| 45965-1 | Name:-:Pt:^Patient:Set: | |
| 45403-3 | Room # | |
| 54593-9 | Assessment reference date - observation end date:Date:RptPeriod:^Patient:Qn:CMS Assessment | |
| 45455-3 | Date of reentry to facility:Date:Pt:^Patient:Qn:MDS | |
| 45404-1 | Marital status | |
| 46106-1 | MRN | |
| 45984-2 | Current payment sources for nursing home stay:-:Pt:^Patient:Set: | |
| 50943-0 | Reasons for assessment (full):-:Pt:^Patient:Set: | |
| 45985-9 | Responsibility &or legal guardian:-:Pt:^Patient:Set: | |
| 45986-7 | Advance directives:-:Pt:^Patient:Set: | |