October 2016 v1 12/10/2015 Page 1 of 10
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1 State Section S s Effective October 1, 2016 Overview The tables list the Section S items that will be active on records with a target date on or after October 1, The active on each item subset code (ISC) is marked with a Y. The item marked with an N for the ISC is not active. The specifications for each item are in the Data Specifications available on the CMS Technical Information page at Assessment-Instruments/NursingHomeQualityInits/NHQI30TechnicalInformation.html. Please note: The following Section S item have been revised: S0511 and S9100C. The following Section S items have been added: S0509, S1002, S1003, S1004, S1150, S3310A-D, Y-Z, S3315A-D, Y-Z, S6052, S6053A, S6053B, S6201, and S6211. Please read the Data Specifications and any information provided by the state collecting the items for information on the changes. Please note: For records with target dates prior to October 1, 2016, please refer to the applicable state requirements for October 1, 2015, October 1, 2014, October 1, 2013, October 1, 2012, April 1, 2012, October 1, 2011, April 1, 2011 and October 1, If an item is not listed on this document for the state, it is not active starting October 1, Section S items are not collected on NPE records. Arkansas + + S1100A Y Y Y N Y N N N N Table 1: Arkansas California + + S9040A Y Y N Y Y N N N N S9040B Y Y N Y Y N N N N S9040C1 Y Y N Y Y N N N N S9040D1 Y Y N Y Y N N N N S9040E Y Y N Y Y N N N N S9040F Y Y N Y Y N N N N S9040G Y Y N Y Y N N N N S9040H Y Y N Y Y N N N N Table 2: California October 2016 v1 12/10/2015 Page 1 of 10
2 Connecticut + + S0501 Y Y N N N N N N N S0102 Y Y N N N N N N N S8010F Y Y N N N N N N N S8010G Y Y N N N N N N N S8020C3 Y Y N N N N N N N S9120 Y Y N N N N N N N Table 3: Connecticut Florida + + S0140 Y Y N N Y N N N N S0141 Y Y N N Y N N N N S0165A Y Y N N Y N N N N S0165B Y Y N N Y N N N N S0165C Y Y N N Y N N N N S0165D Y Y N N Y N N N N S0165E Y Y N N Y N N N N S0509 Y N N N N N N N N S0511 Y N N N N N N N N S1000 Y Y N N Y N N N N S1001 Y Y N N Y N N N N S1002 Y Y N N Y N N N N S1003 Y Y N N Y N N N N S1100A Y Y N N Y N N N N S1100B Y Y N N Y N N N N S1100C Y Y N N Y N N N N S1100D Y Y N N Y N N N N S1100E Y Y N N Y N N N N S1100F Y Y N N Y N N N N S1100F1 Y Y N N Y N N N N S1100F2 Y Y N N Y N N N N S1100G Y Y N N Y N N N N S1100H Y Y N N Y N N N N S1100I Y Y N N Y N N N N S1100J Y Y N N Y N N N N S1100Z Y Y N N Y N N N N S6050 Y Y N N Y N N N N S6051A Y Y N N Y N N N N S6051B Y Y N N Y N N N N S6051C Y Y N N Y N N N N October 2016 v1 12/10/2015 Page 2 of 10
