Name

926 DRCTR_MDL_INITL_NAME Char 1 Directors Middle Initial

927 DRCTR_MODRT_B_1_CNT Num 8 Director - Moderate (B)(1)












882 DRCTR_QUALN_CD Char 1 Director Qualifications

883 DRCTR_QUALN_DESC Char 9 Director Qualification Description

549 DRCT_CARE_PRSNEL_CNT Num 8 Direct Care Personnel

689 DRUG_ERR_RATE_NUM Num 8 Drug Error Rate

109 DRUG_REACTN_SW Char 1 ASC Records: Drug Reactions

698 DSBL_CHLDRN_BED_CNT Num 8 Special Care Beds - Disabled Child

332 DSCHRG_CNT Num 8 Discharge Count

112 DSCHRG_DGNS_SW Char 1 ASC Records: Discharge Diagnosis

288 DSCPLN_ADMINR_CD Char 1 Discipline of Administrator

289 DSCPLN_ADMINR_DESC Char 29 Discipline of Administrator Description

12 DTRMNTN_APRVL_DT Char 8 Determination Approval Date

726 DTRY_OFSITE_RSDNT_SW Char 1 Service: Dietary Off-Site Residents

725 DTRY_ONST_NRSDNT_SW Char 1 Service: Dietary On-Site Nonresidents

724 DTRY_ONST_RSDNT_SW Char 1 Service: Dietary On-Site Residents

438 DTRY_SRVC_CD Char 1 Services Provided: Dietary

439 DTRY_SRVC_DESC Char 39 Services Provided: Dietary Description

76 EKG_SRVC_CD Char 1 Service: EKG

77 EKG_SRVC_DESC Char 39 EKG Service Description

10 ELGBLTY_SW Char 1 Eligibility Switch

94 EMER_CALL_SYS_SW Char 1 ASC Equipment: Call System

103 EMER_DRUG_SUPLY_SW Char 1 ASC Equipment: Drugs and Supplies

486 EMER_PSYCH_SRVC_CD Char 1 Services Provided: Psychiatric - Emergency

487 EMER_PSYCH_SRVC_DESC Char 39 Services Provided: Psychiatric Emergency Description

360 EMPLEE_CNT Num 8 Total Number of Employees

214 ESRD_NTWRK_NUM Char 2 ESRD Network Number

705 EXPRMT_RSRCH_CNDCTD_SW Char 1 Experimental Research Conducted

693 EXTND_SRVY_BGN_DT Char 8 Extended Survey Begin Date

694 EXTND_SRVY_END_DT Char 8 Extended Survey End Date

115 FAC_STF_PRVDD_SW Char 1 Facility Staff Provided Code

280 FED_FUNDD_FQHC_SW Char 1 Federally Funded Health Center

875 FED_PGM_NAME Char 26 Title of Federal Program

874 FED_PGM_SPRT_SW Char 1 Federal Program Support

869 FEED_ASTNC_PGM_SW Char 1 Feeding Assistance Program Switch

816 FOOD_SRVC_CNTRCT_CNT Num 8 Food Service - Contract

814 FOOD_SRVC_FLTM_CNT Num 8 Food Service - Full-Time

815 FOOD_SRVC_PRTM_CNT Num 8 Food Service - Part-Time

934 FORM_116_ACRDTD_ Num 8 Application Accredited Annual Test Volume

TEST_VOL_CNT

935 FORM_116_CMPLNC_SCHDL_CD Char 1 Application Compliance Schedule Code

936 FORM_116_CMPLNC_ Char 45 Form 116 Compliance Schedule Description

SCHDL_DESC

937 FORM_116_CRTFCT_SCHDL_CD Char 1 Application Certification Schedule Code






938 FORM_116_CRTFCT_ Char 45 Form 116 Certificate Schedule Description

SCHDL_DESC

939 FORM_116_TEST_VOL_CNT Num 8 Application Total Annual Test Volume

940 FORM_1557_CMPLNC_SCHDL_CD Char 1 Survey Compliance Schedule Code

941 FORM_1557_CMPLNC_ Char 45 Form 1557 Compliance Schedule Description

SCHDL_DESC

942 FORM_1557_CRTFCT_SCHDL_CD Char 1 Survey Certificate Schedule Code

943 FORM_1557_CRTFCT_ Char 45 Form 1557 Certificate Schedule Description

SCHDL_DESC

944 FORM_1557_TEST_VOL_CNT Num 8 Survey Test Volume Total

263 FORM_VRSN_NUM Num 8 Form Version Number

281 FQHC_APRVD_RHC_PRVDR_NUM Char 10 FQHC Approved RHC Provider Number

279 FQHC_APRVD_RHC_SW Char 1 FQHC Approved Rural Health Clinic

490 FRNSC_PSYCH_SRVC_CD Char 1 Services Provided: Psychiatric - Forensic

491 FRNSC_PSYCH_SRVC_DESC Char 39 Services Provided: Psychiatric Forensic Description

81 FT_SRGRY_SW Char 1 Specialty: Foot

20 GNRL_CNTL_TYPE_CD Char 2 General Type of Control Code

21 GNRL_CNTL_TYPE_DESC Char 55 General Control Type Description

22 GNRL_FAC_TYPE_CD Char 2 Type of Facility

23 GNRL_FAC_TYPE_DESC Char 44 General Facility Type Description

945 GNRL_SPRVSR_B_1_CNT Num 8 General Supervisor (B)(1)

946 GNRL_SPRVSR_B_2_CNT Num 8 General Supervisor (B)(2)

947 GNRL_SPRVSR_CYTOLGY_A_CNT Num 8 General Supervisor Cytology (A)

948 GNRL_SPRVSR_CYTOLGY_B_CNT Num 8 General Supervisor Cytology (B)

949 GNRL_SPRVSR_C_1_CNT Num 8 General Supervisor ( C)(1)

950 GNRL_SPRVSR_C_2_CNT Num 8 General Supervisor (C)(2)




954 GNRL_SPRVSR_E_CNT Num 8 General Supervisor (E)

955 GNRL_SPRVSR_HIGH_D_1_CNT Num 8 General Supervisor (D)(1) Blood Gas



82 GNRL_SRGRY_SW Char 1 Specialty: Surgery

195 GRMCD_FRMLN_SW Char 1 Germicide - Formalin Switch

197 GRMCD_GLTRLDHYD_SW Char 1 Germicide - Gluteraldehyde Switch

196 GRMCD_HEAT_SW Char 1 Germicide - Heat Switch

199 GRMCD_OTHR_SW Char 1 Germicide - Other Switch

198 GRMCD_PERCTC_ACID_SW Char 1 Germicide - Peracetic Acid Switch

444 GRNTLGCL_SPCLTY_SRVC_CD Char 1 Services Provided: Gerontological Specialty

445 GRNTLGCL_SPCLTY_SRVC_DESC Char 39 Services Provided: Gerontological Specialty Description

138 GRP_THRPST_ARNGMT_CNT Num 8 Therapist (Group) - Arrangement

137 GRP_THRPST_EMPLEE_CNT Num 8 Therapist (Group) - Direct

492 GRTRC_PSYCH_SRVC_CD Char 1 Services Provided: Psychiatric - Geriatric

493 GRTRC_PSYCH_SRVC_DESC Char 39 Services Provided: Psychiatric Geriatric Description






699 HEAD_TRMA_BED_CNT Num 8 Special Care Beds - Head Trauma

335 HHA_QLFYD_OPT_SPCH_SW Char 1 HHA Qualified For Outpatient Physical Therapy

282 HHA_STD_SRVY_FREQ_CD Char 1 Survey Frequency Code

283 HHA_STD_SRVY_FREQ_DESC Char 41 HHA Standard Survey Frequency Description

319 HHA_TRNG_PGM_CD Char 1 Aide Training / Competency Programs

320 HHA_TRNG_PGM_DESC Char 45 HHA Training Program Description

317 HH_AIDE_CNT Num 8 Home Health Aides employed by an HHA

355 HH_AIDE_EMPLEE_CNT Num 8 Home Health Aides employed by a hospice

303 HH_AIDE_SRVC_CD Char 1 Service: Home Health Aide

304 HH_AIDE_SRVC_DESC Char 39 Home Health Aide Hospice Service Description

356 HH_AIDE_VLNTR_CNT Num 8 Home Health Aides - Volunteer

116 HMDLYS_DLYS_TYP_SW Char 1 Hemodialysis Dialysis Type Code

188 HMDLYS_HOME_SPRT_SW Char 1 Service: Home Support Hemodialysis

186 HMDLYS_HOME_TRNG_SRVC_SW Char 1 Service: Home Training Hemodialysis

201 HMDLYS_PTNT_CNT Num 8 Number of Dialysis Patients Hemodialysis

183 HMDLYS_SRVC_SW Char 1 Service: Hemodialysis

204 HMDLYS_STN_ESRD_CNT Num 8 Stations - Hemodialysis

205 HMDLYS_STN_TRNG_CNT Num 8 Number of Stations Hemodialysis Training

353 HMMKR_EMPLEE_CNT Num 8 Homemakers - Staff

339 HMMKR_SRVC_CD Char 1 Service: Homemaker

340 HMMKR_SRVC_DESC Char 39 Homemaker Hospice Service Description

354 HMMKR_VLNTR_CNT Num 8 Homemakers - Volunteer

701 HNTGTN_DEASE_BED_CNT Num 8 Special Care Beds - Huntingtons

262 HOME_PD_PTNTS_NUM Num 8 Home Peritoneal Dialysis Patients Number

207 HOME_PTNT_CNT Num 8 Number of patients at Home

323 HOME_VISIT_NO_REC_RVW_CNT Num 8 Home Visits - No Records Reviewed

373 HOME_VISIT_PRVT_RSDNC_CNT Num 8 Home Visits - Private Residence

374 HOME_VISIT_RSDNTL_FAC_CNT Num 8 Home Visits -Residential Facility

700 HOSPC_BED_CNT Num 8 Special Care Beds - Hospice

362 HOSPC_FORM_SW Char 1 Hospice Form Indicator

369 HOSPC_HOME_CARE_OTHR_SW Char 1 Home Care - Other

371 HOSPC_PTNT_12_MO_ADMT_CNT Num 8 Patients Admitted 12 Month Period

178 HOSP_BSD_SW Char 1 Hospital Based Switch

958 HOSP_LAB_EXCPTN_SW Char 1 Hospital Lab Exception Switch

261 HOSP_MN_CMPS_IND Char 1 Hospital Main Campus Indicator

864 HSEKPNG_CNTRCT_CNT Num 8 Housekeeping - Contract

862 HSEKPNG_FLTM_CNT Num 8 Housekeeping - Full-Time

863 HSEKPNG_PRTM_CNT Num 8 Housekeeping - Part-Time

774 HSEKPNG_SRVC_OFSITE_ Char 1 Service: Housekeeping Off-Site to Residents

RSDNT_SW

773 HSEKPNG_SRVC_ONST_ Char 1 Service: Housekeeping On-Site to Nonresidents

NRSDNT_SW

772 HSEKPNG_SRVC_ Char 1 Service: Housekeeping On-Site to Residents

ONST_RSDNT_SW

553 ICFMR_CLNT_CNT Num 8 Clients in ICF/MR






449 ICU_SRVC_CD Char 1 Services Provided: ICU Medical/Surgical

448 ICU_SRVC_DESC Char 44 Services Provided: ICU Medical/Surgical Description

688 IDR_CMPLTN_DT Char 8 IDR Completion Date

