Step-by-Step Coding Guide for Item Set F0400D: Resident Interview - Have Snacks Between Meals

1. Review of Medical Records

• Objective: Gather accurate information regarding the resident’s habit of having snacks between meals.
• Steps:
  1. Collect Information: Review the resident’s comprehensive medical records, including dietary notes, nutrition assessments, care plans, and previous assessments.
  2. Identify Snack Consumption: Look for documented instances of the resident having snacks between meals, such as dietary logs, snack requests, or notes from nutritionists.
  3. Confirm Details: Verify the consistency and accuracy of the documentation through various sources within the medical records.

2. Understanding Definitions

• Have Snacks Between Meals: The activity of the resident consuming snacks outside of regular meal times. This can include any food or drink taken between breakfast, lunch, and dinner.
• Key Points:
  • Snacks can include fruits, nuts, sweets, drinks, and any other light food items.
  • The frequency and type of snacks should be considered during the assessment.

3. Coding Instructions

• Steps:
  1. Conduct Interview: During the assessment period, ask the resident about their habit of having snacks between meals.
  2. Evaluate Participation: Determine how often the resident has snacks based on their response.
  3. Code Appropriately: Use the following scale to code the resident’s snacking habits:
     • 0: Never
     • 1: Rarely or some of the time
     • 2: Frequently or all of the time

4. Coding Tips

• Accurate Questioning: Ensure the questions about snacking habits are asked clearly and in a way the resident can understand.
• Clarify Definitions: Make sure the resident understands what is meant by “snacks between meals.”
• Consistent Terminology: Use consistent terminology and phrasing when documenting and coding the resident’s snacking habits.

5. Documentation

• Required:
  • Interview Notes: Document the resident’s responses during the interview, including details about their snacking habits and preferences.
  • Staff Reports: Include reports from staff members detailing their observations and interactions with the resident regarding snacking.
  • Dietary Logs: Records of the resident’s snack consumption as documented by dietary staff or nutritionists.

6. Common Errors to Avoid

• Misclassification: Ensure accurate classification by verifying the resident’s snacking habits through multiple observations and interviews.
• Incomplete Documentation: Make sure all relevant details about the resident’s snacking habits are thoroughly documented.
• Assumptions: Do not assume the resident’s snacking habits without proper documentation and verification.

7. Practical Application

• Example:
  • Resident Profile: Emma, an 85-year-old resident, enjoys having fruits and nuts as snacks between her meals.
  • Steps:
    1. Conduct Interview: The nurse asks Emma about her snacking habits during the assessment period.
    2. Evaluate Response: Emma reports that she frequently has fruits and nuts as snacks between her meals.
    3. Document and Code: The nurse documents Emma’s responses and codes F0400D as "2".
  • Outcome: Emma’s snacking habits are accurately documented and coded, ensuring proper follow-up and care planning.

Please note that the information provided in this guide for MDS 3.0 Item set F0400D 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.