| FileMan FileNo | FileMan Filename | Package | 
|---|---|---|
| 631 | HBHC PATIENT | Hospital Based Home Care | 
| Package | Total | FileMan Files | 
|---|---|---|
| Hospital Based Home Care | 2 | HBHC EVALUATION/ADMISSION ERROR(S)(#634.1)[1] HBHC DISCHARGE ERROR(S)(#634.3)[1] | 
| Package | Total | FileMan Files | 
|---|---|---|
| Hospital Based Home Care | 7 | HBHC REJECT/WITHDRAW REASON(#631.1)[15]    HBHC EXPRESSIVE COMMUNICATION(#631.2)[21, 49]    HBHC RECEPTIVE COMMUNICATION(#631.3)[22, 50]    HBHC PROVIDER(#631.4)[37, 65, 67] HBHC PERIOD OF SERVICE(#631.7)[7] HBHC VALID STATE CODE(#631.8)[2] HBHC MEDICAL FOSTER HOME(#633.2)[89]  | 
| Registration | 2 | MEDICAL CENTER DIVISION(#40.8)[91] PATIENT(#2)[.01] | 
| DRG Grouper | 1 | ICD DIAGNOSIS(#80)[18, 46] | 
| Kernel | 1 | NEW PERSON(#200)[80, 82] | 
| Field # | Name | Loc | Type | Details | 
|---|---|---|---|---|
| .01 | NAME | 0;1 | POINTER TO PATIENT FILE (#2) | ************************REQUIRED FIELD************************ PATIENT(#2)
  | 
| 1 | EVALUATION DATE | 0;2 | DATE | 
  | 
| 2 | STATE CODE | 0;3 | POINTER TO HBHC VALID STATE CODE FILE (#631.8) | ************************REQUIRED FIELD************************ HBHC VALID STATE CODE(#631.8)
  | 
| 3 | COUNTY CODE | 0;4 | NUMBER | 
  | 
| 4 | ZIP CODE | 0;5 | FREE TEXT | 
  | 
| 5 | ELIGIBILITY @ EVALUATION | 0;6 | SET | 
 
  | 
| 6 | BIRTH YEAR | COMPUTED DATE | 
  | 
|
| 7 | PERIOD OF SERVICE | 0;8 | POINTER TO HBHC PERIOD OF SERVICE FILE (#631.7) | ************************REQUIRED FIELD************************ HBHC PERIOD OF SERVICE(#631.7)
  | 
| 8 | SEX | COMPUTED | 
  | 
|
| 9 | RACE | COMPUTED | 
  | 
|
| 9.1 | RACECOMP | COMPUTED | 
  | 
|
| 10 | MARITAL STATUS @ EVALUATION | 0;11 | SET | 
 
  | 
| 11 | LIVING ARRANGEMENTS @ EVAL | 0;12 | SET | 
 
  | 
| 12 | LAST AGENCY PROVIDING CARE | 0;13 | SET | 
 
  | 
| 13 | TYPE OF LAST CARE AGENCY | 0;14 | SET | 
 
  | 
| 14 | ADMIT/REJECT ACTION | 0;15 | SET | 
 
  | 
| 15 | REJECT/WITHDRAW REASON | 0;16 | POINTER TO HBHC REJECT/WITHDRAW REASON FILE (#631.1) | HBHC REJECT/WITHDRAW REASON(#631.1)
  | 
| 16 | REJECT/WITHDRAW DISPOSITION | 0;17 | SET | 
 
  | 
| 17 | DATE | 0;18 | DATE | ************************REQUIRED FIELD************************ 
  | 
| 18 | PRIMARY DIAGNOSIS @ ADMISSION | 0;19 | POINTER TO ICD DIAGNOSIS FILE (#80) | ICD DIAGNOSIS(#80)
  | 
| 19 | VISION @ ADMISSION | 0;20 | SET | 
 
  | 
| 20 | HEARING @ ADMISSION | 0;21 | SET | 
 
  | 
| 21 | EXPRESSIVE COMMUNICATION @ ADM | 0;22 | POINTER TO HBHC EXPRESSIVE COMMUNICATION FILE (#631.2) | HBHC EXPRESSIVE COMMUNICATION(#631.2)
  | 
| 22 | RECEPTIVE COMMUNICATION @ ADM | 0;23 | POINTER TO HBHC RECEPTIVE COMMUNICATION FILE (#631.3) | HBHC RECEPTIVE COMMUNICATION(#631.3)
  | 
| 23 | BATHING @ ADMISSION | 0;24 | SET | 
 
