Search Data Variables

Race/ethnicity as identified by patient:  Native Hawaiian or Pacific Islander.

Race/ethnicity as identified by patient:  Unknown.

Race/ethnicity as identified by patient:  White

Current payment sources for home care:  Medicaid (traditional fee-for-service).

Current payment sources for home care:  Medicaid (HMO/managed care).

Current payment sources for home care:  Medicare (traditional fee-for-service).

Current payment sources for home care:  Medicare (HMO/managed care).

Current payment sources for home care:  none, no charge for current services.

Current payment sources for home care:  other government (e.g., Tricare VA, etc.).

Current payment sources for home care:  other (specify).

Current payment sources for home care:  private HMO managed care.

Current payment sources for home care:  private insurance.

Current payment sources for home care:  self-pay.

Current payment sources for home care:  title programs (e.g., Title III, V, or XX).

Current payment sources for home care:  unknown.

Current payment sources for home care:  worker's compensation.

Financial factors limiting ability of patient/family to meet basic health needs:  unable to afford food.

Financial factors limiting ability of patient/family to meet basic health needs:  unable to afford medical expenses not covered by insurance/Medicare (e.g., co-payments).

Financial factors limiting ability of patient/family to meet basic health needs:  unable to afford medicine or medical supplies.

Financial factors limiting ability of patient/family to meet basic health needs:  none.

Financial factors limiting ability of patient/family to meet basic health needs:  other (specify).

Financial factors limiting ability of patient/family to meet basic health needs: Rent/Utilities

From which of the following inpatient facilities was the patient discharged during the past 14 days:  Hospital.

From which of the following inpatient facilities was the patient discharged during the past 14 days:  Nursing home.

From which of the following inpatient facilities was the patient discharged during the past 14 days:  Other (specify). 

From which of the following inpatient facilities was the patient discharged during the past 14 days:  Patient was not discharged from an inpatient facility.

From which of the following inpatient facilities was the patient discharged during the past 14 days:  Rehabilitation facility.

Inpatient facility admitted from during past 14 days - hospital.

Inpatient facility admitted from during past 14 days - not discharged from an inpatient facility.

Inpatient facility admitted from during past 14 days - other.

Inpatient facility admitted from during past 14 days - other nursing home.

Inpatient facility admitted from during past 14 days - rehabilitation facility.

Inpatient facility admitted from during past 14 days - skilled nursing facility.

Inpatient discharge date (most recent).

Inpatient discharge date (most recent):  unknown.

Inpatient diagnosis and ICD code categories: inpatient facility diagnosis, ICD Code - a.

Inpatient diagnosis and ICD code categories: inpatient facility diagnosis, ICD Code - b.

Medical treatment regimen change within past 14 days.

List patient's medical diagnosis and ICD code categories (three digits required; five optional), ICD - a.

List patient's medical diagnosis and ICD code categories (three digits required; five optional), ICD - b.

List patient's medical diagnosis and ICD code categories (three digits required; five optional), ICD - c.

List patient's medical diagnosis and ICD code categories (three digits required; five optional), ICD - d.

Conditions prior to medical or treatment regimen change or inpatient stay within past 14 days:  disruptive or socially inappropriate behavior.

Conditions prior to medical or treatment regimen change or inpatient stay within past 14 days:  impaired decision making.

Conditions prior to medical or treatment regimen change or inpatient stay within past 14 days:  indwelling/suprapubic catheter.

Conditions prior to medical or treatment regimen change or inpatient stay within past 4 days:  intractable pain.

Conditions prior to medical or treatment regimen change or inpatient stay within past 14 days:  memory loss to the extent that supervision is required.

Conditions prior to medical or treatment regimen change or inpatient stay within past 14 days:  no inpatient facility discharge and no change in medical or treatment regimen in past 14 days.

Conditions prior to medical or treatment regimen change or inpatient stay within past 14 days:  none of the above.

Conditions prior to medical or treatment regimen change or inpatient stay within past 14 days:  unknown.