3 + + S6051D Y Y N N Y N N N N S6200 Y Y N N Y N N N N S6201 Y Y N N Y N N N N S6210 Y Y N N Y N N N N S6211 Y Y N N Y N N N N S9020 Y Y N N Y N N N N Table 4: Florida Illinois + + S0161A Y Y N N N N N N N S0161B Y Y N N N N N N N S0161C Y Y N N N N N N N S0161D Y Y N N N N N N N S0161Z Y Y N N N N N N N S0600A Y Y N N N N N N N S0600B Y Y N N N N N N N S0600C Y Y N N N N N N N S0600D Y Y N N N N N N N S0600E Y Y N N N N N N N S0600Z Y Y N N N N N N N S1004 Y Y N N N N N N N S1150 Y Y N N N N N N N S1200A Y Y N N N N N N N S1200B Y Y N N N N N N N S1200C Y Y N N N N N N N S1200D Y Y N N N N N N N S1200E Y Y N N N N N N N S1200F Y Y N N N N N N N S1200G Y Y N N N N N N N S1200H Y Y N N N N N N N S1200I Y Y N N N N N N N S3310A Y Y N N N N N N N S3310B Y Y N N N N N N N S3310C Y Y N N N N N N N S3310D Y Y N N N N N N N S3310Y Y Y N N N N N N N S3310Z Y Y N N N N N N N S3315A Y Y N N N N N N N S3315B Y Y N N N N N N N S3315C Y Y N N N N N N N October 2016 v1 12/10/2015 Page 3 of 10
4 + + S3315D Y Y N N N N N N N S3315Y Y Y N N N N N N N S3315Z Y Y N N N N N N N S6052 Y Y N N N N N N N S6053A Y Y N N N N N N N S6053B Y Y N N N N N N N S6232 Y Y N N N N N N N S6234 Y Y N N N N N N N S6236 Y Y N N N N N N N Table 5: Illinois Louisiana + + S0174 Y Y N N N N N N N S0175 Y Y N N N N N N N S6200 Y N N N N N N N N S6210 Y N N N N N N N N S9140 Y Y N N N N N N N Table 6: Louisiana October 2016 v1 12/10/2015 Page 4 of 10
5 Massachusetts + + S0170A Y Y N N N N N N N S0170B Y Y N N N N N N N S0170C Y Y N N N N N N N S0170D Y Y N N N N N N N S0170E Y Y N N N N N N N S0170F Y Y N N N N N N N S0170G Y Y N N N N N N N S0170H Y Y N N N N N N N S0170Z Y Y N N N N N N N S0171A Y Y N N N N N N N S0171B Y Y N N N N N N N S0172A Y N N N N N N N N S0172B Y N N N N N N N N S0172C Y N N N N N N N N S0172D Y N N N N N N N N S0172E Y N N N N N N N N S0172F Y N N N N N N N N S0172G Y N N N N N N N N S0173 Y N N N N N N N N S2060A Y Y N N N N N N N S2060B Y Y N N N N N N N S2060C Y Y N N N N N N N S2060D Y Y N N N N N N N S2060E Y Y N N N N N N N S2060Z Y Y N N N N N N N S6230 Y Y N N N N N N N S6232 Y Y N N N N N N N S6234 Y Y N N N N N N N S6236 Y Y N N N N N N N Table 7: Massachusetts October 2016 v1 12/10/2015 Page 5 of 10
6 Maryland + + S0101 Y N N N Y Y Y N N S0111 Y N N N Y Y Y N N S0120 Y N N N Y Y Y N N S0122 Y N N N Y Y Y N N S0123 Y N N N Y Y Y N N S0130 Y N N N Y Y Y N N S0180 N N N N Y Y Y N N S8000A3 Y Y N N Y Y Y N N S8010B3 Y Y N N Y Y Y N N S8020A3 Y Y N N Y Y Y N N S8030C Y Y N N Y Y Y N N S8040A3 Y Y N N Y Y Y N N S8040D3 Y Y N N Y Y Y N N Table 8: Maryland Maine + + S0120 Y Y Y Y Y N N N N S0170A Y Y Y N Y Y Y Y Y S0170B Y Y Y N Y Y Y Y Y S0170C Y Y Y N Y Y Y Y Y S0170D Y Y Y N Y Y Y Y Y S0170E Y Y Y N Y Y Y Y Y S0170F Y Y Y N Y Y Y Y Y S0170G Y Y Y N Y Y Y Y Y S0170H Y Y Y N Y Y Y Y Y S0170Z Y Y Y N Y Y Y Y Y S0510 Y Y Y N Y Y Y Y Y S0511 Y Y Y N Y Y Y Y Y S0513 Y Y Y N Y Y Y Y Y S3300 Y Y Y N Y Y Y Y Y S3305A Y Y Y N Y Y Y Y Y S3305B Y Y Y N Y Y Y Y Y S3305C Y Y Y N Y Y Y Y Y S3305D Y Y Y N Y Y Y Y Y S3305E Y Y Y N Y Y Y Y Y S3305Y Y Y Y N Y Y Y Y Y S6020A Y Y Y N Y Y Y Y Y S6020B Y Y Y N Y Y Y Y Y S6020C Y Y Y N Y Y Y Y Y October 2016 v1 12/10/2015 Page 6 of 10
