Step-by-Step Coding Guide for Item Set A1010F: Race - Filipino

1. Review of Medical Records

• Objective: Gather accurate information regarding the resident’s race identification as Filipino.
• Steps:
  1. Collect Information: Review the resident’s comprehensive medical records, including admission forms, demographic information, previous assessments, and personal identification documents.
  2. Identify Race Documentation: Look for documented instances of the resident’s race identification, specifically noting if they identify as Filipino.
  3. Confirm Details: Verify the consistency and accuracy of the race documentation through various sources within the medical records.

2. Understanding Definitions

• Filipino: A person having origins in any of the original peoples of the Philippines. This includes people who identify with Filipino culture, heritage, and ethnicity.
• Key Points:
  • It is important to accurately record the resident's self-identified race to ensure personalized and culturally competent care.
  • The resident’s race should be self-reported whenever possible.

3. Coding Instructions

• Steps:
  1. Identify Relevant Documentation: Confirm the resident’s race as Filipino based on medical records and self-identification.
  2. Verify Documentation: Ensure the identification of the resident’s race as Filipino is clearly documented in the resident’s records, including admission forms and demographic information.
  3. Code Appropriately: Enter the code for Filipino in item set A1010F. If the resident identifies as Filipino, code as "1"; if not, code as "0".

4. Coding Tips

• Accurate Identification: Ensure the resident's race is self-identified and accurately documented in the records.
• Consistent Terminology: Use consistent terminology when documenting and coding the resident’s race as Filipino.
• Consult Residents or Family: If there is any uncertainty, consult with the resident or their family members for clarification.

5. Documentation

• Required:
  • Admission Forms: Ensure the resident’s admission forms clearly indicate their race as Filipino if applicable.
  • Personal Identification: Include copies of personal identification documents that show the resident’s race if available.
  • Previous Assessments: Verify the resident’s race identification across previous assessments to ensure consistency.

6. Common Errors to Avoid

• Misclassification: Ensure accurate classification by verifying the resident’s race through multiple records and consultations.
• Incomplete Documentation: Make sure all relevant identification documents and admission forms are included.
• Assumptions: Do not assume the resident’s race without proper documentation and verification.

7. Practical Application

• Example:
  • Resident Profile: Maria Santos, a 70-year-old resident, identifies her race as Filipino.
  • Steps:
    1. Review Records: The nurse reviews Maria’s medical records, including admission forms and demographic information that document her race as Filipino.
    2. Identify Race: It is confirmed that Maria self-identifies as Filipino.
    3. Document and Code: The nurse enters "1" in item set A1010F for Maria to indicate her race as Filipino.
  • Outcome: Maria’s race is accurately documented and coded, ensuring culturally competent care and appropriate follow-up.

Please note that the information provided in this guide for MDS 3.0 Item set A1010F was originally based on the CMS's RAI Version 3.0 Manual, October 2023 edition. Every effort will be made to update it to the most current version. The MDS 3.0 Manual is typically updated every October. If there are no changes to the Item Set, there will be no changes to this guide. This guidance is intended to assist healthcare professionals, particularly new nurses or MDS coordinators, in understanding and applying the correct coding procedures for this specific item within MDS 3.0. 

The guide is not a substitute for professional judgment or the facility’s policies. It is crucial to stay updated with any changes or updates in the MDS 3.0 manual or relevant CMS regulations. The guide does not cover all potential scenarios and should not be used as a sole resource for MDS 3.0 coding. 

Additionally, this guide refrains from handling personal patient data and does not provide medical or legal advice. Users are responsible for ensuring compliance with all applicable laws and regulations in their respective practices.