CMS: List of Participant Medical Records (LOPMR)

Field	Data Type	Description	Source
Participant First Name	Text	Participant’s first name.	CareHub Participant Profile
Participant Last Name	Text	Participant’s last name.	CareHub Participant Profile
Medicare Beneficiary Identifier	Text	MBI of the participant if available. “NA” if the participant is not a Medicare beneficiary. Dashes removed.	CareHub Participant Profile > Medicare ID (MBI)
Participant ID	Text	Pace Organization member ID for the participant.	CareHub Participant Profile
Pace Center	Text	Assigned center value. “NA” if there is only one center.	CareHub Participant Profile
Date Enrollment	Date	In the format of MM/DD/YYYY.	CareHub’s Most Recent Active Enrollment for the Participant
Date of Disenrollment	Date	In the format of MM/DD/YYYY. “NA” if the participant is still enrolled.	CareHub’s Most Recent Active Enrollment for the Participant
Reason for Disenrollment	Text	“NA” if the participant is still enrolled.	CareHub’s Most Recent Active Enrollment for the Participant
Enrollment Type	Text	Options Medicare only Medicaid only Dual Eligible Private Pay	CareHub’s Participant Profile > Insurance Information
Participant’s Preferred Language	Text		CareHub Participant Profile
Participant’s Current Living Situation	Text		CareHub Participant Profile
Change in Living Situation	Text	“Y” if the participant’s living arrangement changed significantly during the data collection period.	Calculated
Number of Hospital Admissions/ Observations	Text	The number of inpatient admissions and observation stays during the collection period.	qualifying CareHub Authorizations Qualifying means auth type = 'ER Visit and Inpatient Admission',        'ER Visit and Observation Stay',          'Inpatient Admission'
30-Day Hospital Readmissions	Text	“Y” if the participant had an unplanned hospital readmission, for any cause, within 30 days of discharge from the previous admission, during the data collection period. “N” otherwise.	qualifying CareHub Authorizations where the authorization occurred within 30 days of another qualifying authorization. Qualifying means auth type = 'ER Visit and Inpatient Admission',             'Inpatient Admission'
Number of Emergency Room Visits	Text	Total ER visits during the collection period.	qualifying CareHub Authorizations Qualifying means auth type = 'ER Visit and Inpatient Admission',        'ER Visit and Observation Stay',   ‘Emergency Room Visit’
Hospitalization/ Emergency Room Reason	Text	"Y” if the participant went to the ER or was hospitalized with a primary or secondary diagnosis of hypoglycemia, hyperglycemia, internal bleeding, sepsis, medication overdose, or decreased oxygen saturation.	CareHub Authorization > CMS Audit ER/Admit Reasons field
Number of SNF/NF Admissions	Text	The number of skilled nursing facility admissions that occurred during the collection period.	qualifying CareHub Authorizations Qualifying: authorization_type contains: SNF, or Nursing service_type_description contains: SNF, or Nursing
Specialist Consultations/ Visits	Text	This will be pulled from the scheduling module.  Comma separated if more than one applies. Options Cardiology Endocrinology Gastroenterology Oncology Ophthalmology Pulmonary Medicine Rheumatology Infectious Disease  Mental Health  Oral Maxillofacial Surgery  If none, then “N”	qualifying CareHub Appointments Qualifying: Category = External Visit, and Appointment Type = 'Cardiology', 'Endocrinology', 'Gastroenterology', 'Oncology', 'Ophthalmology', 'Rheumatology', 'Pulmonology'
Diagnoses	Text	This will be determined based on the ICD codes in the Elation Problem List. Comma separated list of the ICD code descriptions that fall into any of the following categories during the collection period: • AIDS • Anemia • Auto-immune disorder (any type -  specify the type in the response) • Cancer (any type – specify the type in the response) • Cellulitis • Cerebrovascular Accident (CVA) • Chronic Obstructing Pulmonary Disease (COPD) • Congestive Heart Failure (CHF) • Dementia • Diabetes Mellitus • Hemolytic Uremic Syndrome • Hepatitis C • Hereditary Angioedema • Human immunodeficiency virus (HIV) • Mental Illness (any type- specify the type in the response) • Multiple Sclerosis • Myasthenia Gravis • Paroxysmal Nocturnal Hemoglobinuria • Pneumonia • Sepsis • Current Drug Abuse • Necrotizing Fasciitis • Psychosis	qualifying Elation Problem List entries
CHF Exacerbation	Text	“Y” if the participant was diagnosed with a CHF exacerbation during the collection period. Else “N”.	Elation Problem List and Reference Code Set
COPD Exacerbation	Text	“Y” if the participant was diagnosed with a COPD exacerbation during the collection period.	Elation Problem List and Reference Code Set
Received Home Care	Text	As entered into CareHub’s scheduling module	CareHub Scheduling items with a location = In Home.
