Institutional Care Stay (IC) SectionBOX_00 (IC1000) Route Details: 01 Box = BOX_00, BOX_10 04 Single Select = IC10, IC20 11 Multiple Select with Add/Edit/Delete = IC30 Roster 3 = IC30 BOX_05 (IC1005) Programmer Instructions: If provider already has IC10 (provider type) recorded for this round (for any RU member) or in a previous round (for any RU member) (preload.ICPlaceTp=1) go to IC20, otherwise, continue with IC10. IC10 (IC1010) BLAISE NAME: ICPlaceTP Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE PROVIDER......} {ADM-DT} {DIS-DT} Question Text: &IC-1. Looking at card IC-1, what kind of place is {PROVIDER}? HELP: F1 Responses: INPATIENT REHABILITATION FACILITY OR CONVALESCENT HOME 1 IC20 (IC1015) NURSING HOME 2 IC20 (IC1015) RESIDENTIAL MENTAL HEALTH TREATMENT CENTER 3 IC20 (IC1015) RESIDENTIAL EATING DISORDER TREATMENT CENTER 4 IC20 (IC1015) RESIDENTIAL DRUG AND ALCOHOL OR ADDICTION TREATMENT CENTER 5 IC20 (IC1015) RESIDENTIAL HOSPICE CARE 6 IC20 (IC1015) RESIDENTIAL RESPITE CARE 7 IC20 (IC1015) OTHER 91 IC20 (IC1015) REFUSED RF IC20 (IC1015) DON'T KNOW DK IC20 (IC1015) Display Instructions: IC20 (IC1015) BLAISE NAME: ICRelCond Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE PROVIDER......} {ADM-DT} {DIS-DT} Question Text: Was {your/{PERSON}’s} stay at {PROVIDER} related to any specific health condition or were any conditions discovered during this stay? Responses: YES 1 IC30 (IC1020) NO 2 BOX_10 (IC1025) REFUSED RF BOX_10 (IC1025) DON'T KNOW DK BOX_10 (IC1025) Display Instructions: IC30 (IC1020) BLAISE NAME: ICCondRoster Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE PROVIDER......} {ADM-DT} {DIS-DT} Question Text: What conditions were discovered or led {you/{PERSON}} to enter {PROVIDER}? PROBE: Any other condition? ENTER ALL THAT APPLY CTRL-A: ADD CTRL-E: EDIT CTRL-D: DELETE HELP: F1 Responses: {MEDICAL CONDITION} 1 1 BOX_10 (IC1025) {MEDICAL CONDITION} 2 2 BOX_10 (IC1025) {MEDICAL CONDITION} 3 3 BOX_10 (IC1025) {MEDICAL CONDITION} 4 4 BOX_10 (IC1025) {MEDICAL CONDITION}N 5 BOX_10 (IC1025) Programmer Instructions: Roster behavior:
The link is created when the collection of utilization and/or charge/payment data is complete. Display Instructions: Roster 3 – add/edit/delete allowed Roster definition: This item displays Person-Medical-Conditions-Roster for selection and addition of one or many medical conditions associated with this event. Display name of medical condition (COND.CONDNAM) Roster filter: Display all conditions on person's roster; display all. BOX_10 (IC1025) Route Details: The Charge/Payment (CP) section is not required for this Institutional Care Stay (IC) event. Go to the Event Driver (ED) section. |