C0200. Repetition of Three Words, Step-by-Step

Step-by-step Coding Guide for C0200: Repetition of Three Words

1. Review of Medical Records

Before attempting the C0200 interview, it's crucial to review the resident's medical records. This review should focus on any documented cognitive impairments, diagnoses that may affect cognitive function (such as dementia, stroke, etc.), and any medications that could impact memory or cognitive abilities. Understanding the resident's baseline cognitive status can help inform how to approach the interview and interpret responses.

2. Understanding Definitions

• Immediate Recall: The ability of the resident to remember information over a short time span, typically a few minutes.

3. Coding Instructions

• Instruction: You are to say three words to the resident (sock, blue, and bed), giving one second to say each word. Then ask the resident to repeat all three words immediately.
• Coding Options:
  • 0: Resident accurately repeats all three words immediately after you say them.
  • 1: Resident repeats only two words correctly.
  • 2: Resident repeats only one word correctly.
  • 3: Resident is unable to repeat any of the words.

4. Coding Tips

• Ensure the environment is quiet and free from distractions before starting the interview.
• Speak clearly and at a moderate pace.
• If the resident does not understand the task, you may repeat the instructions and the words one time.
• Do not prompt or give hints to the resident about the words.

5. Documentation

Document the resident's response in the MDS assessment form under Section C0200. If the resident was unable to attempt or complete the task, note any contributing factors, such as refusal, hearing impairment, or lack of English proficiency, in the resident's medical record or care plan.

6. Common Errors to Avoid

• Failing to review the resident's medical history for relevant cognitive impairments.
• Administering the test in a noisy or distracting environment.
• Rushing through the instructions or words, not allowing the resident ample processing time.
• Prompting the resident with hints or cues.

7. Practical Application

Example: Mrs. A is a new resident with a documented history of mild cognitive impairment. During the C0200 item interview, after you say "sock, blue, bed," Mrs. A immediately repeats "blue, bed, sock." According to the coding instructions, Mrs. A's response is coded as 0 since she accurately repeated all three words, although the order was different.

The Step-by-Step Coding Guide for item C0200 in MDS 3.0 Section C 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.