Assistance with Administering Medications	Text	This is pulled from the MAR in CareHub and only will be filled correctly if the program is using the MAR. Enter Y if an employee/contracted employee administered medication to the participant in the participant’s home and/or the PACE center at any time during the data collection period. Enter N if an employee/contracted employee did not administer medication to the participant in the participant’s home and/or the PACE center at any time during the data collection period. Prompting/medication reminders are not considered medication administration assistance.	CareHub where the patient has a Medication Administration Record
Current Center Attendance	Text	Number of days per month the participant is scheduled based on the data recorded in the scheduling module.  “0” is entered if the participant is not scheduled or has disenrolled at the time the universe is generated.	CareHub Schedule- Counts the number of Day Center appointments scheduled for the next 30 days.
Number of Falls with Injury	Text		CareHub where the patient has a documented Falls with Injury Incident
Number of Pressure Ulcers	Text		CareHub where the patient has a documented Pressure Injury Incident
Number of Confirmed Abuse Reports	Text	As pulled from the Incidents module.	CareHub where the patient has a documented Abuse Incident
Unexpected Death	Text	As pulled from the Incidents module.	CareHub where the patient has a documented  Unexpected Death Incident
Functional Decline	Text	“Y” if the participant had a functional decline during the data collection period.	CareHub Status Change Assessments where the reason for the change = “Functional Decline”
Number of Infections	Text	Based on the ICD codes in the problem list.	Elation Problem List
Incontinent	Text	Based on the ICD codes in the problem list. “Y” if the participant was routinely incontinent during the collection period.	Elation Problem List
Indwelling Catheter	Text	Based on the ICD codes in the problem list. “Y” if the participant had an indwelling catheter during the collection period.	Elation Problem List
Significant Weight Loss	Text	Enter Y if the participant had a weight loss of more than 5% within a 30-day period or 10% within a 180-day period. Enter N if the participant did not have a weight loss of more than 5% within a 30-day period or 10% within a 180-day period.	Elation Vitals
Restraints	Text	Based on Incidents module. Enter Y if physical or chemical restraints were used on the participant at any point during the data collection period, Enter N if physical or chemical restraints were not used on the participant at any point during the data collection period.	CareHub where the patient has a documented Restraint Use Incident
Oxygen Use	Text	Enter Y if the participant required oxygen on a regular basis at any point during the data collection period. Enter N if the participant did not require oxygen on a regular basis at any point during the data collection period.	Elation Problem List
Dialysis		Enter Y if the participant received dialysis during the data collection period. Enter N if the participant did not receive dialysis during the data collection period.	Elation Problem List
Impaired Vision		Enter Y if the participant had impaired vision (i.e., blindness or severely impaired vision without corrective lenses) during the data collection period. Enter N if the participant did not have impaired vision during the data collection period.	Elation Problem List
Palliative Care, Comfort Care, or End- of-Life Services Initiated	Text	Enter Y if palliative care, comfort care, or end-of-life care services were initiated during the data collection period. Enter N if palliative care, comfort care, or end-of-life care services were not initiated during the data collection period.	CareHub where ppt has an Authorization with “Hospice” as the type.
Wound Care	Text	Enter Y if the participant received regularly scheduled wound care during the audit review period. Do not include one-time instances of wound care. Enter N if the participant did not receive regularly scheduled wound care.	None in Q1 2026 (left blank)
Type of Disenrollment	Text	Valid entries include: Voluntary, Involuntary, and Deceased. Enter NA if the participant is still enrolled.	CareHub enrollment records