source: internationalization/trunk/TranslationSpreadsheets/WV-DIALOG-0038.txt@ 1311

Last change on this file since 1311 was 604, checked in by George Lilly, 15 years ago

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1English French Notes Complete/Exclude
2collection of information. Send comments regarding this burden estimate or any other aspects of this collection, including
3suggestions for reducing this burden to VA Clearance Officer (045A4), 810 Vermont Avenue, NW, Washington, DC 20420.
4PRIVACY ACT NOTICE: The information requested on this form is solicited under authority of Title 38, U.S.C., Sections 710, 1712
5and 1722. It is being collected to enable us to determine your eligibility for medical benefits, identify your medical records,
6and provide basic data for your treatment. Additional information, such as medical history, may be solicited during the course of
7your medical evaluation or treatment. The income and eligibility information you supply may be verified through a computer
8matching program at any time and information may be disclosed outside VA as permitted by law; possible disclosures include
9those described in the
10routine uses
11 identified in the VA system of records 24VA136, Patient Medical Records-VA, published
12in the Federal Register in accordance with the Privacy Act of 1974. These
13 include disclosures: in response
14to court subpoenas; to epidemiological and other research facilities for research purposes; in connection with collections
15of amounts owed to the United States; to the Department of Justice for use in litigation; to other Federal agencies in connection
16with their employment determinations, investigations, or issuance of licenses or benefits; to report apparent law violations to
17other Federal, State or local agencies charged with law enforcement responsibilities; in response to an official request from a
18criminal or civil law enforcement governmental agency charged with the protection of public health or safety; to the Internal
19Revenue Service to verify unearned income, collect amounts owed VA, and to report as income debts that are waived, compromised or
20otherwise forgiven; to the Social Security Administration to verify earned income and employment data; to notify State licensing
21boards and Federal agencies of the health care practices of health care providers; to non-VA health care providers; to non-VA
22health care providers of facilities when the patient is referred for medical care at VA expense; to private sector organizations
23for the purpose of obtaining accreditation or approval rating for the health care facility; to non-VA nursing homes for
24preadmission screening; or, to contractors to perform the services covered by the contract. Disclosure is voluntary, however,
25failure to furnish the information will result in our inability to process your request and serve your medical needs.
26Failure to furnish the information will have no adverse effect on any other benefits to which you may be entitled.
27Disclosure of the Social Security number(s) of those for whom benefits are claimed is requested under the authority of
28Title 38, U.S.C., and is voluntary. Social Security numbers will be used in the administration of veteran's benefits,
29in the identification of veterans or persons claiming or receiving VA benefits and their records and may be used for
30other purposes where authorized by both Title 38, U.S.C., and the Privacy Act of 1974 (5 U.S.C. 552a) or where
31required by another statute.
32STREET ADDRESS [LINE 1]
33STREET ADDRESS [LINE 2]
34K-ADDRESS SAME AS PATIENT'S?
35K-STREET ADDRESS [LINE 1]
36K-STREET ADDRESS [LINE 2]
37K-STREET ADDRESS [LINE 3]
38FXa
39K-PHONE NUMBER
40K-WORK PHONE NUMBER
41E-EMER. CONTACT SAME AS NOK?
42E-RELATIONSHIP TO PATIENT
43E-STREET ADDRESS [LINE 1]
44E-STREET ADDRESS [LINE 2]
45E-STREET ADDRESS [LINE 3]
46E-PHONE NUMBER
47E-WORK PHONE NUMBER
48SERVICE BRANCH [LAST]
49DIC(23,
50SERVICE NUMBER [LAST]
51CURRENT PH INDICATOR
52CURRENT PURPLE HEART STATUS
531:PENDING;2:IN PROCESS;3:CONFIRMED;
54PH DIVISION
55CURRENT PURPLE HEART REMARKS
561:UNACCEPTABLE DOCUMENTATION;2:NO DOCUMENTATION REC'D;3:ENTERED IN ERROR;4:UNSUPPORTED PURPLE HEART;5:VAMC;6:UNDELIVERABLE MAIL;
57ENVIRONMENTAL CONTAMINANTS?
58DISABILITY RET. FROM MILITARY?
590:NO;1:YES, RECEIVING MILITARY RETIREMENT;2:YES, RECEIVING MILITARY RETIREMENT IN LIEU OF VA COMPENSATION;3:UNKNOWN;
60DIC(21,
61STREET ADDRESS [LINE 3]
62PHONE NUMBER [RESIDENCE]
63BAD ADDRESS INDICATOR
641:UNDELIVERABLE;2:HOMELESS;3:OTHER;
65K-NAME OF PRIMARY NOK
66K-RELATIONSHIP TO PATIENT
67CONFIDENTIAL ADDRESS DATA, SCREEN <
68UNK. CITY/STATE
69SC AWARD DATE
70RATED INCOMPETENT?