687 IDR_RQST_DT Char 8 IDR Request Date

959 IMNOHMTLGY_TEST_PRFMD_SW Char 1 Immunohematology Test Performed

52 INACTVTY_DT Char 8 Inactivity Date

260 INCNTR_NCTRNL_HD_NUM Num 8 In-Center Nocturnal Hemodialysis Number

259 INCNTR_PD_PTNTS_NUM Num 8 In-Center Peritoneal Dialysis Patients Number

407 INHLTN_THRPST_CNT Num 8 Respiratory Therapists

50 INITL_COP_APRVL_DT Char 8 Initial Conditions of Participation Approval Date

284 INITL_CRTFCTN_ Char 1 Type of Survey - Initial

SRVY_TYPE_CD

285 INITL_CRTFCTN_ Char 24 Initial Certification Survey Type Description

SRVY_TYPE_DESC

51 INITL_DNL_DT Char 8 Initial Denial Date

305 INTRN_RSDNT_SRVC_CD Char 1 Service: Interns and Residents

306 INTRN_RSDNT_SRVC_DESC Char 39 Intern Resident HHA Service Description

363 IP_CARE_ON_PRMS_SW Char 1 Inpatient Care on Premises

510 IP_SRGCL_SRVC_CD Char 1 Services Provided: Inpatient Surgical

511 IP_SRGCL_SRVC_DESC Char 39 Services Provided: Inpatient Surgical Description

258 ISO_AGRMT_IND Char 1 Isolation Agreement Indicator

257 ISO_AREA_IND Char 1 Isolation Area Indicator

256 ISO_ROOM_IND Char 1 Isolation Room Indicator

206 ISO_STN_SW Char 1 ISO Station Switch

384 JC_ACRDTN_STUS_SW Char 1 JCAHO Accreditation Status Switch

960 LAB_SITE_CNT Num 8 Number of Lab Sites

71 LAB_SRVC_CD Char 1 Service: Laboratory

73 LAB_SRVC_DESC Char 39 Laboratory Service Description

401 LAB_TCHNCN_CNT Num 8 Lab Technician Count

209 LPN_CNT Num 8 Number of License Practical Nurses

709 LPN_LVN_24_HR_WVR_DT Char 8 Date of 24 Hour LPN/LVN Waiver

313 LPN_LVN_CNT Num 8 Licensed Practical/Vocational Nurses

798 LPN_LVN_CNTRCT_CNT Num 8 LPN/LVN - Contract

796 LPN_LVN_FLTM_CNT Num 8 LPN/LVN - Full-Time

710 LPN_LVN_HR_WVR_CNT Num 8 LN Hours Waived Per Week

797 LPN_LVN_PRTM_CNT Num 8 LPN/LVN - Part-Time

350 LPN_LVN_VLNTR_CNT Num 8 LPNS/LVNS Volunteer

551 LRGR_ORG_BED_CNT Num 8 Beds in Larger Organization

552 LRGR_ORG_CLNT_CNT Num 8 Clients in Larger Organization

550 LRGR_ORG_MBRSHP_SW Char 1 Member of Larger Organization

101 LRYNGSCP_ENDTRCHL_TUBE_SW Char 1 ASC Equipment: Laryngoscope, Endotracheal

72 LSC_WVR_SW Char 1 Compliance: Life Safety Code

96 MCHNCL_VNTLTN_EQUIP_SW Char 1 ASC Equipment: Mechanical Ventilation

692 MDCD_SNF_BED_CNT Num 8 Beds - Nursing Facility

778 MDCL_DRCTR_CNTRCT_CNT Num 8 Medical Director - Contract






779 MDCL_DRCTR_FLTM_CNT Num 8 Medical Director - Full-Time

780 MDCL_DRCTR_PRTM_CNT Num 8 Medical Director - Part-Time

106 MDCL_HSTRY_SW Char 1 ASC Records: Medical History

386 MDCL_SCHL_AFLTN_CD Char 1 Medical School Affiliation

387 MDCL_SCHL_AFLTN_DESC Char 14 Medical School Affiliation Description

301 MDCL_SCL_SRVC_CD Char 1 Service: Medical Social

302 MDCL_SCL_SRVC_DESC Char 39 Medical Social Service Description

351 MDCL_SCL_WORKR_CNT Num 8 Medical Social Workers

352 MDCL_SCL_WORKR_VLNTR_CNT Num 8 Medical Social Workers - Volunteer

341 MDCL_SUPLY_SRVC_CD Char 1 Service: Medical Supplies

342 MDCL_SUPLY_SRVC_DESC Char 39 Medical Supply Hospice Service Description

402 MDCL_TCHNLGST_CNT Num 8 Medical Technologist Count

415 MDCR_DPNDNT_HOSP_SW Char 1 Medicare Dependent Hospital Switch

255 MDCR_ENRLMT_APRVD_IND Char 1 Medicare Enrollment Approved Indicator

254 MDCR_ENRLMT_IND Char 1 Medicare Enrollment Indicator

291 MDCR_HOSPC_SW Char 1 Hospice Switch

691 MDCR_MDCD_SNF_BED_CNT Num 8 Beds - SNF / NF

143 MDCR_PRTCPTN_ Char 1 Participation Medicare OPT / SP

OP_PT_SPCH_SW

690 MDCR_SNF_BED_CNT Num 8 Beds - Medicare SNF

516 MDCR_TRNSPLNT_ Char 1 Services Provided: Transplant Center (Medicare Certified)

CNTR_SRVC_CD

517 MDCR_TRNSPLNT_ Char 39 Services Provided: Transplant Center

CNTR_SRVC_DESC (Medicare Certified) Description

807 MDCTN_AIDE_CNTRCT_CNT Num 8 Medication Aides / Techs - Contract

805 MDCTN_AIDE_FLTM_CNT Num 8 Medication Aides / Techs - Full-Time

806 MDCTN_AIDE_PRTM_CNT Num 8 Medication Aides / Techs - Part-Time

124 MD_OTHR_ARNGMT_CNT Num 8 MD Other - Arrangement

123 MD_OTHR_EMPLEE_CNT Num 8 MD Other - Direct

122 MD_PSYCHTRST_ARNGMT_CNT Num 8 MD Psychiatrist - Arrangement

121 MD_PSYCHTRST_EMPLEE_CNT Num 8 MD Psychiatrist - Direct

759 MENTL_HLTH_OFSITE_ Char 1 Service: Mental Health Off-Site to Residents

RSDNT_SW

758 MENTL_HLTH_ONST_NRSDNT_SW Char 1 Service: Mental Health On-site to Nonresidents

757 MENTL_HLTH_ONST_RSDNT_SW Char 1 Service: Mental Health On-Site to Residents

861 MENTL_HLTH_SRVC_ Num 8 Mental Health Services - Contract

CNTRCT_CNT

859 MENTL_HLTH_SRVC_FLTM_CNT Num 8 Mental Health Services - Full-Time

860 MENTL_HLTH_SRVC_PRTM_CNT Num 8 Mental Health Services - Part-Time

458 MGNTC_RSNC_IMG_SRVC_CD Char 1 Services Provided: Magnetic Resonance Imaging

459 MGNTC_RSNC_IMG_SRVC_DESC Char 39 Services Provided: Magnetic Resonance Imaging Description

383 MLTPL_ACRDTN_STUS_SW Char 1 Multiple Accreditation Status Switch

253 MLT_FAC_MNGD_IND Char 1 Multiple Facility Managed Indicator

181 MLT_FAC_ORG_NAME Char 38 Multi-Facility Organization Name

252 MLT_FAC_OWND_IND Char 1 Multiple Facility Owned Indicator






375 MLT_LCTN_SW Char 1 More Than One Location Switch

180 MLT_OWND_FAC_ORG_SW Char 1 Multi-Facility Organization Owned

961 MLT_SITE_EXCPTN_SW Char 1 Multiple Site Certificate Switch

555 MR_BED_CNT Num 8 Beds - ICF / MR

559 MR_DAY_PGM_SITE_CNT Num 8 Day Program Sites

804 NAT_CNTRCT_CNT Num 8 Nurse Aides in Training - Contract

802 NAT_FLTM_CNT Num 8 Nurse Aides in Training - Full-Time

803 NAT_PRTM_CNT Num 8 Nurse Aides in Training - Part-Time

450 NEONTL_ICU_SRVC_CD Char 1 Services Provided: ICU Neonatal

451 NEONTL_ICU_SRVC_DESC Char 39 Services Provided: Neonatal ICU Description

460 NEONTL_NRSRY_SRVC_CD Char 1 Services Provided: Neonatal Nursery

461 NEONTL_NRSRY_SRVC_DESC Char 39 Services Provided: Neonatal Nursery Description

368 NF_HOME_CARE_SW Char 1 Home Care - Nursing Facility

329 NH_DSCHRG_CNT Num 8 Census - Discharges - Nursing Home

119 NH_PRVDR_NUM Char 10 Nursing Home Provider Number

117 NH_STF_PRVDD_SW Char 1 Nursing Home Staff Provided Code

962 NON_PRFT_EXCPTN_SW Char 1 Non-Profit Code

83 NRLGCL_SRGRY_SW Char 1 Specialty: Neurological

176 NRSNG_2_SRVC_CD Char 1 Service: Nursing #2

177 NRSNG_3_SRVC_CD Char 1 Service: Nursing #3

297 NRSNG_SRVC_CD Char 1 Service: Nursing

298 NRSNG_SRVC_DESC Char 39 Nursing Service Description

720 NRSNG_SRVC_OFSITE_ Char 1 Service: Nursing Off-Site to Residents

RSDNT_SW

719 NRSNG_SRVC_ONST_NRSDNT_SW Char 1 Service: Nursing On-Site to Nonresidents

718 NRSNG_SRVC_ONST_RSDNT_SW Char 1 Service: Nursing On-Site to Residents

365 NRSNG_SRVC_WVR_DT Char 8 Date of Nursing Service Waiver

364 NRSNG_SRVC_WVR_SW Char 1 Waiver of Nursing Services

462 NRSRGCL_SRVC_CD Char 1 Services Provided: Neurosurgical Services

463 NRSRGCL_SRVC_DESC Char 39 Services Provided: Neurosurgical Description

790 NRS_ADMINV_CNTRCT_CNT Num 8 Nurses With Administrative Duties - Contract

791 NRS_ADMINV_FLTM_CNT Num 8 Nurses With Administrative Duties - Full-Time

792 NRS_ADMINV_PRTM_CNT Num 8 Nurses With Administrative Duties - Part-Time

801 NRS_AIDE_CNTRCT_CNT Num 8 Certification Nurse Aides - Contract

799 NRS_AIDE_FLTM_CNT Num 8 Certification Nurse Aides - Full-Time

800 NRS_AIDE_PRTM_CNT Num 8 Certification Nurse Aides - Part-Time

128 NRS_ARNGMT_CNT Num 8 Nurse - Arrangement

127 NRS_EMPLEE_CNT Num 8 Nurse - Direct

877 NRS_PRCTNR_1_YR_PGM_CNT Num 8 Nurse Practitioners - 1 Year Program

400 NRS_PRCTNR_CNT Num 8 Nurse Practitioners

878 NRS_PRCTNR_EXPRNC_CNT Num 8 Nurse Practitioners - Experience

307 NTRTNL_GDNC_SRVC_CD Char 1 Service: Nutritional Guidance

308 NTRTNL_GDNC_SRVC_DESC Char 39 Nutritional Guidance HHA Service Description

464 NUCLR_MDCN_SRVC_CD Char 1 Services Provided: Nuclear Medicine

