Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) & LCDS Manual

This page includes the current versions of the LCDS, LCDS Manual and associated documents. This page will be updated when:

• An update is made to either of these resources
• A newer version becomes available
• Important information regarding these tools needs to be communicated

The older versions of these documents will remain available for reference in the LTCH Quality Reporting Program Archives.

For additional information related to the LTCH Prospective Payment System (PPS) requirements, please refer to the LTCH PPS webpage.

The LCDS Section I, Active Diagnoses, to ICD-10 Mapping

A resource document that provides a mapping of Section I data elements in the Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) to International Classification of Diseases, Tenth Edition (ICD-10) codes, where applicable, is available. Definitions of primary diagnoses, comorbidities, and coexisting conditions in Section I remain unchanged. Providers should follow the coding instructions found in Chapter 3, Section I of the LCDS Manual, available in the Downloads section of this webpage. This information is intended to assist providers in identifying patients with these diagnoses. For those diagnosis categories that are not based on a hierarchical condition category (HCC), the list of diagnosis codes is not all-inclusive.

Questions regarding this file should be sent to the LTCH Quality Questions Help Desk at LTCHQualityQuestions@cms.hhs.gov.

The LCDS

The Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) is the assessment instrument LTCH providers use to collect patient assessment data in accordance with the LTCH Quality Reporting Program (QRP). Patient assessment data is collected on all patients at admission, discharge (planned or unplanned), and for patients who die (expired). The LCDS Version 5.0 was implemented October 1, 2022 and is currently in use. For more information about data collection and submission, please refer to the LTCH Quality Reporting Data Submission Deadlines webpage.

The LCDS Manual

The Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) Manual provides guidance to LTCHs regarding quality data collection, submission, and reporting to comply with the requirements of the LTCH Quality Reporting Program (QRP). The LCDS Manual offers item-by-item coding instructions and coding examples for each item for LTCH staff to accurately complete the LCDS. The most recent version of the LCDS Manual (previously referenced as the LTCH QRP Manual) is available in the Downloads section below.

Updates

September 3, 2024

CMS LCDS Quarterly Q&As, September 2024, Consolidated September 2020 to September 2024

The Centers for Medicare & Medicaid Services (CMS) is publishing the Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) Quarterly Q&As, in September of 2024. The document contains the consolidated Q&As from September 2020 to September 2024 so that all LTCH providers have the benefit of clarifications to existing guidance, CMS identifies the opportunity to clarify or refine guidance.

The Quarterly Q&A document is available in the Downloads section of this webpage.

August 26, 2024

LCDS Version 5.2 Item Sets posted

The FY 2025 Inpatient Prospective Payment System (IPPS)/Long-Term Care Hospital (LTCH) Prospective Payment System Final Rule (CMS-1808-F) finalized the collection and submission of four new standardized patient assessment data elements under the SDOH category at admission only beginning with October 1, 2026 LTCH admissions:  (1) Living Situation; (2) Food; and (3) Utilities. CMS also finalized the modification of the standardized patient assessment data element, Transportation, at admission only beginning with October 1, 2026 LTCH admissions. These items have been added to the LCDS Continuity Assessment Record and Evaluation (Care) Data Set (LCDS) Version 5.2 item sets. 

The LCDS 5.2 Item Sets can be accessed via the Downloads section of the Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) and LCDS Manual webpage. 

June 18, 2024

CMS LCDS Quarterly Q&As, June 2024, Consolidated September 2020 to June 2024

The Centers for Medicare & Medicaid Services (CMS) is publishing the Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) Quarterly Q&As, in June of 2024. The document contains the consolidated Q&As from September 2020 to June 2024 so that all LTCH providers have the benefit of clarifications to existing guidance, CMS identifies the opportunity to clarify or refine guidance.

The Quarterly Q&A document is available in the Downloads section of this webpage.

March 20, 2024

CMS LCDS Quarterly Q&As, March 2024, Consolidated September 2020 to March 2024

The Centers for Medicare & Medicaid Services (CMS) is publishing the Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) Quarterly Q&As, in March of 2024. The document contains the consolidated Q&As from September 2020 to March 2024 so that all LTCH providers have the benefit of the clarifications to existing guidance, CMS identifies the opportunity to clarify or refine guidance. While no new Q&As were added to the consolidated document for this release, CMS has archived some Q&As either because the guidance has been added to the LCDS 5.1 Manual, or the Q&As have been retired.

The Quarterly Q&A document is available in the Downloads section of this webpage.

February 1, 2024

CMS LCDS Manual Version 5.1 

The Centers for Medicare & Medicaid Services (CMS) is publishing the Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) Manual Version 5.1, effective October 1, 2024. A Change Table outlining the revisions to the CMS LCDS Manual Version 5.1 is also published.

The Manual and Change Table is available in the Downloads section of this webpage.

LTCH Quality Reporting Program Archives