  | 
| 24 | DRESSING @ ADMISSION | 0;25 | SET | 
 
  | 
| 25 | TOILET USAGE @ ADMISSION | 0;26 | SET | 
 
  | 
| 26 | TRANSFERRING @ ADMISSION | 0;27 | SET | 
 
  | 
| 27 | EATING @ ADMISSION | 0;28 | SET | 
 
  | 
| 28 | WALKING @ ADMISSION | 0;29 | SET | 
 
  | 
| 29 | BOWEL CONTINENCE @ ADMISSION | 0;30 | SET | 
 
  | 
| 30 | BLADDER CONTINENCE @ ADMISSION | 0;31 | SET | 
 
  | 
| 31 | MOBILITY @ ADMISSION | 0;32 | SET | 
 
  | 
| 32 | ADAPTIVE TASKS @ ADMISSION | 0;33 | SET | 
 
  | 
| 33 | BEHAVIOR PROBLEMS @ ADMISSION | 0;34 | SET | 
 
  | 
| 34 | DISORIENTATION @ ADMISSION | 0;35 | SET | 
 
  | 
| 35 | MOOD DISTURBANCE @ ADMISSION | 0;36 | SET | 
 
  | 
| 36 | CAREGIVER LIMITATIONS @ ADM | 0;37 | SET | 
 
  | 
| 37 | PERSON COMPLETING EVL/ADM FORM | 0;38 | POINTER TO HBHC PROVIDER FILE (#631.4) | HBHC PROVIDER(#631.4)
  | 
| 38 | DATE EVAL/ADM FORM COMPLETED | 0;39 | DATE | 
  | 
| 39 | DISCHARGE DATE | 0;40 | DATE | 
  | 
| 40 | ELIGIBILITY @ DISCHARGE | 0;41 | SET | 
 
  | 
| 41 | MARITAL STATUS @ DISCHARGE | 0;42 | SET | 
 
  | 
| 42 | LIVING ARRANGEMENTS @ D/C | 0;43 | SET | 
 
  | 
| 43 | DISCHARGE STATUS | 0;44 | SET | 
 
  | 
| 44 | TRANSFER DESTINATION | 0;45 | SET | 
 
  | 
| 45 | TYPE OF DESTINATION AGENCY | 0;46 | SET | 
 
  | 
| 46 | PRIMARY DIAGNOSIS @ DISCHARGE | 0;47 | POINTER TO ICD DIAGNOSIS FILE (#80) | ICD DIAGNOSIS(#80)
  | 
| 47 | VISION @ DISCHARGE | 0;48 | SET | 
 
  | 
| 48 | HEARING @ DISCHARGE | 0;49 | SET | 
 
  | 
| 49 | EXPRESSIVE COMMUNICATION @ D/C | 0;50 | POINTER TO HBHC EXPRESSIVE COMMUNICATION FILE (#631.2) | HBHC EXPRESSIVE COMMUNICATION(#631.2)
  | 
| 50 | RECEPTIVE COMMUNICATION @ D/C | 0;51 | POINTER TO HBHC RECEPTIVE COMMUNICATION FILE (#631.3) | HBHC RECEPTIVE COMMUNICATION(#631.3)
  | 
| 51 | BATHING @ DISCHARGE | 0;52 | SET | 
 