465 NUCLR_MDCN_SRVC_DESC Char 39 Services Provided: Nuclear Medicine Description






403 NUCLR_MDCN_TCHNCN_CNT Num 8 Nuclear Medicine Technician Count

84 OB_GYN_SRGRY_SW Char 1 Specialty: Obstetrics / Gynecology

466 OB_SRVC_CD Char 1 Services Provided: Obstetrics

467 OB_SRVC_DESC Char 39 Services Provided: Obstetrics Description

136 OCPTNL_THRPST_ARNGMT_CNT Num 8 Therapist (Occupational) - Arrangement

315 OCPTNL_THRPST_CNT Num 8 Occupational Therapists

819 OCPTNL_THRPST_CNTRCT_CNT Num 8 Occupational Therapist - Contract

135 OCPTNL_THRPST_EMPLEE_CNT Num 8 Occupational Therapist - Direct

817 OCPTNL_THRPST_FLTM_CNT Num 8 Occupational Therapist - Full-Time

818 OCPTNL_THRPST_PRTM_CNT Num 8 Occupational Therapist - Part-Time

963 ODIE_CRTFCT_EFCTV_DT Char 8 ODIE Certificate Effective Date

964 ODIE_CRTFCT_TYPE_CHG_SW Char 1 Certificate Changed Due to Survey

965 ODIE_ENTRY_PNDNG_DT Char 8 ODIE Survey Entry Pending Date

679 OMBDMN_NTFY_SW Char 1 Ombudsman Notified Prior to Survey

680 OMBDMN_PRSNT_SW Char 1 Ombudsman Present During Survey

428 OPEN_HRT_SRGRY_SRVC_CD Char 1 Services Provided: Cardiac - Thoracic Surgery

429 OPEN_HRT_SRGRY_SRVC_DESC Char 39 Services Provided: Cardiac - Thoracic Surgery Description

267 OPNG_TMS_MWF_PTNTS_NUM Num 8 Opening Times Monday, Wednesday,

and Friday Patients Number

270 OPNG_TMS_MWF_STF_NUM Num 8 Opening Times Monday, Wednesday, and Friday Staff Number

269 OPNG_TMS_TTS_PTNTS_NUM Num 8 Opening Times Tuesday, Thursday

and Saturday Patients Number

268 OPNG_TMS_TTS_STF_NUM Num 8 Opening Times Tuesday, Thursday and Saturday Staff Number

396 OPRTG_ROOMS_NUM Num 8 Operating Rooms Number

93 OPRTG_ROOM_CNT Num 8 Operating Rooms

468 OPRTG_ROOM_SRVC_CD Char 1 Services Provided: Operating Rooms

469 OPRTG_ROOM_SRVC_DESC Char 39 Services Provided: Operating Room Description

108 OPRTN_FNDNG_SW Char 1 ASC Records: Operation Findings

470 OPTHLMC_SRGY_SRVC_CD Char 1 Services Provided: Ophthalmic Surgery

471 OPTHLMC_SRGY_SRVC_DESC Char 39 Services Provided: Ophthalmic Surgery Description

85 OPTHMLGY_SRGRY_SW Char 1 Specialty: Opthamology

472 OPTMTRC_SRVC_CD Char 1 Services Provided: Optometric

473 OPTMTRC_SRVC_DESC Char 44 Services Provided: Optometric Description

55 OPTN_CD Char 4 Organ Procurement and Transplantation Network Codes

496 OP_PSYCH_SRVC_CD Char 1 Services Provided: Psychiatric - Outpatient

497 OP_PSYCH_SRVC_DESC Char 39 Services Provided: Psychiatric Outpatient Description

506 OP_REHAB_SRVC_CD Char 1 Services Provided: Rehabilitation Outpatient

507 OP_REHAB_SRVC_DESC Char 39 Services Provided: Rehabilitation Outpatient Description

512 OP_SRGRY_UNIT_SRVC_CD Char 1 Services Provided: Outpatient Surgery

513 OP_SRGRY_UNIT_SRVC_DESC Char 39 Services Provided: Outpatient Surgery Description

478 OP_SRVC_CD Char 1 Services Provided: Outpatient

479 OP_SRVC_DESC Char 39 Services Provided: Outpatient Description

104 ORAL_SRGRY_SW Char 1 Specialty: Oral

53 ORGNL_PGM_APRVD_DT Char 8 Original Program Approved Date

54 ORGNL_PGM_SW Char 1 Original Program Switch






704 ORGNZ_FMLY_MBR_GRP_SW Char 1 Organized Family Group

703 ORGNZ_RSDNT_GRP_SW Char 1 Organized Resident Group

474 ORGN_TRNSPLNT_SRVC_CD Char 1 Services Provided: Organ Transplant

(Not Medicare Certified)

475 ORGN_TRNSPLNT_SRVC_DESC Char 39 Services Provided: Organ Transplant

(Not Medicare Certified) Description

86 ORTHPDC_SRGRY_SW Char 1 Specialty: Orthopedic

476 ORTHPDC_SRGY_SRVC_CD Char 1 Services Provided: Orthopedic Surgery

477 ORTHPDC_SRGY_SRVC_DESC Char 39 Services Provided: Orthopedic Surgery Description

174 ORTHTC_PRSTHTC_2_SRVC_CD Char 1 Service: Orthotic Prosthetic #2

175 ORTHTC_PRSTHTC_3_SRVC_CD Char 1 Service: Orthotic/Prosthetic #3

172 ORTHTC_PRSTHTC_SRVC_CD Char 1 Orthotic/Prosthetic Service Code

173 ORTHTC_PRSTHTC_SRVC_DESC Char 39 Orthotic/Prosthetic Service Description

91 OTHR_SRVC_CD Char 1 Service: Other

92 OTHR_SRVC_DESC Char 39 Other Service Description

87 OTLRYNGLGY_SRGRY_SW Char 1 Specialty: Otolaryngology

162 OT_2_SRVC_CD Char 1 Service: Occupational Therapy #2

163 OT_3_SRVC_CD Char 1 Service: Occupational Therapy #3

825 OT_AIDE_CNTRCT_CNT Num 8 Occupational Therapy Aide - Contract

823 OT_AIDE_FLTM_CNT Num 8 Occupational Therapy Aide - Full-Time

824 OT_AIDE_PRTM_CNT Num 8 Occupational Therapy Aide - Part-Time

822 OT_ASTNT_AIDE_CNTRCT_CNT Num 8 Occupational Therapy Assistant - Contract

820 OT_ASTNT_AIDE_FLTM_CNT Num 8 Occupational Therapy Assistant - Full-Time

821 OT_ASTNT_AIDE_PRTM_CNT Num 8 Occupational Therapy Assistant - Part-Time

160 OT_SRVC_CD Char 1 Services Provided: Occupational Therapy

161 OT_SRVC_DESC Char 39 Services Provided: Occupational Therapy Description

729 OT_SRVC_OFSITE_RSDNT_SW Char 1 Service: Occupational Therapy Off-Site to Residents

728 OT_SRVC_ONST_NRSDNT_SW Char 1 Service: Occupational Therapy On-Site to Nonresidents

727 OT_SRVC_ONST_RSDNT_SW Char 1 Service: Occupational Therapy On-Site to Residents

526 OVRRD_BED_CNT_SW Char 1 Regional Override # 1 (Number Beds)

528 OVRRD_NRS_BED_SW Char 1 Regional Override # 3 (Nurse - Bed)

527 OVRRD_STFG_SW Char 1 Regional Override # 2 (Staffing)

95 OXGN_EQUIP_SW Char 1 ASC Equipment: Oxygen

377 PART_ANTHR_ENT_SW Char 1 Part of Another Entity

120 PART_PRTCPTG_PRVDR_SW Char 1 Part Of a Participating Provider

858 PDTRST_CNTRCT_CNT Num 8 Podiatrists - Contract

856 PDTRST_FLTM_CNT Num 8 Podiatrists - Full-Time

857 PDTRST_PRTM_CNT Num 8 Podiatrists - Part-Time

756 PDTRY_SRVC_OFSITE_ Char 1 Service: Podiatry Off-Site to Residents

RSDNT_SW

755 PDTRY_SRVC_ONST_NRSDNT_SW Char 1 Service: Podiatry On-Site to Nonresidents

754 PDTRY_SRVC_ONST_RSDNT_SW Char 1 Service: Podiatry On-Site to Residents

57 PED_HOSP_NAME Char 50 Pediatric Hospital Name

58 PED_HOSP_PRVDR_NUM Char 10 Pediatric Hospital Provider Number

56 PED_HRT_PGM_SW Char 1 Pediatric Heart Program Switch






452 PED_ICU_SRVC_CD Char 1 Services Provided: ICU Pediatric

453 PED_ICU_SRVC_DESC Char 39 Services Provided: Pediatric ICU Description

480 PED_SRVC_CD Char 1 Services Provided: Pediatric

481 PED_SRVC_DESC Char 39 Services Provided: Pediatric Description

482 PET_SCAN_SRVC_CD Char 1 Services Provided: PET Scan Services

483 PET_SCAN_SRVC_DESC Char 39 Services Provided: PET Scanner Description

59 PGM_APRVD_DT Char 8 Program Approved Date

141 PGM_PRTCPTN_CD Char 1 Program Participation

142 PGM_PRTCPTN_DESC Char 21 Program Participation Description

60 PGM_SRVY_AGE_NUM Num 8 Program Survey Age Number

61 PGM_TRMNTN_DT Char 8 Program Termination Date

810 PHRMCST_CNTRCT_CNT Num 8 Pharmacists - Contract

808 PHRMCST_FLTM_CNT Num 8 Pharmacists - Full-Time

809 PHRMCST_PRTM_CNT Num 8 Pharmacists - Part-Time

78 PHRMCY_SRVC_CD Char 1 Services Provided: Pharmacy

79 PHRMCY_SRVC_DESC Char 39 Services Provided: Pharmacy Description

723 PHRMCY_SRVC_OFSITE_ Char 1 Service: Pharmacy Off-Site to Residents

RSDNT_SW

722 PHRMCY_SRVC_ONST_ Char 1 Service: Pharmacy On-Site to Nonresidents

NRSDNT_SW

721 PHRMCY_SRVC_ONST_RSDNT_SW Char 1 Service: Pharmacy On-Site to Residents

149 PHYSN_2_SRVC_CD Char 1 Service: Physician #2

150 PHYSN_3_SRVC_CD Char 1 Service: Physician #3

880 PHYSN_ASTNT_1_YR_TRNG_CNT Num 8 Physician Assistants - 1 Year Program

398 PHYSN_ASTNT_CNT Num 8 Physician Assistants (PA)

879 PHYSN_ASTNT_CRTFD_CNT Num 8 Physician Assistants - Certified

881 PHYSN_ASTNT_EXPRNC_CNT Num 8 Physician Assistants - Experience

347 PHYSN_CNT Num 8 Physicians

784 PHYSN_EXT_CNTRCT_CNT Num 8 Physician Extender - Contract

785 PHYSN_EXT_FLTM_CNT Num 8 Physician Extender Full-Time Count (F37B)

786 PHYSN_EXT_PRTM_CNT Num 8 Physician Extender Part-Time Count (F37C)

717 PHYSN_EXT_SRVC_ Char 1 Physician Extender Service Offsite

OFSITE_RSDNT_SW To Resident Switch (F37A3)

