ACESOAI

Accountable health communities (AHC) health-related social needs (HRSN) supplemental questions

Label Value Unit
How hard is it for you to pay for the very basics like food, housing, medical care, and heating:Find:Pt:^Patient:Ord: ?
Wants help finding or keeping work or a job:Find:Pt:^Patient:Ord:
Able to get help with daily activities when needed:Find:Pt:^Patient:Ord:
How often do you feel lonely or isolated from those around you:Find:RptPeriod:^Patient:Ord:CMS Assessment
Speaks a language other than English at home:Find:Pt:^Patient:Ord:
Wants help with school or training:Find:Pt:^Patient:Ord:
How many D per W did you engage in moderate to strenuous physical activity in the last 30D:NRat:30D:^Patient:Qn: ? d/wk
On those D that you engage in moderate to strenuous exercise, how many M, on average, do you exercise:NRat:Pt:^Patient:Qn: min/d
How many times in the past Y have you have X or more drinks in a D:NRat:1Y:^Patient:Qn: ? {#}/a
Tobacco freq 12Mo
Prescription drug use 1Y
Illegal drug non-med reason past Y nRate {#}/a
Little interest or pleasure in doing things in last 2W:Find:2W:^Patient:Ord:
Feeling down, depressed, or hopeless in last 2W:Find:2W:^Patient:Ord:
Stress level
Because of a physical, mental, or emotional condition, do you have serious difficulty concentrating, remembering, or making decisions:Find:Pt:^Patient:Ord:
Because of a physical, mental, or emotional condition, do you have difficulty doing errands alone such as visiting a physician's office or shopping:Find:Pt:^Patient:Ord: