A1300D. Lifetime Occupation (s), Step-by-Step

Step-by-Step Coding Guide for Item Set A1300D: Lifetime Occupation

This guide is intended to assist in accurately coding and documenting a resident's lifetime occupation in the MDS 3.0, specifically within item A1300D.

1. Review of Medical Records

• Objective: Identify the resident's primary or most significant occupation held during their lifetime.
• Key Points:
  • Review the resident's social history, admission interviews, or any biographical information provided at admission or during care planning sessions.
  • Look for mentions of the resident's employment history in conversations with the resident or their family.

2. Understanding Definitions

• Objective: Define "Lifetime Occupation."
• Key Points:
  • Lifetime Occupation: Refers to the job or career that a resident primarily engaged in or identifies as their main work during their active working years. This can reflect a significant part of the resident's identity and social history.

3. Coding Instructions

• Objective: Provide guidance on how to accurately document the resident's lifetime occupation.
• Key Points:
  • Code the specific occupation or job title as described by the resident or their family. Use general terms if the specific job title is not known (e.g., "teacher," "farmer," "nurse").
  • Avoid using vague terms like "retired" or "homemaker" unless no other information is available or if the resident specifically identifies with these terms.

4. Coding Tips

• Clarify any unclear job titles with the resident or their family to ensure accurate documentation.
• Be sensitive to the resident's perception of their occupation, especially if they held multiple jobs, by choosing the one they consider most significant.

5. Documentation

• Objective: Ensure comprehensive documentation of the resident’s lifetime occupation.
• Key Points:
  • Document the source of information regarding the resident’s occupation, noting whether the information came directly from the resident, family members, or other documents.
  • Include any relevant details that the resident shares about their occupation, as this can enrich their social history and inform personalized care planning.

6. Common Errors to Avoid

• Documenting only the last job held before retirement rather than the occupation the resident identifies as their lifetime work.
• Failing to update the resident's social history if new, more relevant information about their lifetime occupation becomes available.

7. Practical Application

• Scenario: Mr. George Miller, a new resident at Pine Grove Care Facility, mentions during his admission interview that he worked as a civil engineer for over 40 years and considers this his lifetime occupation. The social worker documents "civil engineer" in A1300D of Mr. Miller's MDS assessment and notes in his social history that this career was a significant part of his identity. This information is used to engage Mr. Miller in conversations about his past projects, enhancing his social engagement and personalizing his care plan.

The Step-by-Step Coding Guide for item A1300D in MDS 3.0 Section A is based on the Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual, Version 1.18.11, dated October 2023. Healthcare guidelines, policies, and regulations can undergo frequent updates. Therefore, healthcare professionals must ensure they are referencing the most current version of the MDS 3.0 manual. This guide aims to assist with understanding and applying the coding procedures as outlined in the referenced manual version. However, in cases where there are updates or changes to the manual after the mentioned date, users should refer to the latest version of the manual for the most accurate and up-to-date information. The guide should not substitute for professional judgment and the consultation of the latest regulatory guidelines in the healthcare field.