716 PHYSN_EXT_SRVC_ Char 1 Physician Extender Service Onsite

ONST_NRSDNT_SW To Non-Resident Switch (F37A2)

715 PHYSN_EXT_SRVC_ Char 1 Physician Extender Service Onsite

ONST_RSDNT_SW To Resident Switch (F37A1)

781 PHYSN_OTHR_CNTRCT_CNT Num 8 Other Physician Contract

782 PHYSN_OTHR_FLTM_CNT Num 8 Other Physician Full-Time

783 PHYSN_OTHR_PRTM_CNT Num 8 Other Physician Part-Time

148 PHYSN_SRVC_CD Char 1 Service: Physician

151 PHYSN_SRVC_DESC Char 39 Physician Service Description

714 PHYSN_SRVC_OFSITE_ Char 1 Service: Physician Off-Site to Residents

RSDNT_SW

713 PHYSN_SRVC_ONST_NRSDNT_SW Char 1 Service: Physician On-Site to Nonresidents






712 PHYSN_SRVC_ONST_RSDNT_SW Char 1 Service: Physician On-Site to Residents

348 PHYSN_VLNTR_CNT Num 8 Physicians - Volunteer

871 PHYS_THRPST_ARNGMT_CNT Num 8 Physical Therapist - Arrangement

404 PHYS_THRPST_CNT Num 8 Physical Therapists

828 PHYS_THRPST_CNTRCT_CNT Num 8 Physical Therapists - Contract

826 PHYS_THRPST_FLTM_CNT Num 8 Physical Therapists - Full-Time

827 PHYS_THRPST_PRTM_CNT Num 8 Physical Therapists - Part-Time

314 PHYS_THRPST_STF_CNT Num 8 Physical Therapists on Staff

88 PLSTC_SRGRY_SW Char 1 Specialty: Plastic Surgery

411 PPS_EXCLSN_PSYCH_UNIT_SW Char 1 PPS Exclusion Psychiatric Unit Switch

412 PPS_EXCLSN_REHAB_UNIT_SW Char 1 PPS Exclusion Rehabilitation Unit Switch

107 PREOPRTV_DGNS_SW Char 1 ASC Records: Pre-Operative Diagnosis

966 PRFCNCY_TSTG_ENRLMT_ Char 1 Proficiency Testing Enrollment Records on File Switch

REC_FIL_SW

967 PRFCNCY_TSTG_SCRE_ Char 1 Proficiency Testing Score Records on File Switch

REC_FIL_SW

775 PROFNL_ADMIN_CNTRCT_CNT Num 8 Administrator - Contract

776 PROFNL_ADMIN_FLTM_CNT Num 8 Administrator - Full-Time

777 PROFNL_ADMIN_PRTM_CNT Num 8 Administrator - Part-Time

213 PRSNEL_OTHR_CNT Num 8 Other Personnel

189 PRTNL_DLYS_HOME_ Char 1 Service: Home Support Peritoneal Dialysis

SPRT_SRVC_SW

187 PRTNL_DLYS_HOME_ Char 1 Service: Home Training Peritoneal Dialysis

TRNG_SRVC_SW

202 PRTNL_DLYS_PTNT_CNT Num 8 Number of Dialysis Patients Peritoneal

184 PRTNL_DLYS_SRVC_SW Char 1 Service: Peritoneal Dialysis

118 PRTNL_DLYS_TYP_SW Char 1 Peritoneal Dialysis Type Code

548 PRVDR_BSD_FAC_SW Char 1 Provider Based Facility

24 PRVDR_CTGRY_CD Char 2 Provider Category Code

25 PRVDR_CTGRY_DESC Char 60 Provider Category Description

376 PRVDR_LCTN_CNT Num 8 Number of Locations


366 PRVT_RSDNC_HOME_CARE_SW Char 1 Home Care - Private Residence

484 PSTOPRTV_RCVRY_SRVC_CD Char 1 Services Provided: Postoperative Recovery Room

485 PSTOPRTV_RCVRY_SRVC_DESC Char 39 Services Provided: Postoperative

Recovery Room Description

157 PSYCHLGCL_2_SRVC_CD Char 1 Service: Psychological #2

158 PSYCHLGCL_3_SRVC_CD Char 1 Service: Psychological #3

156 PSYCHLGCL_SRVC_CD Char 1 Service: Psychological

159 PSYCHLGCL_SRVC_DESC Char 39 Psychological CORF Service Description

126 PSYCHLGST_ARNGMT_CNT Num 8 Psychologist - Arrangement

405 PSYCHLGST_CNT Num 8 Psychologist Count

125 PSYCHLGST_EMPLEE_CNT Num 8 Psychologist - Direct

494 PSYCH_SRVC_CD Char 1 Services Provided: Psychiatric - Adult Inpatient






495 PSYCH_SRVC_DESC Char 39 Services Provided: Psychiatric

- Adult Inpatient Description

111 PTNT_CNSNT_SW Char 1 ASC Records: Informed Patient Consent

105 PTNT_ID_SW Char 1 ASC Records: Patient Identification

145 PT_2_SRVC_CD Char 1 Service: Physical Therapy #2

146 PT_3_SRVC_CD Char 1 Service: Physical Therapy #3

834 PT_AIDE_CNTRCT_CNT Num 8 Physical Therapy Aide - Contract

832 PT_AIDE_FLTM_CNT Num 8 Physical Therapy Aide - Full-Time

833 PT_AIDE_PRTM_CNT Num 8 Physical Therapy Aide - Part-Time

831 PT_ASTNT_CNTRCT_CNT Num 8 Physical Therapy Assistant - Contract

829 PT_ASTNT_FLTM_CNT Num 8 Physical Therapy Assistant - Full-Time

830 PT_ASTNT_PRTM_CNT Num 8 Physical Therapy Assistant - Part-Time

732 PT_OFSITE_RSDNT_SW Char 1 Service: Physical Therapy Off-Site to Residents

731 PT_ONST_NRSDNT_SW Char 1 Service: Physical Therapy On-Site to Nonresidents

730 PT_ONST_RSDNT_SW Char 1 Service: Physical Therapy On-Site to Residents

870 PT_SPCH_THRPY_SRVC_DESC Char 39 Physical Therapy/Speech Therapy OPT Service Description

144 PT_SRVC_CD Char 1 Services Provided: Physical Therapy

147 PT_SRVC_DESC Char 39 Services Provided: Physical Therapy Description

502 RCNSTRCTN_SRGY_SRVC_CD Char 1 Services Provided: Reconstructive Surgery

503 RCNSTRCTN_SRGY_SRVC_DESC Char 39 Services Provided: Reconstruction Surgery Description

63 RCRTFCTN_DUE_DT Char 8 Recertification Due Date

286 RCRTFCTN_SRVY_TYPE_CD Char 1 Type of Survey - Recertification

287 RCRTFCTN_SRVY_TYPE_DESC Char 27 Recertification Survey Type Description

134 RCRTNL_THRPST_ARNGMT_CNT Num 8 Therapist (Recreational) - Arranged

133 RCRTNL_THRPST_EMPLEE_CNT Num 8 Therapist (Recreational) - Direct

74 RDLGY_SRVC_CD Char 1 Service: Radiology

75 RDLGY_SRVC_DESC Char 39 Radiology Service Description

406 RDLGY_TCHNCN_CNT Num 8 Radiology Technician Count

62 REACTVTN_DT Char 8 Reactivation Date

372 REC_REV_CNT Num 8 Number of Records Reviewed

321 REC_REV_HOME_VISIT_CNT Num 8 Records Reviewed - Home Visits

322 REC_REV_NO_HOME_VISIT_CNT Num 8 Records Reviewed - No Home Visits



318 REG_PHRMCST_CNT Num 8 Registered Pharmacists

868 REHAB_BED_CNT Num 8 Special Care Bed - Specialized Rehab

392 RES_PGM_APPR_PDTRC_SW Char 1 Resident Program Approve Podiatric Switch

190 REUSE_CNTRLZD_OFST_IND Char 1 Reuse Systems Centralized/Offsite Indicator

194 REUSE_SYS_AUTOMT_SW Char 1 Reuse System Automated Switch

192 REUSE_SYS_MNL_SW Char 1 Reuse System Manual Switch

191 REUSE_SYS_PRCTC_SW Char 1 Reuse System Practiced Switch

193 REUSE_SYS_SEMI_AUTOMTC_SW Char 1 Reuse System Semi-Automatic Switch

416 RGNL_RFRL_CNTR_SW Char 1 Regional Referral Center Switch

34 RGN_CD Char 2 Region Code

35 RGN_DESC Char 16 Region Description






523 RN_24_HR_WVR_SW Char 1 Compliance: 24 Hour Registered Nurse

708 RN_7_DAY_WVD_HR_CNT Num 8 RN Hours Waived Per Week

707 RN_7_DAY_WVR_DT Char 8 Date of 7 Day RN Waiver

677 RN_7_DAY_WVR_SW Char 1 Compliance: 7 Day Registered Nurse

208 RN_CNT Num 8 Registered Nurses

795 RN_CNTRCT_CNT Num 8 Registered Nurse - Contract

787 RN_DRCTR_CNTRCT_CNT Num 8 RN Director of Nursing - Contract

788 RN_DRCTR_FLTM_CNT Num 8 RN Director of Nursing - Full-Time

789 RN_DRCTR_PRTM_CNT Num 8 RN Director of Nursing - Part-Time

793 RN_FLTM_CNT Num 8 Registered Nurse - Full-Time

794 RN_PRTM_CNT Num 8 Registered Nurse - Part-Time

349 RN_VLNTR_CNT Num 8 Registered Nurses - Volunteer

532 ROOM_SIZE_WVR_SW Char 1 Compliance: Patient Room Size

37 RO_ANLYST_TXT Char 3 RO Analyst Text

543 RO_MDCD_RVW_CMPLT_DT Char 8 Date of Regional Office Title 19 Final Review

11 RO_RCPT_DT Char 8 Regional Office Receipt Date

278 RQSTD_HOME_HD_TS_IND Char 1 Requested Home Hemodialysis Training & Support Indicator

277 RQSTD_HOME_PD_TS_IND Char 1 Requested Home Peritoneal Dialysis

Training & Support Indicator

276 RQSTD_INCNTR_HD_IND Char 1 Requested In-Center Hemodialysis Indicator

275 RQSTD_INCNTR_PD_IND Char 1 Requested In-Center Peritoneal Dialysis Indicator

540 RSCND_SUSPNSN_DT Char 8 Rescind Suspension Date

542 RSCND_SUSPNSN_PRIOR_DT Char 8 Prior Rescind Suspension Date