71DATE RULED INCOMPETENT (CIVIL)
72DATE RULED INCOMPETENT (VA)
73CLAIM FOLDER LOCATION
74TOTAL ANNUAL VA CHECK AMOUNT
75GI INSURANCE POLICY?
76SERVICE CONNECTED CONDITIONS
77AMOUNT OF GI INSURANCE
78Applicant doesn't have GI Insurance.
79AGENCY/ALLIED COUNTRY
80DIC(35,
81RECALLED TO ACTIVE DUTY
820:NO;1:NATIONAL GUARD;2:RESERVES;
83DIC(25002.1,
84Variable DGDR must be defined!
85Executing HL7 ADT Messaging (RAI/MDS)
86HL7 ADT MESSAGE (RAI/MDS)
87VAFH(
88From ASIH
89Unable to determine wards for transfer cancellation
90-1^Server Protocol not found
91-1^Unable to build segment list to transmit
92-1^An error occurred in one of the segments
93RAI/MDS HL7 MESSAGE XMIT
94RAI/MDS APPLICATION
95DGRU HL7SND
96RAI/MDS HL7 ADT ERROR
97DGRU RAI ERROR
98DGRU-RAI-A03-SERVER
99-1^Unable to build segment list
100-1^Error while building segment
101The field
102 is missing data.
103Service of ward must be the same as bedsection
104A RUG-II GROUP CAN NOT BE DETERMINED ON THIS PATIENT
105Do you wish to edit now
106There are fields missing data for this patient. The PAI will
107 not be complete until all data is entered. You can
108 complete the PAI at this time by responding 'Y'es.
109RUG-II GROUP:
110HIERARCHY GROUP:
111HEAVY REHABILITATION
112SPECIAL CARE
113CLINICAL COMPLEX
114ADL SUM:
115RUG-II WWUs:
116DG RUG CLOSE PAI
117Close this record now
118If 'TUBE FEEDING' or 'PARENTERAL FEEDING'
119 is marked 'Y'es then question 'EATING' must be marked '5'.
120If 'TUBE FEEDING' and 'PARENTERAL FEEDING'
121 are marked 'N'o then question 'EATING' must not be marked '5'.
122If 'TUBE FEEDING'
123 is marked 'Y'es then question 'TUBE FEEDING ROUTE' must not be marked '1'.
124If 'CHRONIC VENTILATOR DEP. (CVD)' is marked 'N'o then all CVD related
125questions must be marked '1'.
126For each of the therapy questions,'DAYS PER WEEK' and 'HOURS PER WEEK' must be '0' if level is '1'.
127and 'HOURS/MINUTES PER WEEK' must be greater than 29 minutes if level is
128greater than '1'.
129Can not have more than 10 hours of therapy per day
130If 'NASAL OR ENTERIC FEEDING'
131if level is greater than '1'.
132PATIENT ASSESSMENT INSTRUMENTS HAVE BEEN CREATED FOR THE FOLLOWING PATIENTS
133DUE TO ADMISSION/TRANSFER IN
134DATE OF ADMISSION/TRANSFER IN
135There was an attempt to set up a PAI record on
136Please verify that this patient's data is accurate and create a PAI record.
137ADT/HL7 MDS COTS UPDATE
138COTS UPDATE
139EVENT-NUM
140VAR-PTR
141-1^Could not find entry in PATIENT file
142DGRU-PATIENT-A08-SERVER
143RAI/MDS HL7 BUILD ERROR
144Select PATIENT ADMISSION:
145(A)dmission/transfer or (S)emi Annual Census: A//
146A - Assessment purpose is admission transfer
147S - Assessment purpose is semi-annual census
148NEITHER ADMISSION NOR TRANSFERS ARE TO INTERMEDIATE CARE OR NURSING HOME WARDS
149AFTER THE LAST CLOSEOUT
150There is already an admission/transfer assessment created for that
151admission/transfer date
152FBAAV(
153Record Deleted.
154ADMISSION/TRANSFER DATE:
155ASSESSMENT RECORD CREATED
156THERE ARE NO ADMISSIONS ON FILE FOR THIS PATIENT
157Assessment date:
158Enter the PAF record to reopen:
159Ok to reopen
160Enter PAF record to delete:
161Ok to delete
162 PAF record
163Answer YES or NO
164Enter PAF record to close:
165Ok to close
166ANSWER 'Y'ES OR 'N'O
167 -- ADMISSION DATE
168'^' TO EXIT
169RETURN FOR MORE CHOICES
170There is already a PAF entry for that date.
171Assessment date must be within a month of the semi-annual census date
172The assessment date must not be before the date of admission/transfer in.
173Assessment date can not be changed to after the RUG17 conversion date. Must remain before
174Assessment date can not be changed to prior to conversion. Date must be on or after
175Can not have more than 59 minutes of therapy
176DG RUG SUPERVISOR
177RUG-II
178This option will send the RUG/PAI data to the Austin DPC.
