Step-by-Step Coding Guide for F0800: Staff Assessment of Daily and Activity Preferences

Introduction:

F0800 in the MDS 3.0 focuses on understanding the resident's daily and activity preferences through staff observation. This section is critical for tailoring care plans to meet individual needs and preferences, enhancing quality of life and satisfaction with care.

Objective:

To accurately code F0800 by observing and documenting the resident's preferences for daily routines and activities.

Key Points:

• Importance of Observation: Staff observations are invaluable in assessing preferences, especially when residents cannot communicate their preferences due to cognitive impairments or language barriers.
• Interdisciplinary Approach: All staff members interacting with the resident contribute insights, ensuring a comprehensive understanding of the resident's preferences.

Steps for Assessment:

1. Review Resident's Routine:

   • Examine the resident’s daily routine and activities over the 7-day look-back period.
   • Consult with various staff members (e.g., nursing, activities, therapy) who interact with the resident across different shifts.

2. Observe the Resident:

   • Pay attention to the resident's engagement and reactions during activities and daily routines.
   • Note preferences indicated by positive engagement (smiling, active participation) or disengagement (withdrawal, refusal to participate).

3. Document Observations:

   • Record observed preferences in F0800, marking all applicable preferences.
   • If the resident appears to enjoy or engage in an activity, check the corresponding box in F0800.

Coding Instructions:

• Check All That Apply: Mark each item in F0800 that aligns with the resident's observed preferences during the assessment period.
• Consider Environmental Adjustments: Adjustments made to accommodate the resident’s preferences, such as offering snacks between meals or facilitating family involvement in care discussions, should be noted.

Common Errors to Avoid:

• Overlooking Subtle Cues: Failing to recognize non-verbal cues indicating preferences can lead to inaccurate coding.
• Incomplete Observation: Not consulting with staff across all shifts or disciplines may result in missing key information about the resident's preferences.

Practical Application:

• Case Study: Mrs. Smith, a resident with mild cognitive impairment, shows a clear preference for wearing her own clothes, participating in group activities, and spending time outdoors. Despite her inability to verbally communicate these preferences, staff observe her positive reactions to these activities, such as choosing her clothes with assistance, smiling, and actively engaging in group discussions. These observations are documented in F0800, informing her care plan to include these preferences.
• Role-Playing: Staff can engage in role-playing exercises to better understand how to observe and interpret non-verbal cues indicating residents' preferences.

Resources for Further Learning:

• CMS RAI Version 3.0 Manual: Refer to the latest version for detailed guidance on coding F0800.
• In-Service Training: Participate in educational sessions focusing on observation skills and understanding non-verbal cues.

Q&A and Interactive Session:

• Encourage Questions: Staff should feel comfortable asking questions about how to observe and document preferences accurately.
• Share Experiences: Discuss scenarios where observing and coding preferences impacted resident care positively.

The Step-by-Step Coding Guide for item F0800 in MDS 3.0 Section F 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.