370 RSDNT_FAC_HOSPC_PTNT_CNT Num 8 Patients in Residential Facilities

389 RSDNT_PGM_ADA_APRVD_SW Char 1 Resident Program Approved by ADA

388 RSDNT_PGM_AMA_APRVD_SW Char 1 Resident Program Approved by AMA

390 RSDNT_PGM_AOA_APRVD_SW Char 1 Resident Program Approved by AOA

391 RSDNT_PGM_OTHR_APRVD_SW Char 1 Resident Program Approved by Other

397 RSDNT_PHYSN_CNT Num 8 Physicians (Residents)

166 RSPRTRY_CARE_2_SRVC_CD Char 1 Service: Respiratory Care #2

167 RSPRTRY_CARE_3_SRVC_CD Char 1 Service: Respiratory Care #3

164 RSPRTRY_CARE_SRVC_CD Char 1 Services Provided: Respiratory Care

165 RSPRTRY_CARE_SRVC_DESC Char 44 Services Provided: Respiratory Care Description

293 SBUNIT_CNT Num 8 Subunits

292 SBUNIT_OPRTN_SW Char 1 Subunit Operation Switch

294 SBUNIT_SW Char 1 Subunit Switch

414 SB_SIZE_CD Char 1 Swing Bed Size Code

413 SB_SW Char 1 Swing Bed Switch

154 SCL_2_SRVC_CD Char 1 Service: Social #2

155 SCL_3_SRVC_CD Char 1 Service: Social #3

152 SCL_SRVC_CD Char 1 Services Provided: Social

153 SCL_SRVC_DESC Char 39 Services Provided: Social Description

750 SCL_SRVC_OTHR_OFSITE_ Char 1 Service: Other Off-Site to Residents

RSDNT_SW






749 SCL_SRVC_OTHR_ Char 1 Service: Other On-Site to Nonresidents

ONST_NRSDNT_SW

740 SCL_SRVC_OTHR_ Char 1 Service: Other On-Site to Residents

ONST_RSDNT_SW

852 SCL_SRVC_OTHR_ Num 8 Other Social Service Staff - Contract

STF_CNTRCT_CNT

850 SCL_SRVC_OTHR_ Num 8 Other Social Service Staff - Full-Time

STF_FLTM_CNT

851 SCL_SRVC_OTHR_ Num 8 Other Social Service Staff - Part-Time

STF_PRTM_CNT

130 SCL_WORKR_BS_ARNGMT_CNT Num 8 Social Worker (BS) - Arrangement

129 SCL_WORKR_BS_EMPLEE_CNT Num 8 Social Worker (BS) - Direct

210 SCL_WORKR_CNT Num 8 Social Workers

849 SCL_WORKR_CNTRCT_CNT Num 8 Social Worker - Contract

847 SCL_WORKR_FLTM_CNT Num 8 Social Worker - Full-Time

132 SCL_WORKR_MS_ARNGMT_CNT Num 8 Social Worker (MS) - Arrangement

131 SCL_WORKR_MS_EMPLEE_CNT Num 8 Social Worker (MS) - Direct

848 SCL_WORKR_PRTM_CNT Num 8 Social Worker - Part-Time

748 SCL_WORK_SRVC_OFSITE_ Char 1 Service: Social Work Off-Site to Residents

RSDNT_SW

747 SCL_WORK_SRVC_ Char 1 Service: Social Work On-Site to Nonresidents

ONST_NRSDNT_SW

746 SCL_WORK_SRVC_ Char 1 Service: Social Work On-Site to Residents

ONST_RSDNT_SW

524 SCOPE_OF_SRVC_WVR_SW Char 1 Compliance: Scope of Service

514 SHCK_TRMA_SRVC_CD Char 1 Services Provided: Trauma Center (Designated)

515 SHCK_TRMA_SRVC_DESC Char 39 Services Provided: Trauma Center (Designated) Description

243 SHIFT_1_FRI_PTNT_CNT Num 8 Number of Patients Friday 1st Shift

227 SHIFT_1_MON_PTNT_CNT Num 8 Number of Patients Monday 1st Shift

247 SHIFT_1_SAT_PTNT_CNT Num 8 Number of Patients Saturday 1st Shift

223 SHIFT_1_SUN_PTNT_CNT Num 8 Number of Patients Sunday 1st Shift

239 SHIFT_1_THU_PTNT_CNT Num 8 Number of Patients Thursday 1st Shift

231 SHIFT_1_TUE_PTNT_CNT Num 8 Number of Patients Tuesday 1st Shift

235 SHIFT_1_WED_PTNT_CNT Num 8 Number of Patients Wednesday 1st Shift

244 SHIFT_2_FRI_PTNT_CNT Num 8 Number of Patients Friday 2nd Shift

228 SHIFT_2_MON_PTNT_CNT Num 8 Number of Patients Monday 2nd Shift

248 SHIFT_2_SAT_PTNT_CNT Num 8 Number of Patients Saturday 2nd Shift

224 SHIFT_2_SUN_PTNT_CNT Num 8 Number of Patients Sunday 2nd Shift

240 SHIFT_2_THU_PTNT_CNT Num 8 Number of Patients Thursday 2nd Shift

232 SHIFT_2_TUE_PTNT_CNT Num 8 Number of Patients Tuesday 2nd Shift

236 SHIFT_2_WED_PTNT_CNT Num 8 Number of Patients Wednesday 2nd Shift

245 SHIFT_3_FRI_PTNT_CNT Num 8 Number of Patients Friday 3rd Shift

229 SHIFT_3_MON_PTNT_CNT Num 8 Number of Patients Monday 3rd Shift

249 SHIFT_3_SAT_PTNT_CNT Num 8 Number of Patients Saturday 3rd Shift

225 SHIFT_3_SUN_PTNT_CNT Num 8 Number of Patients Sunday 3rd Shift






241 SHIFT_3_THU_PTNT_CNT Num 8 Number of Patients Thursday 3rd Shift

233 SHIFT_3_TUE_PTNT_CNT Num 8 Number of Patients Tuesday 3rd Shift

237 SHIFT_3_WED_PTNT_CNT Num 8 Number of Patients Wednesday 3rd Shift

246 SHIFT_4_FRI_PTNT_CNT Num 8 Number of Patients Friday 4th Shift

230 SHIFT_4_MON_PTNT_CNT Num 8 Number of Patients Monday 4th Shift

250 SHIFT_4_SAT_PTNT_CNT Num 8 Number of Patients Saturday 4th Shift

226 SHIFT_4_SUN_PTNT_CNT Num 8 Number of Patients Sunday 4th Shift

242 SHIFT_4_THU_PTNT_CNT Num 8 Number of Patients Thursday 4th Shift

234 SHIFT_4_TUE_PTNT_CNT Num 8 Number of Patients Tuesday 4th Shift

238 SHIFT_4_WED_PTNT_CNT Num 8 Number of Patients Wednesday 4th Shift

343 SHRT_TERM_IP_SRVC_CD Char 1 Service: Short Term Inpatient

344 SHRT_TERM_IP_SRVC_DESC Char 39 Short Term Inpatient Care Hospice Service Description

968 SHR_LAB_SW Char 1 Shared Lab Switch

179 SNF_BASE_SW Char 1 SNF Based Switch

367 SNF_HOME_CARE_SW Char 1 Home Care - SNF

417 SOLE_CMNTY_HOSP_SW Char 1 Sole Community Hospital Switch

873 SPCH_PTHLGST_ARNGMT_CNT Num 8 Speech Pathologists - Arrangement

316 SPCH_PTHLGST_AUDLGST_CNT Num 8 Speech Pathologist or Audiologist

872 SPCH_PTHLGST_CNT Num 8 Speech Pathologists - Total

837 SPCH_PTHLGST_CNTRCT_CNT Num 8 Speech Pathologist - Contract

835 SPCH_PTHLGST_FLTM_CNT Num 8 Speech Pathologist - Full-Time

836 SPCH_PTHLGST_PRTM_CNT Num 8 Speech Pathologist - Part-Time

170 SPCH_PTHLGY_2_SRVC_CD Char 1 Service: Speech Pathology #2

171 SPCH_PTHLGY_3_SRVC_CD Char 1 Service: Speech Pathology #3

735 SPCH_PTHLGY_OFSITE_ Char 1 Service: Speech Pathology Off-Site to Residents

RSDNT_SW

734 SPCH_PTHLGY_ONST_ Char 1 Service: Speech Pathology On-Site to Nonresidents

NRSDNT_SW

733 SPCH_PTHLGY_ONST_RSDNT_SW Char 1 Service: Speech Pathology On-Site to Residents

168 SPCH_PTHLGY_SRVC_CD Char 1 Services Provided: Speech Pathology

169 SPCH_PTHLGY_SRVC_DESC Char 39 Services Provided: Speech Pathology Description

299 SPCH_THRPY_SRVC_CD Char 1 Service: Speech Therapy

300 SPCH_THRPY_SRVC_DESC Char 39 Speech Therapy HHA Service Description

678 SPCL_FCS_FAC_SW Char 1 Special Focus Facility

18 SPCL_RO_DT Char 8 Special Regional Office Date Field

19 SPCL_RO_TXT Char 30 Special Regional Office Text Field

16 SPCL_SA_DT Char 8 Special State Agency Date Field

17 SPCL_SA_TXT Char 30 Special State Agency Text Field

274 SP_HOME_TRNG_SPRT_HD_SW Char 1 Service Provided Home Training

& Support Hemodialysis Switch

273 SP_HOME_TRNG_SPRT_PD_SW Char 1 Service Provided Home Training & Support

Peritoneal Dialysis Switch

454 SRGCL_ICU_SRVC_CD Char 1 Services Provided: ICU Surgical

455 SRGCL_ICU_SRVC_DESC Char 39 Services Provided: Surgical ICU Description

336 SRTY_BOND_CD Char 1 Surety Bond Indicator






325 SRVYR_HOME_VISIT_CNT Num 8 Home Visits - Total

324 SRVYR_REV_REC_CNT Num 8 Records Reviewed - Total

9 SRVYR_SGN_DT Char 8 Surveyor Signature Date

333 SRVYR_SMRY_CD Char 1 Surveyor Summary

334 SRVYR_SMRY_DESC Char 37 Surveyor Summary Description

13 SRVY_ADD_DT Char 8 Survey Record Add Date

686 SRVY_ADD_LCTN_CD Char 20 Survey Add Location Code

969 SRVY_ADD_SPCLTY_STUS_SW Char 1 Survey Status - Add Specialities

8 SRVY_AGNCY_RVW_DT Char 8 Survey Agency Review Date

544 SRVY_BGN_DT Char 8 Survey Beginning Date

546 SRVY_CD Char 1 Survey Code

547 SRVY_DESC Char 23 Survey Description

3 SRVY_DT Char 8 Survey Date

545 SRVY_END_DT Char 8 Survey Ending Date