179REPLY (Y)ES OR (N)O
180Survey purpose: (A)dmission/transfer & CNH or (S)emi-annual?
181ASSESSMENT START DATE:
182You must have transmission turned on to Q-
183 and off for Q-
184Transmission is presently turned on to:
185Transmission is turned on to the wrong queue. Can not proceed at this time.
186Enter '^' at the device prompt to leave this option.
187Depending on type of survey being transmitted enter
188A - Admission/Transfer and CNH PAI Surveys
189S - Semi-annual PAI survey
190Start date must be within current closeout cycle.
191Date must not be before
192Can not transmit for future dates
193You can not overlap the RUG17 Conversion date.
194Dates must both be prior to or after
195Enter Yes to continue or No to quit
196Enter the Division you want to do Data Seeding for
197Select the division you want to load the patient data for into the COTS database.
198You have selected:
199Station Number :
200Enter Yes or No. Yes will select, No will cancel.
201RAI/MDS DATA SEED FOR DIVISION
202** The data seed process was not tasked **
203The data seed process has been tasked (#
204DGRU-RAI-A01-SERVER
205Looping through ward
206 -- Last DFN sent was
207Task stopped as requested
208Task ran to completion
209Enter the patient you want to data seed:
210Select the patient you want to load into the COTS database.
211You cannot proceed with this patient
212You may select another patient or quit.
213Enter Yes or No. Yes will select this patient. No will cancel the selection of this patient.
214Select another patient?
215Enter Yes or No. Yes will allow you to select another patient.
216 is not in an RAI ward.
217 is not an active patient in an RAI ward.
218Sending message...
219You are about to enter national fiscal year RUG values. All entries must be
220completed, otherwise those that you have entered will be deleted.
221Enter fiscal year (4 digits):
222 WWU value not assigned
223Do you want to enter these values now
224WARNING: All existing WWU values for fiscal year
225 will be deleted. OK to continue
226Enter RUG
227Enter fiscal year (4 digits) from which you want RUG-II WWU values.
228Must not precede 1987.
229Sort by (A)ssessment or (T)ransfer/Admission Date: T//
230A - Date range for the search is by Assessment Date
231T - Date range is by Transfer or admission date
232RUG group
233Enter Category:
234ALL//
235 Enter a category or 'return' when all categories
236have been selected
237You have selected output for:
238Assessment
239Transfer/Admission
240 dates between
241Patients:
242Divisions for Wards:
243Wards:
244CNH Locations:
245RUG-II Groups:
246This output requires 132 columns!
247***RUG-II INDEX REPORTS--NO MATCHES FOUND***
248Choose from (H)eavy Rehabilitation, (S)pecial Care, (C)linical Complex
249RUG-II INDEX REPORT
250BY ADMISSION/TRANSFER DATE
251BY ASSESSMENT DATE
252RUN ON:
253DATE/PURPOSE
254HEAVY REHAB
255CLIN COMPLEX
256CURRENT STATUS:
257** = Absent from ward
258ASSESSMENT PURPOSE:
259S-A = Semi-annual census
260CNH = Contract Nursing Home
261HISTOGRAM FOR
262 ALL LOCATIONS
263FOR PERIOD COVERING:
264PERCENTAGE OF PATIENTS IN GROUP
265RUG
266DGRU-RAI-MFU-SERVER
267NURSING UNIT
268ADMISSION/TRANSFER
269SEMI-ANNUAL CENSUS
270CONTRACT NURSING HOME
271INCOMPLETE PATIENT ASSESSMENT INSTRUMENTS
272No location listed in Patient Assessment File for:
273HIT <RETURN> TO CONTINUE
274INCOMPLETE PATIENT ASSESSMENTS
275THERE ARE NO PATIENTS WITH THE STATUS OF INCOMPLETE
276FOR DATE RANGE:
277 DATE PRINTED:
278FOR LOCATIONS:
279ALL Contract Nursing Homes
280ALL Wards
281 (A)SSESSMENT OR (T)RANSFER/ADMISSION DATE: ASSESSMENT//
282A - Sort by Assessment date range
283T - Sort by Transfer in/Admission date range
284TIME PER WEEK==> DAYS:
2851 - HEAVY REHABILITATION
2862 - SPECIAL CARE
2873 - CLINICAL COMPLEX
288>>>>PATIENT ASSESSMENT INSTRUMENT<<<<
289RUG-II GROUP:
290ADL SUM:
291YEAR OF BIRTH:
292ASSESSMENT DATE:
293RUG-II WWUs:
294ASSESSMENT PURPOSE:
2952 SEMI-ANNUAL CENSUS
2963 CONTRACT NURSING HOME
297DATE OF ADMISSION/TRANSFER IN:
298RECORD STATUS:
299MEDICAL CENTER CODE:
300BED SECTION:
301-INTERMEDIATE MED.
302-NURSING HOME CARE
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