  | 
| 52 | DRESSING @ DISCHARGE | 0;53 | SET | 
 
  | 
| 53 | TOILET USAGE @ DISCHARGE | 0;54 | SET | 
 
  | 
| 54 | TRANSFERRING @ DISCHARGE | 0;55 | SET | 
 
  | 
| 55 | EATING @ DISCHARGE | 1;1 | SET | 
 
  | 
| 56 | WALKING @ DISCHARGE | 1;2 | SET | 
 
  | 
| 57 | BOWEL CONTINENCE @ DISCHARGE | 1;3 | SET | 
 
  | 
| 58 | BLADDER CONTINENCE @ DISCHARGE | 1;4 | SET | 
 
  | 
| 59 | MOBILITY @ DISCHARGE | 1;5 | SET | 
 
  | 
| 60 | ADAPTIVE TASKS @ DISCHARGE | 1;6 | SET | 
 
  | 
| 61 | BEHAVIOR PROBLEMS @ DISCHARGE | 1;7 | SET | 
 
  | 
| 62 | DISORIENTATION @ DISCHARGE | 1;8 | SET | 
 
  | 
| 63 | MOOD DISTURBANCE @ DISCHARGE | 1;9 | SET | 
 
  | 
| 64 | CAREGIVER LIMITATIONS @ D/C | 1;10 | SET | 
 
  | 
| 65 | PERSON COMPLETING D/C FORM | 1;11 | POINTER TO HBHC PROVIDER FILE (#631.4) | HBHC PROVIDER(#631.4)
  | 
| 66 | DATE DISCHARGE FORM COMPLETED | 1;12 | DATE | 
  | 
| 67 | CASE MANAGER | 1;13 | POINTER TO HBHC PROVIDER FILE (#631.4) | HBHC PROVIDER(#631.4)
  | 
| 68 | SECONDARY DIAGNOSES @ ADM | 1;14 | FREE TEXT | 
  | 
| 69 | CAUSE OF DEATH | 1;15 | FREE TEXT | 
  | 
| 70 | SECONDARY DIAGNOSES @ D/C | 1;16 | FREE TEXT | 
  | 
| 71 | FORM 3 TRANSMIT STATUS | 1;17 | SET | 
 
  | 
| 72 | FORM 5 TRANSMIT STATUS | 1;18 | SET | 
 
  | 
| 73 | FORM 3 FILED IN HBHC(634) DATE | 1;19 | DATE | 
  | 
| 74 | FORM 3 BATCH INITIAL MM MSG # | 1;20 | FREE TEXT | 
  | 
| 75 | FORM 3 MAIL MESSAGE DATE | 1;21 | DATE | 
  | 
| 76 | FORM 5 FILED IN HBHC(634) DATE | 1;22 | DATE | 
  | 
| 77 | FORM 5 BATCH INITIAL MM MSG # | 1;23 | FREE TEXT | 
  | 
| 78 | FORM 5 MAIL MESSAGE DATE | 1;24 | DATE | 
  | 
| 79 | FORM 3 TRANSMIT FLAG EDIT DATE | 1;25 | DATE | 
  | 
| 80 | FORM 3 TRANSMIT FLAG EDIT DUZ | 1;26 | POINTER TO NEW PERSON FILE (#200) | NEW PERSON(#200)
  | 
| 81 | FORM 5 TRANSMIT FLAG EDIT DATE | 1;27 | DATE | 
  | 
| 82 | FORM 5 TRANSMIT FLAG EDIT DUZ | 1;28 | POINTER TO NEW PERSON FILE (#200) | NEW PERSON(#200)
  | 
| 83 | FORM 3 RE-TRANS BATCH MM MSG # | 2;1 | FREE TEXT | 
  | 
| 84 | FORM 3 RE-TRANSMIT DATE | 2;2 | DATE | 
  | 
| 85 | FORM 5 RE-TRANS BATCH MM MSG # | 2;3 | FREE TEXT | 
  | 
| 86 | FORM 5 RE-TRANSMIT DATE | 2;4 | DATE | 
  | 
| 87 | REFERRED WHILE INPATIENT | 1;29 | SET | 
 
  | 
| 88 | MEDICAL FOSTER HOME PATIENT | 3;1 | SET | 
 
  | 
| 89 | MEDICAL FOSTER HOME NAME | 3;2 | POINTER TO HBHC MEDICAL FOSTER HOME FILE (#633.2) | HBHC MEDICAL FOSTER HOME(#633.2)
  | 
| 90 | RATE PAID | 4;0 | DATE Multiple #631.01 | 631.01
  | 
| 91 | PARENT SITE | 5;1 | POINTER TO MEDICAL CENTER DIVISION FILE (#40.8) | ************************REQUIRED FIELD************************ MEDICAL CENTER DIVISION(#40.8)
  |