529 SRVY_EVER_ACRDTD_SW Char 1 Current Survey Ever Accredited

530 SRVY_EVER_NACRDTD_SW Char 1 Current Survey Ever Non-Accredited

531 SRVY_EVER_SB_SW Char 1 Current Survey Ever Swing Bed

65 SRVY_LCTN_CD Char 1 Survey Location Code

970 SRVY_OTHR_STUS_SW Char 1 Survey Status - Other

26 SRVY_PRPSE_CD Char 1 Type of Action

27 SRVY_PRPSE_DESC Char 45 Type of Action Description

219 SRVY_PRTCL_BASIC_SW Char 1 Survey Protocol Basic Switch

221 SRVY_PRTCL_CMBNTN_SW Char 1 Survey Protocol Combination Switch

220 SRVY_PRTCL_INITL_SW Char 1 Survey Protocol Initial Switch

222 SRVY_PRTCL_SPLMTL_SW Char 1 Survey Protocol Supplemental Switch

971 SRVY_STATE_EXEMP_STUS_SW Char 1 Survey Status - State Exempt

64 SRVY_SW Char 1 Survey Switch

216 SRVY_TYPE_CMPLNT_SW Char 1 Survey Type Complaint Switch

215 SRVY_TYPE_INITL_SW Char 1 Survey Type Initial Switch

218 SRVY_TYPE_OTHR_SW Char 1 Survey Type Other Switch

217 SRVY_TYPE_RCRTFCTN_SW Char 1 Survey Type Recertification Switch

32 SSA_STATE_CD Char 2 SSA State Code

33 SSA_STATE_DESC Char 25 SSA State Description



395 STATE_LCNSD_BEDS_NUM Num 8 State Licensed Bed Number

972 STATE_LCNS_NUM Char 12 State License Number

394 STF_BED_CNT Num 8 Staff Bed Count

140 STF_OTHR_ARNGMT_CNT Num 8 Other - Arrangement

867 STF_OTHR_CNTRCT_CNT Num 8 Other - Contract

139 STF_OTHR_EMPLEE_CNT Num 8 Other - Direct

865 STF_OTHR_FLTM_CNT Num 8 Other - Full-Time

866 STF_OTHR_PRTM_CNT Num 8 Other - Part-Time

272 STF_SPRT_NH_DLYS_IND Char 1 Staff Support Nursing Home Dialysis Indicator

681 STGRD_SRVY_CD Char 1 Staggered Survey Code






683 STGRD_SRVY_DAY_NAME Char 3 Staggered Survey Day Name

682 STGRD_SRVY_DESC Char 7 Staggered Survey Description

684 STGRD_SRVY_TIME Char 5 Staggered Survey Time

685 STGRD_SRVY_TIME_CD Char 1 Staggered Survey Time Code

102 SUCTN_EQUIP_SW Char 1 ASC Equipment: Suction

973 TCHNCL_CNSLTNT_B_1_CNT Num 8 Technical Moderate Consultant 1




525 TCHNCL_PRSNEL_WVR_SW Char 1 Compliance: Technical Personnel Waiver

977 TCHNCL_SPRVSR_B_CNT Num 8 Technical Supervisor (B)

978 TCHNCL_SPRVSR_C_CNT Num 8 Technical Supervisor (C )

979 TCHNCL_SPRVSR_D_CNT Num 8 Technical Supervisor (D)

980 TCHNCL_SPRVSR_E_CNT Num 8 Technical Supervisor (E)

981 TCHNCL_SPRVSR_F_CNT Num 8 Technical Supervisor (F)

982 TCHNCL_SPRVSR_G_CNT Num 8 Technical Supervisor (G)

983 TCHNCL_SPRVSR_H_CNT Num 8 Technical Supervisor (H)

984 TCHNCL_SPRVSR_I_CNT Num 8 Technical Supervisor (I)

985 TCHNCL_SPRVSR_J_CNT Num 8 Technical Supervisor (J)

986 TCHNCL_SPRVSR_K_1_CNT Num 8 Technical Supervisor (K) (1)

987 TCHNCL_SPRVSR_K_2_CNT Num 8 Technical Supervisor (K ) (2)

988 TCHNCL_SPRVSR_L_CNT Num 8 Technical Supervisor (L)

989 TCHNCL_SPRVSR_M_CNT Num 8 Technical Supervisor (M)

990 TCHNCL_SPRVSR_N_CNT Num 8 Technical Supervisor (N)

991 TCHNCL_SPRVSR_O_CNT Num 8 Technical Supervisor (O)

992 TCHNCL_SPRVSR_P_CNT Num 8 Technical Supervisor (P)

993 TCHNCL_SPRVSR_Q_CNT Num 8 Technical Supervisor (Q)

212 TCHNCN_CNT Num 8 Number of Technicians

886 TCHNLGST_2_YR_RDLGC_CNT Num 8 Technologists - 2 Year Radiology

885 TCHNLGST_ASCT_DGR_CNT Num 8 Technologists - Associate Degree

884 TCHNLGST_BS_BA_DGR_CNT Num 8 Technologists - BS/BA Degree

99 THORCTMY_SET_SW Char 1 ASC Equipment: Thoracotomy Set

89 THORC_SRGRY_SW Char 1 Speciality: Thoracic Surgery

840 THRPTC_RCRTNL_CNTRCT_CNT Num 8 Therapeutic Recreational Specialty - Contract

838 THRPTC_RCRTNL_FLTM_CNT Num 8 Therapeutic Recreational Specialty - Full-Time

738 THRPTC_RCRTNL_OFSITE_ Char 1 Service: Therapeutic Recreational

RSDNT_SW Specialty Off-Site to Residents

737 THRPTC_RCRTNL_ Char 1 Service: Therapeutic Recreational

ONST_NRSDNT_SW Specialty On-Site to Non Residents

736 THRPTC_RCRTNL_ Char 1 Service: Therapeutic Recreational

ONST_RSDNT_SW Specialty On-Site to Residents

839 THRPTC_RCRTNL_PRTM_CNT Num 8 Therapeutic Recreational Specialty - Part-Time

500 THRPTC_RDLGY_SRVC_CD Char 1 Services Provided: Radiology (Therapeutic)

501 THRPTC_RDLGY_SRVC_DESC Char 39 Services Provided: Radiology Therapeutic Description

28 TOT_HR_CNT Num 8 Total Hour Count






100 TRCHOSTMY_SET_SW Char 1 ASC Equipment: Tracheostomy Set

185 TRNSPLNTN_SRVC_SW Char 1 Service: Transplantation

66 TRNSPLNT_PGM_STUS_CD Char 2 Transplant Program Status Code

67 TRNSPLNT_PGM_TYPE_CD Char 3 Transplant Program Type Code

519 URGNT_CARE_SRVC_CD Char 1 Services Provided: Urgent Care Center Services

518 URGNT_CARE_SRVC_DESC Char 39 Services Provided: Urgent Care Description

90 URLGY_SRGRY_SW Char 1 Speciality: Urology

311 VCTNL_GDNC_SRVC_CD Char 1 Service: Vocational Guidance

312 VCTNL_GDNC_SRVC_DESC Char 39 Vocational Guidance HHA Service Description

762 VCTNL_SRVC_OFSITE_ Char 1 Service: Vocational Off-Site to Residents

RSDNT_SW

761 VCTNL_SRVC_ONST_NRSDNT_SW Char 1 Service: Vocational On-Site to Nonresidents

760 VCTNL_SRVC_ONST_RSDNT_SW Char 1 Service: Vocational On-Site to Residents

994 VLDTN_SRVY_DT Char 8 Date of Validation Survey

361 VLNTR_CNT Num 8 Volunteers - Total

359 VLNTR_OTHR_CNT Num 8 Volunteers - Other

702 VNTLTR_BED_CNT Num 8 Special Care Beds - Ventilator

271 WBST_ADR_TXT Char 512 Website Address

995 WVD_TEST_VOL_CNT Num 8 Total Waived Test Volume

443 XTRCRPRL_SHCK_LTHTRPTR_ Char 39 Services Provided: Extracorporeal Shock Wave Description

SRVCDSC

442 XTRCRPRL_SHCK_LTHTRPTR_ Char 1 Services Provided: Extracorporeal Shock Wave

SRVC_CD

Sort Information

Sortedby PRVDR_NUM

Validated YES

Character Set ANSI



DEP Health Deficiencies 20:42 Saturday, June 9, 2012




Engine V9 Indexes 0





Label






First Data Page 1

Max Obs per Page 12






Host Created XP_PRO





17 DFCNCY_CMPLTN_DT Char 8 Deficiency Completion Date

18 DFCNCY_CRCTN_DT Char 8 Deficiency Correction Date

12 DFCNCY_PREX_CD Char 1 Deficiency Prefix Code

13 DFCNCY_PREX_DESC Char 44 Deficiency Prefix Description

15 DFCNCY_STUS_CD Char 1 Deficiency Status Code

16 DFCNCY_STUS_DESC Char 45 Deficiency Status Description

14 DFCNCY_STUS_DT Char 8 Deficiency Status Date

19 DFCNCY_TAG_NUM Char 4 Deficiency Tag Number





20 SCOPE_SVRTY_CD Char 1 Scope and Severity Code

21 SCOPE_SVRTY_DESC Char 23 Scope and Severity Description

28 SPCLTY_010A_CD Char 1 Specialty 010A Code

29 SPCLTY_010A_DESC Char 41 Specialty 010A Switch Description

30 SPCLTY_010B_CD Char 1 Specialty 010B Code






31 SPCLTY_010B_DESC Char 41 Specialty 010B Switch Description

26 SPCLTY_010_CD Char 1 Specialty 010 Code

27 SPCLTY_010_DESC Char 41 Specialty 010 Switch Description


















































24 SPCLTY_SUBSPCLTY_CMPLXTY_CD Char 1 Specialty Subspecialty Complexity Code

25 SPCLTY_SUBSPCLTY_CMPLXTY_DESC Char 41 Specialty Subspecialty Complexity Description

5 SRVY_CYC_CD Char 1 Survey Cycle Code

6 SRVY_CYC_DESC Char 16 Survey Cycle Description


7 SRVY_TYPE_CD Char 1 Type of Survey

8 SRVY_TYPE_DESC Char 18 Survey Type Description



Sort Information

Sortedby PRVDR_NUM

Validated YES

Character Set ANSI



DEP Health Surveys 20:42 Saturday, June 9, 2012




Engine V9 Indexes 0





Label






First Data Page 1

Max Obs per Page 18






Host Created XP_PRO



32 APSY_NAME Char 4 Subsystem Name

