A1250C: Transportation (from NACHC): No, Step-by-Step

Step-by-Step Coding Guide for Item Set A1250C: Transportation (from NACHC©): No

1. Review of Medical Records

• Objective: To determine whether the resident has transportation services provided as part of their care plan or community resources.
• Process:
  • Review the resident's care plan for any mention of transportation services provided by the facility or through community resources.
  • Examine social service or case management notes that detail arrangements for transportation to appointments or activities outside the facility.
  • Consult with the resident or family members to confirm the current status of transportation services as perceived and understood by them.

2. Understanding Definitions

• Transportation Services: This typically refers to the provision of transport for residents to and from medical appointments, social activities, or other destinations as required. It is an important part of ensuring access to necessary care and maintaining quality of life.

3. Coding Instructions

• Code A1250C:
  • 0: Transportation is provided.
  • 1: No transportation is provided.
• Example: If the facility or associated community services do not provide transportation services to a resident, code A1250C as '1'.

4. Coding Tips

• Verify whether the lack of transportation includes all types of off-site movements, including medical and non-medical trips.
• Consider the availability of transportation services within the local community that might be accessible to the resident but not directly provided by the facility.

5. Documentation

• Required Documentation:
  • Entries in the care plan that clearly state the non-availability of transportation services.
  • Documentation from social services or case management sessions that discuss the resident’s needs for and barriers to transportation.
• Ensure that the absence of transportation services is clearly documented and agreed upon in care planning and review sessions.

6. Common Errors to Avoid

• Misinterpreting occasional transport assistance for regular service provision.
• Failing to update the transportation status in the resident’s records when changes occur, such as when services are added or discontinued.
• Overlooking transportation services provided by external organizations or community programs that the facility staff may not directly coordinate.

7. Practical Application

• Scenario: A resident at the facility requires regular visits to a specialist clinic. During a care plan review, it’s noted that the resident must arrange their transportation independently as the facility does not provide this service for non-emergency medical visits. This status is confirmed during a meeting with the resident and their family, and it's agreed that they will use a community shuttle service. The social services coordinator documents this in the resident's care plan, including that the facility itself does not provide transportation. The MDS coordinator uses this documentation to correctly code A1250C as '1', indicating that no transportation is provided by the facility.

Please note that the information provided in this guide for MDS 3.0 Item set A1250C 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.