Specifications for Section S Version 2008 Submission File

Specifications for Submisssion File
  Section S Version 2008  
Item Description Length  Start   End  Required on Blank on Picture Type Range Format Info Item Consistency
S1 Unit Number 2 903 904 A,AM,AO,Y,YM,YO,
Q,QM,QO,OM		 D,R X(2) Text     S1  
S2 Pressure Ulcers 1 905 905 A,AM,AO,Y,YM,YO,
Q,QM,QO,OM		 D,R X(1) Code 1,2,3,4,-,Space   S2  
S3 Substance Abuse History 1 906 906 A,AM,AO,Y,YM,YO,
Q,QM,QO,OM		 D,R X(1) Code 0,1,2,-   S3  
S4a HIV Dementia 1 907 907 A,AM,AO,Y,YM,YO,
Q,QM,QO,OM		 D,R X(1) Checklist 0,1,-   S4a S4j consistency
S4b HIV Wasting Syndrome 1 908 908 A,AM,AO,Y,YM,YO,
Q,QM,QO,OM		 D,R X(1) Checklist 0,1,-   S4b S4j consistency
S4c Non-psychotic disorder following organic brain damage 1 909 909 A,AM,AO,Y,YM,YO,
Q,QM,QO,OM		 D,R X(1) Checklist 0,1,-   S4c S4j consistency
S4d Psychotic disorder following organic brain damage 1 910 910 A,AM,AO,Y,YM,YO,
Q,QM,QO,OM		 D,R X(1) Checklist 0,1,-   S4d S4j consistency
S4e Spinal Cord injury 1 911 911 A,AM,AO,Y,YM,YO,
Q,QM,QO,OM		 D,R X(1) Checklist 0,1,-   S4e S4j consistency
S4f Hemiplegia 1 912 912 A,AM,AO,Y,YM,YO,
Q,QM,QO,OM		 D,R X(1) Checklist 0,1,-   S4f S4j consistency
S4g Hemipareses 1 913 913 A,AM,AO,Y,YM,YO,
Q,QM,QO,OM		 D,R X(1) Checklist 0,1,-   S4g S4j consistency
S4h Huntington's Disease 1 914 914 A,AM,AO,Y,YM,YO,
Q,QM,QO,OM		 D,R X(1) Checklist 0,1,-   S4h S4j consistency
S4i Dementia registry report 1 915 915 A,AM,AO,Y,YM,YO,
Q,QM,QO,OM		 D,R X(1) Checklist 0,1,- See Tab ICD-9 Codes S4i S4j consistency;Complete appropriate ICD-9 codes in Section 1, 3a, and b
S4i1 County (FIPS) code of prior residence 3 916 918 A,AM,AO,Y,YM,YO,
Q,QM,QO,OM		 D,R X(3) Code Space(3),001,123,
Dash(3)		 See tab County FIPS codes S4i1 Not included as an item in consistency of S4j. If S4i=1 this should not be blank
S4i2 Physician license number 6 919 924 A,AM,AO,Y,YM,YO,
Q,QM,QO,OM		 D,R X(6) Text Dashes(6),Spaces(6),
L#(5),#(6), Six
dashes, six spaces,
L followed by 5 numbers,
or 6 numbers		   S4i2 Not included as an item in consistenct of S4j. If S4i=1 this should no be blank.
S4j None of the above 1 925 925 A,AM,AO,Y,YM,YO,
Q,QM,QO,OM		 D,R X(1) Checklist 0,1,-   S4j Value must be 0 (zero) if any item S4a,S4b,S4c,S4d,S4e,S4f,S4g,S4h,S4i=0 (zero). Value must be - (dash) if any item S4a,S4b,S4c,S4d,S4e,S4f,S4g,S4h,S4i= - (dash) and none of those item = 1 (one)
S5a FILLER: formerly used, no longer in use 1 926 926 A,AM,AO,Y,YM,YO,
Q,QM,QO,OM		 D,R X(1) Filler Space(1)   S5a No edit check; any submitted data ignored
S5b FILLER: formerly used, no longer in use 5 927 931 A,AM,AO,Y,YM,YO,
Q,QM,QO,OM		 D,R X(5) Filler Space(5)   S5b No edit check; any submitted data ignored
S0a State Operating Certificate Number 8 932 939 A,AM,AO,Y,YM,YO,
Q,QM,QO,OM		 D,R X(8) Text Item not on the MDS form; Valid Code Upper Case S0a Operating Certificate number: This item is not on the MDS2 form, but is a required piece of information from the nursing facility similar to the Fac_id/facility id/ and is used to identify the current nursing home operator contract with Dept of Health.
S0b FILLER: formerly used, no longer in use 19 940 958 A,AM,AO,Y,YM,YO,
Q,QM,QO,OM		 D,R X(19) Filler Space(19)   S0b No edit check; any submitted data ignored
S0c FILLER: formerly used, no longer in use 11 959 969 A,AM,AO,Y,YM,YO,
Q,QM,QO,OM		 D,R X(11) Filler Space(11)   S0c No edit check; any submitted data ignored
S5 Specialty Unit/Facility Reimbursement 1 970 970 A,AM,AO,Y,YM,YO,
Q,QM,QO,OM		 D,R X(1) Code 1,2,3,4,5,6,7   S5 Should not be blank.
S6 Resident Eligible for Enhanced Medicaid Reimbursement 1 971 971 A,AM,AO,Y,YM,YO,
Q,QM,QO,OM		 D,R X(1) Code 1,2,3   S6 Should not be blank.
S7 Primary Payor 1 972 972 A,AM,AO,Y,YM,YO,
Q,QM,QO,OM		 D,R X(1) Code 1,2,3,4   S7 Should not be blank.
St_Filler State Filler 230 973 1202 A,AM,AO,Y,YM,YO,
Q,QM,QO,OM		 D,R X(230) Filler Space(230)   St_Filler No edit check; any submitted data ignored