37 APSY_NAME_DESC Char 36 Application Sub-System Name Description

36 CMPLT_670_SW Char 1 Complete 670 Switch

26 CNSCTV_0_DFCNCY_CNT Num 8 Consecutive Zero Deficiency Count


5 CYC_VISIT_DT Char 8 Cycle Visit Date

6 CYC_VISIT_NUM Num 8 Cycle Visit Number


29 HIGHST_SCOPE_SVRTY_CD Char 1 Highest Scope / Severity Code

35 INITL_CYC_VISIT_SW Char 1 Initial Cycle Visit Switch

25 LSC_BLDG_CNT Num 8 Total Number of Buildings

93 ONST_HR_BTWN_ Num 8 Onsite Hours Between 12AM and 8AM Count

12AM_8AM_CNT

94 ONST_HR_BTWN_ Num 8 Onsite Hours Between 6PM and 12AM Count

6PM_12AM_CNT

95 ONST_HR_BTWN_ Num 8 Onsite Hours Between 8AM and 6PM Count

8AM_6PM_CNT

27 POC_SGN_DT Char 8 Date Provider Signed the POC









45 QIS_SRVY_SW Char 1 Quality Indicator Survey Switch





54 RO_CLRCL_HR_CNT Num 8 Regional Office Clerical Hour Count

55 RO_SPRVSR_RVW_HR_CNT Num 8 Regional Supervisor Review Hour Count

96 RVSD_670_SW Char 1 Revised 670 Switch (CLIA only)

53 SA_CLRCL_HR_CNT Num 8 State Agency Clerical Hour Count

52 SA_SPRVSR_RVW_HR_CNT Num 8 State Agency Supervisor Review Hour Count

34 SPRNKLR_STUS_CD Char 2 Sprinkler Status Code

20 SRVYR_UPDT_DT Char 8 Surveyor Update Date

40 SRVY_ADD_DT Char 8 Survey Record Add Date

12 SRVY_ADD_LCTN_CD Char 2 Survey Add Location Code

13 SRVY_ADD_LCTN_DESC Char 31 Survey Add Location Description

14 SRVY_AGE_NUM Num 8 Survey Age Number

19 SRVY_CMPLTN_DT Char 8 Survey Complete Date



18 SRVY_DFCNCY_CNT Num 8 Survey Deficiency Count


17 SRVY_DT_MATCH_SW Char 1 Survey Date Match Switch

21 SRVY_PRPSE_CD Char 1 Type of Action

22 SRVY_PRPSE_DESC Char 45 Type of Action Description

41 SRVY_SQC_CNT Num 8 NH Substandard Quality of Care Count







56 STMT_DFCNCY_SW Char 1 Statement of Deficiencies Switch

44 SYS_INVLVMT_TYPE_CD Char 2 System Involvement Type Code

33 SYS_NAME Char 50 System Name

46 TOT_HR_CNT Num 8 Total Hour Count

51 TOT_OFSITE_HR_CNT Num 8 Total Offsite Hour Count

50 TOT_ONST_HR_CNT Num 8 Total Onsite Hour Count

48 TOT_PRE_SRVY_HR_CNT Num 8 Total Presurvey Hour Count

57 TOT_SRVYR_ACRDTD_ Num 8 Total Surveyors, Accredited Administrator Count

ADMIN_CNT

58 TOT_SRVYR_ARCHTCT_CNT Num 8 Total Surveyors, Architect Count

59 TOT_SRVYR_CYTOTCHLGS_ Num 8 Total Surveyors, Cytotechnologist Count

CNT






62 TOT_SRVYR_DO_CNT Num 8 Total Surveyors, Doctor of Osteopathics Count

63 TOT_SRVYR_DO_QMRP_CNT Num 8 Total Qualified Mental Retardation Professional

Doctors of Osteopathy Surveyor Count

65 TOT_SRVYR_ENGRNG_CNT Num 8 Total Surveyors, Engineer Count

66 TOT_SRVYR_GNRLST_CNT Num 8 Total Surveyors, Generalist count

64 TOT_SRVYR_HLTH_ Num 8 Total Qualified Mental Retardation Professional

CARE_CNT Health Care Surveyor Count

67 TOT_SRVYR_HMAN_ Num 8 Total Qualified Mental Retardation Professional

SRVC_QMRP_CNT Human Service Surveyor Count

68 TOT_SRVYR_LAB_MDCL_ Num 8 Total Qualified Mental Retardation Professional

TCHNCN_CNT Laboratory Medical Technician Surveyor Count

69 TOT_SRVYR_LPN_CNT Num 8 Total Surveyors, LPN Vocational Count

70 TOT_SRVYR_LSC_ Num 8 Total Surveyors, LSC Specialist Count

SPCLST_CNT

60 TOT_SRVYR_MD_CNT Num 8 Total Surveyors, Doctor of Medicine Count

61 TOT_SRVYR_MD_QMRP_CNT Num 8 Total Qualified Mental Retardation Professional

Medical Doctor Surveyor Count

71 TOT_SRVYR_NH_ Num 8 Total Surveyors, Nursing Home Administrator Count

ADMINR_CNT

72 TOT_SRVYR_NTRTNL_ Num 8 Total Surveyors, Nutritional Diet Count

DIET_CNT

73 TOT_SRVYR_NTRTNL_ Num 8 Total Qualified Mental Retardation Professional

DIET_QMRP_CNT Nutritional Dietary Surveyor Count

47 TOT_SRVYR_ONST_CNT Num 8 Total Surveyor, Onsite Count

76 TOT_SRVYR_OTHR_CNT Num 8 Total Surveyors, Other Count

74 TOT_SRVYR_OT_CNT Num 8 Total Surveyors,Occupational Therapy Count

75 TOT_SRVYR_OT_QMRP_CNT Num 8 Total Qualified Mental Retardation Professional

Occupational Therapist Surveyor C

78 TOT_SRVYR_PHRMCST_CNT Num 8 Total Surveyors, Pharmacist Count

81 TOT_SRVYR_PSYCHLGST_ Num 8 Total Surveyors, Psychologist Count

CNT

82 TOT_SRVYR_PSYCHLGST_ Num 8 Total Qualified Mental Retardation Professional

QMRP_CNT Psychologist Surveyor Count

77 TOT_SRVYR_PTHLGST_CNT Num 8 Total Surveyors, Pathologist Count

79 TOT_SRVYR_PT_CNT Num 8 Total Surveyors, Physical Therapy Count

80 TOT_SRVYR_PT_QMRP_CNT Num 8 Total Qualified Mental Retardation Professional

Physical Therapist Surveyor Count

84 TOT_SRVYR_RCRTNLTHRPY_ Num 8 Total Qualified Mental Retardation Professional

QMRP_CNT Recreational Therapist Surveyor Count

83 TOT_SRVYR_RCRTNL_ Num 8 Total Surveyors, Recreational Therapy Count

THRPY_CNT

87 TOT_SRVYR_REC_ Num 8 Total Surveyors, Record Administration Count

ADMIN_CNT

85 TOT_SRVYR_RN_CNT Num 8 Total Surveyor, RN Count






86 TOT_SRVYR_RN_QMRP_CNT Num 8 Total Qualified Mental Retardation Professional

Registered Nurse Surveyor Count

89 TOT_SRVYR_SCL_ Num 8 Total Surveyor, Social Worker Count

WORKR_CNT

90 TOT_SRVYR_SCL_ Num 8 Total Qualified Mental Retardation Professional

WORKR_QMRP_CNT Social Worker Surveyor Count

88 TOT_SRVYR_SNTRN_CNT Num 8 Total Surveyor, Sanitarian Count

92 TOT_SRVYR_SPCHAUDLGST_ Num 8 Total Qualified Mental Retardation Professional

QMRP_CNT Speech Audiologist Surveyor Count

91 TOT_SRVYR_SPCH_ Num 8 Total Surveyor, Speech Audiologist Count

AUDLGST_CNT

49 TOT_TRVL_HR_CNT Num 8 Total Travel Hours - Team

28 TRANS_DT Char 8 Transaction Date

7 VISIT_AGE_NUM Num 8 Visit Age Number

Sort Information

Sortedby PRVDR_NUM

Validated YES

Character Set ANSI



DEP Life Safety Surveys 20:42 Saturday, June 9, 2012




Engine V9 Indexes 0





Label






First Data Page 1

Max Obs per Page 127






Host Created XP_PRO



3 CYC_VISIT_DT Char 8 Cycle Visit Date

4 CYC_VISIT_NUM Num 8 Cycle Visit Number

6 LSC_BLDG_CNT Num 8 Total Number of Buildings

5 POC_SGN_DT Char 8 Date Provider Signed the POC


7 SRVY_CMPLTN_DT Char 8 Survey Complete Date


Sort Information

Sortedby PRVDR_NUM

Validated YES

Character Set ANSI



DEP Life Safety Deficiencies 20:42 Saturday, June 9, 2012




Engine V9 Indexes 0





Label






First Data Page 1

Max Obs per Page 64






Host Created XP_PRO





17 DFCNCY_CMPLTN_DT Char 8 Deficiency Completion Date

18 DFCNCY_CRCTN_DT Char 8 Deficiency Correction Date

12 DFCNCY_PREX_CD Char 1 Deficiency Prefix Code

13 DFCNCY_PREX_DESC Char 44 Deficiency Prefix Description

15 DFCNCY_STUS_CD Char 1 Deficiency Status Code

16 DFCNCY_STUS_DESC Char 45 Deficiency Status Description

14 DFCNCY_STUS_DT Char 8 Deficiency Status Date

19 DFCNCY_TAG_NUM Char 4 Deficiency Tag Number





20 SCOPE_SVRTY_CD Char 1 Scope and Severity Code

21 SCOPE_SVRTY_DESC Char 23 Scope and Severity Description





DEP Life Safety Deficiencies 20:42 Saturday, June 9, 2012








Sort Information

Sortedby PRVDR_NUM

Validated YES

Character Set ANSI



DEP Provider 20:42 Saturday, June 9, 2012




Engine V9 Indexes 0





Label






First Data Page 2

Max Obs per Page 10






Host Created XP_PRO



62 AABB_ACRDTD_CD Char 1 Accredited by AABB

63 AABB_ACRDTD_DESC Char 10 AABB Accredited Description

64 AABB_ACRDTD_RMRK_CD Char 2 Accredited AABB Remarks

65 AABB_ACRDTD_RMRK_DESC Char 44 AABB Accredited Remarks Description

66 AABB_ACRDTD_RMRK_DT Char 8 Accredited Remarks Date AABB