7 + + S6020D Y Y Y N Y Y Y Y Y S6020Y Y Y Y N Y Y Y Y Y S6020Z Y Y Y N Y Y Y Y Y S6022A Y Y Y N Y Y Y Y Y S6022B Y Y Y N Y Y Y Y Y S6022C Y Y Y N Y Y Y Y Y S6023A Y Y Y N Y Y Y Y Y S6023B Y Y Y N Y Y Y Y Y S6023C Y Y Y N Y Y Y Y Y S6024A Y Y Y N Y Y Y Y Y S6024B Y Y Y N Y Y Y Y Y S6024C Y Y Y N Y Y Y Y Y S6200 Y Y Y N Y Y Y Y Y S6205 Y Y Y N Y Y Y Y Y S6210 Y Y Y N Y Y Y Y Y S8010C3 Y Y Y Y Y N N N N S8010G3 Y Y Y Y Y N N N N S8099 Y Y Y Y Y N N N N S8510A Y Y Y N Y Y Y Y Y S8510B Y Y Y N Y Y Y Y Y S8512A Y Y Y N Y Y Y Y Y S8512B Y Y Y N Y Y Y Y Y Table 9: Maine Mississippi + + S6220 Y Y Y Y Y N N N N Table 10: Mississippi North Dakota + + S6000 Y Y Y N Y Y Y N N S6005 Y Y Y N Y Y Y N N S6010 Y Y Y N Y Y Y N N Table 11: North Dakota October 2016 v1 12/10/2015 Page 7 of 10
8 Nebraska + + S0150 Y Y Y Y Y Y Y N N Table 12: Nebraska New York + + S0160 Y Y Y N Y Y Y Y Y S7000 Y Y Y N Y Y Y Y Y S8055 Y Y Y N Y Y Y Y Y Table 13: New York Ohio + + S0150 Y Y Y Y Y Y Y Y Y S8520C Y Y Y Y Y Y Y Y Y Table 14: Ohio Pennsylvania + + S0120 N N N Y N N N N N S0123 N N N Y N N N N N S9080A Y Y Y Y Y N N N N S9080B Y Y Y Y Y N N N N S9080C Y Y Y Y Y N N N N S9080D Y Y Y Y Y N N N N S9080E N N N Y N N N N N S8010H1 Y Y Y N Y Y Y N N Table 15: Pennsylvania October 2016 v1 12/10/2015 Page 8 of 10
9 South Dakota + + S0510 Y N N N N N N N N S0511 Y N N N N N N N N S0512 Y N N N N N N N N Table 16: South Dakota Virginia + + S9100A Y Y Y Y Y Y Y Y Y S9100B Y Y Y Y Y Y Y Y Y S9100C Y Y Y Y Y Y Y Y Y Table 17: Virginia Vermont + + S0122 Y Y Y N N N N N N S0123 Y Y Y N N N N N N S0125 Y Y Y N N N N N N S0520 Y Y Y N N N N N N S8000C3 Y Y Y N Y N N N N S8000E3 Y Y Y N Y N N N N S8010A1 Y Y Y N Y N N N N S8010C3 Y Y Y N Y N N N N S8010F3 Y Y Y N Y N N N N S8020B3 Y Y Y N Y N N N N S8020C3 Y Y Y N Y N N N N S8040B3 Y Y Y N Y N N N N S8040C3 Y Y Y N Y N N N N S8050A3 Y Y Y N Y N N N N S8500 Y Y Y Y Y N N N N Table 18: Vermont October 2016 v1 12/10/2015 Page 9 of 10
10 West Virginia + + S0115 Y N N N N N N N N S0122 Y N N N N N N N N S0123 Y N N N N N N N N S1000 Y Y N N N N N N N S1001 Y Y N N N N N N N S1100A Y Y N N N N N N N S1100B Y Y N N N N N N N S1100C Y Y N N N N N N N S1100D Y Y N N N N N N N S1100E Y Y N N N N N N N S1100F Y Y N N N N N N N S2000 Y Y N N N N N N N S2001 Y Y N N N N N N N S2015 Y Y N N N N N N N S2040 Y Y N N N N N N N S2050 Y Y N N N N N N N S3100A Y Y N N N N N N N S3100B Y Y N N N N N N N S3100C Y Y N N N N N N N S3100D Y Y N N N N N N N S3100E Y Y N N N N N N N S3100F Y Y N N N N N N N S3100G Y Y N N N N N N N S3100H Y Y N N N N N N N S3100Z Y Y N N N N N N N S3200A Y Y N N N N N N N S3200B Y Y N N N N N N N S5000 Y Y N N N N N N N S5005 Y Y N N N N N N N S5010A1 Y Y N N N N N N N S5010A2 Y Y N N N N N N N S5010B1 Y Y N N N N N N N S5010B2 Y Y N N N N N N N S5010C1 Y Y N N N N N N N S5010C2 Y Y N N N N N N N Table 19: West Virginia October 2016 v1 12/10/2015 Page 10 of 10
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