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New “Data Element Library” from CMS

As part of its bigger push for EHR integration, CMS is releasing information it gathers from nursing homes and rehabilitation hospitals. the Data Element Library (DEL) does not include patient data, but instead includes the data dictionary for various assessments CMS requires (fields, response options). The idea is that companies doing tech design can build in future integration with CMS data sets in this space.


From the DEL announcement on


What is the Data Element Library?

The CMS Data Element Library (DEL) is the centralized resource for CMS assessment instrument data elements (e.g. questions and responses) and their associated health information technology (IT) standards.

DEL Mission and Goals

The mission of the Data Element Library (DEL) is to create a comprehensive, electronic, distributable, and centralized resource of CMS assessment instrument content.

In support of the Improving Medicare Post-Acute Care Transformation Act (IMPACT Act), the goals of the DEL are to:

Serve as a centralized resource for CMS assessment data elements (questions and response options)
Promote the sharing of electronic CMS assessment data sets and health information technology standards; and
Influence and support industry efforts to promote Electronic Health Record (EHR) and other health IT interoperability
In support of CMS’ focus on “Patients over Paperwork”, the DEL promotes interoperable health information exchange by linking CMS assessment questions and response options to nationally accepted health IT standards. Standardized and interoperable data support health information exchange across healthcare settings to facilitate care coordination, improved health outcomes, and reduced provider burden through the reuse of appropriate healthcare data.

What is included in the DEL?

CMS assessment items included in the DEL are derived from the following:

Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI)
Long-Term Care Hospital Continuity Assessment Record & Evaluation (CARE) Data Set (LCDS)
Resident Assessment Instrument (RAI) Minimum Data Set (MDS)
Outcome and Assessment Information Set (OASIS)
Hospice Item Set (HIS)
Functional Assessment Standardized Items (FASI) (In Progress)
The DEL does not contain patient health data. The DEL database includes post-acute care (PAC) assessment questions and their response options, as well as other associated details including the assessment version, item labels, item status, copyright information, CMS item usage, skip pattern information, lookback periods, and linked health IT Standards (e.g. Logical Observation Identifiers Names and Codes (LOINC), and Systematized Nomenclature of Medicine – Clinical Terms (SNOMED) when available).