67 AABB_ACRDTD_Y_MATCH_DT Char 8 Accredited Y Match Date AABB

68 AABB_ACRDTD_Y_MATCH_SW Char 1 Accredited Y Match Switch AABB

55 ACRDTN_TYPE_CD Char 1 Accreditation Type Code

53 ACRDTN_TYPE_DESC Char 7 Accreditation Type Description

51 ADD_DT Char 8 Add Date

69 AOA_ACRDTD_CD Char 1 Accredited by AOA

70 AOA_ACRDTD_DESC Char 10 AOA Accredited Description

71 AOA_ACRDTD_RMRK_CD Char 2 Accredited Remarks AOA

72 AOA_ACRDTD_RMRK_DESC Char 44 AOA Accredited Remarks Description

73 AOA_ACRDTD_RMRK_DT Char 8 Accredited Remarks Date AOA

74 AOA_ACRDTD_Y_MATCH_DT Char 8 Accredited Y Match Date AOA

75 AOA_ACRDTD_Y_MATCH_SW Char 1 Acredited Y Match Switch AOA

56 ASC_BGN_SRVC_DT Char 8 Date Center Began Providing Services

76 ASHI_ACRDTD_CD Char 1 Accredited by ASHI






77 ASHI_ACRDTD_DESC Char 10 ASHI Accredited Description

78 ASHI_ACRDTD_RMRK_CD Char 2 Accredited Remarks ASHI

79 ASHI_ACRDTD_RMRK_DESC Char 44 ASHI Accredited Remarks Description

80 ASHI_ACRDTD_RMRK_DT Char 8 Accredited Remarks Date ASHI

81 ASHI_ACRDTD_Y_MATCH_DT Char 8 Accredited Y Match Date ASHI

82 ASHI_ACRDTD_Y_MATCH_SW Char 1 Acredited Y Match Switch ASHI

49 ASPEN_LD_SW Char 1 ASPEN Facility Loaded Switch

50 ASPEN_UPLD_DT Char 8 ASPEN Last Load Date

83 CAP_ACRDTD_CD Char 1 Accredited by CAP

84 CAP_ACRDTD_DESC Char 10 CAP Accredited Description

85 CAP_ACRDTD_RMRK_CD Char 2 Accredited Remarks CAP

86 CAP_ACRDTD_RMRK_DESC Char 44 CAP Accredited Remarks Description

87 CAP_ACRDTD_RMRK_DT Char 8 Accredited Remarks Date CAP

88 CAP_ACRDTD_Y_MATCH_DT Char 8 Accredited Y Match Date CAP

89 CAP_ACRDTD_Y_MATCH_SW Char 1 Acredited Y Match Switch CAP

46 CHOW_CNT Num 8 Change of Ownership Count

45 CHOW_DT Char 8 Change of Ownership Date

47 CHOW_PRIOR_DT Char 8 Prior Change of Ownership Date

10 CITY_NAME Char 28 City

61 CLIA_BBLDWN_DT Char 8 CLIA Initial Bubble Down Date

90 COLA_ACRDTD_CD Char 1 Accredited by COLA

91 COLA_ACRDTD_DESC Char 10 COLA Accredited Description

92 COLA_ACRDTD_RMRK_CD Char 2 Accredited Remarks COLA

93 COLA_ACRDTD_RMRK_DESC Char 44 COLA Accredited Remarks Description

94 COLA_ACRDTD_RMRK_DT Char 8 Accredited Remarks Date COLA

95 COLA_ACRDTD_Y_MATCH_DT Char 8 Accredited Y Match Date COLA

96 COLA_ACRDTD_Y_MATCH_SW Char 1 Accredited Y Match Switch COLA

57 DEMD_STUS_SW Char 1 Deemed Status Switch

2 FAC_ID Char 16 Facility ID

8 FAC_NAME Char 50 Facility Name

16 FAX_PHNE_NUM Char 10 Fax Phone Number

115 FRI_BGN_TIME Char 4 Open Friday Hours

116 FRI_END_TIME Char 4 Closed Friday Hours

41 FY_END_MO_DAY_CD Char 4 Fiscal Year Ending Date

35 GNRL_CNTL_TYPE_CD Char 2 General Control Type Code

36 GNRL_FAC_TYPE_CD Char 2 Type of Facility

37 INTRMDRY_CARR_CD Char 5 Intermediary Carrier Code

38 INTRMDRY_CARR_DESC Char 45 Intermediary Carrier Description

39 INTRMDRY_CARR_PRIOR_CD Char 5 Intermediary Carrier Prior Code

40 INTRMDRY_CARR_PRIOR_DESC Char 45 Intermediary Carrier Prior Description

97 JCAHO_ACRDTD_CD Char 1 Accredited by JCAHO

98 JCAHO_ACRDTD_DESC Char 10 JCAHO Accredited Description

99 JCAHO_ACRDTD_RMRK_CD Char 2 Accredited Remarks JCAHO

100 JCAHO_ACRDTD_RMRK_DESC Char 44 JCAHO Accredited Remarks Description

101 JCAHO_ACRDTD_RMRK_DT Char 8 Accredited Remarks Date JCAHO






102 JCAHO_ACRDTD_Y_MATCH_DT Char 8 Accredited Y Match Date JCAHO

103 JCAHO_ACRDTD_Y_MATCH_SW Char 1 Accredited Y Match Switch JCAHO

119 LAB_TEMP_TSTG_SITE_SW Char 1 Lab Temporary Testing Site Switch

104 LD_UPDT_DT Char 8 Load Update Date

18 MAIL_ADDTNL_ST_ADR Char 50 Mailing Address-Street Line 2

19 MAIL_CITY_NAME Char 28 Mailing Address-City

20 MAIL_STATE_CD Char 2 Mailing Address-State

21 MAIL_STATE_DESC Char 20 Mail State Description

17 MAIL_ST_ADR Char 50 Mailing Address-Street Line 1

23 MAIL_ZIP4_CD Char 4 Mailing Address-ZIP+Four

22 MAIL_ZIP_CD Char 5 Mailing Address-ZIP Code

127 MDCD_MDCR_PRTCPTG_PRVDR_SW Char 1 Medicare or Medicaid Participating Provider Switch

3 MDCD_VNDR_NUM Char 15 Medicare or Medicaid Vendor Number

124 MEET_1861_SW Char 1 Meets 1861 Definition

121 MLT_FAC_ORG_NAME Char 38 Multi-Facility Organization Name

122 MLT_OWND_FAC_ORG_SW Char 1 Multi-Facility Organization Owned

107 MON_BGN_TIME Char 4 Open Monday Hours

108 MON_END_TIME Char 4 Closed Monday Hours

58 MSA_UPDT_DT Char 8 Date an MSA Field was Updated

60 NEW_APLCTN_EFCTV_DT Char 8 New Effective Date

59 NEW_APLCTN_TYPE_CD Char 1 New Application Type

125 NPP_TYPE_CD Char 1 Type of Non-Participating Provider

126 NPP_TYPE_DESC Char 30 Non-Participating Provider Type Description

54 OLDST_LSC_SHRT_FORM_DT Char 8 Old LSC Short Form Date

31 ORGNL_PRTCPTN_DT Char 8 Participation Date

33 PGM_TRMNTN_CD Char 2 Termination Code 1

34 PGM_TRMNTN_DESC Char 45 Program Termination Description

15 PHNE_NUM Char 10 Telephone Number

120 PPMP_TEST_VOL_CNT Num 8 PPMP Test Volume Count



29 PRVDR_CTGRY_SBTYP_CD Char 2 Provider Category Subtype Code

30 PRVDR_CTGRY_SBTYP_DESC Char 45 Provider Category Subtype Description


128 PRVNC_CD Char 2 Province Code

129 PRVNC_DESC Char 21 Province Description

130 PSYCH_UNIT_BED_CNT Num 8 Psychiatric Unit Bed Count

132 PSYCH_UNIT_EFCTV_DT Char 8 Psychiatric Unit Effective Date

133 PSYCH_UNIT_SW Char 1 Psychiatric Unit Switch

134 PSYCH_UNIT_TRMNTN_CD Char 1 Psychiatric Unit Termination Code

135 PSYCH_UNIT_TRMNTN_DESC Char 41 Psychiatric Unit Termination Description

131 PSYCH_UNIT_TRMNTN_DT Char 8 Psychiatric Unit Termination Date



136 REHAB_UNIT_BED_CNT Num 8 Rehabilitation Unit Bed Count






137 REHAB_UNIT_EFCTV_DT Char 8 Rehabilitation Unit Effective Date

138 REHAB_UNIT_SW Char 1 Rehabilitation Unit Switch

139 REHAB_UNIT_TRMNTN_CD Char 1 Rehabilitation Unit Termination Code

140 REHAB_UNIT_TRMNTN_DESC Char 41 Rehabilitation Unit Termination Description

141 REHAB_UNIT_TRMNTN_DT Char 8 Rehabilitation Unit Termination Date



48 RSRVY_CNT Num 8 Resurvey Counter

117 SAT_BGN_TIME Char 4 Open Saturday Hours

118 SAT_END_TIME Char 4 Closed Saturday Hours

142 SEPRT_CST_ENT_SW Char 1 Separate Cost Entity Switch

42 SKLTN_REC_SW Char 1 Skeleton Record Switch

25 SSA_CNTY_CD Char 3 SSA County Code

26 SSA_CNTY_CD_DESC Char 25 SSA County Description





24 STATE_RGN_CD Char 3 State Region Code

9 ST_ADR Char 50 Street Address

105 SUN_BGN_TIME Char 4 Open Sunday Hours

106 SUN_END_TIME Char 4 Closed Sunday Hours

113 THU_BGN_TIME Char 4 Open Thursday Hours

114 THU_END_TIME Char 4 Closed Thursday Hours

32 TRMNTN_EXPRTN_DT Char 8 Termination Date / Expiration Date 1

109 TUE_BGN_TIME Char 4 Open Tuesday Hours

110 TUE_END_TIME Char 4 Closed Tuesday Hours

52 UPDT_TS Char 8 Last Update Date for Provider

123 VLDTN_SRVY_DT Char 8 Date of Validation Survey

111 WED_BGN_TIME Char 4 Open Wednesday Hours

112 WED_END_TIME Char 4 Closed Wednesday Hours

14 ZIP4_CD Char 4 ZIP Code + 4 Extra Digits

13 ZIP_CD Char 5 ZIP Code

Sort Information

Sortedby PRVDR_NUM

Validated YES

Character Set ANSI


JUN 2012 SNF QIES SURVEY FILE LAYOUT - CASPER…€¦ · JUN 2012 SNF QIES SURVEY FILE LAYOUT -...

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Transcript of JUN 2012 SNF QIES SURVEY FILE LAYOUT - CASPER…€¦ · JUN 2012 SNF QIES SURVEY FILE LAYOUT -...