Step-by-Step Coding Guide for Item Set GG0110C: Mechanical Lift

This guide is designed to help accurately code and document the use of a mechanical lift, as specified in item GG0110C of the MDS 3.0.

1. Review of Medical Records

• Objective: Determine if the resident uses a mechanical lift.
• Key Points:
  • Look through the resident's medical records for any mentions of a mechanical lift use, including physical and occupational therapy assessments, nursing care plans, and physician orders.
  • Pay special attention to mobility assessments and equipment prescriptions that mention the necessity for a mechanical lift for transfers or mobility.

2. Understanding Definitions

• Objective: Define "Mechanical Lift."
• Key Points:
  • Mechanical Lift: A device used to assist in the transfer of a resident from one surface to another, such as from a bed to a wheelchair, often to prevent injury to both the resident and caregivers. It can be a ceiling lift, a sit-to-stand lift, or a Hoyer lift.

3. Coding Instructions

• Objective: Provide guidance on accurately coding the use of a mechanical lift.
• Key Points:
  • Code "1" if the resident uses a mechanical lift for transfers during the assessment period.
  • Code "0" if the resident does not use a mechanical lift.

4. Coding Tips

• Verify the type of lift used and ensure staff members are accurately reporting its use in daily care and activities.
• Consider the resident's entire assessment period when determining lift use, as needs may vary over time.

5. Documentation

• Objective: Ensure comprehensive documentation regarding mechanical lift use.
• Key Points:
  • Document the assessment that led to the recommendation for a mechanical lift, including the date and the healthcare professional's name.
  • Keep a record of training provided to staff and the resident (if applicable) on the proper use of the mechanical lift.

6. Common Errors to Avoid

• Assuming a resident does not use a mechanical lift without reviewing all relevant documentation and staff reports.
• Failing to update the resident's records if the need for a mechanical lift changes during the assessment period.

7. Practical Application

• Scenario: Mr. Robert Jones has been assessed by the physical therapy team as requiring a Hoyer lift for all transfers due to his limited mobility and risk of falls. The nursing care plan includes detailed instructions for using the mechanical lift, and all staff involved in Mr. Jones's care have been trained on its use. During the assessment period, Mr. Jones has been transferred using the Hoyer lift multiple times. The MDS Coordinator reviews this information and codes "1" for GG0110C, reflecting Mr. Jones's reliance on a mechanical lift for safe transfers.

The Step-by-Step Coding Guide for item GG0110C in MDS 3.0 Section GG 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.