Step-by-Step Coding Guide for Item Set GG0170K3: Walk 150 Feet (Discharge Performance)

1. Review of Medical Records

Objective: To evaluate the resident's ability to walk 150 feet at the time of discharge, by thoroughly reviewing medical and therapy records.

• Examine the resident’s therapy notes, nursing assessments, and physician orders for information on mobility status, specifically the ability to walk 150 feet.
• Look for progress notes indicating changes in mobility since admission and interventions that have impacted the resident's walking ability.

2. Understanding Definitions

• Walk 150 Feet: This activity involves the resident walking a distance of 150 feet in a corridor or similar space, without stopping, sitting, or requiring physical assistance.
• Discharge Performance: The resident's performance of the task at discharge, representing their current level of mobility.

3. Coding Instructions

• Code 06 - Independent: The resident walks 150 feet without any assistance, including verbal cues or physical support.
• Code 05 - Set-up or clean-up assistance: The resident requires help only before or after the activity (e.g., placing a walker within reach).
• Code 04 - Supervision or touching assistance: The resident needs verbal encouragement or light touch assistance for balance or navigation.
• Code 03 - Partial/moderate assistance: The helper provides less than half of the effort required for the task.
• Code 02 - Substantial/maximal assistance: The helper provides more than half of the effort.
• Code 01 - Dependent: The resident is unable to walk 150 feet; the helper does all the work.
• Code 07 - Resident refused: The resident chooses not to perform the task.
• Code 09 - Not applicable: The resident is not capable of walking.
• Code 88 - Not attempted due to medical condition or safety concerns: Walking 150 feet is contraindicated due to the resident's condition.

4. Coding Tips

• Ensure a safe and clear path for the assessment, free of obstacles.
• Assess using the resident’s usual assistive device, if any, and note its use in documentation.
• Consider the resident’s endurance and fatigue levels during the walk.

5. Documentation

• Document the resident's ability to walk 150 feet, including any assistive devices used and the level of assistance provided.
• Record observations about the resident’s pace, stability, and any signs of distress or fatigue.
• Note comparisons between admission and discharge performance to illustrate progress or decline.

6. Common Errors to Avoid

• Misclassifying the resident's need for supervision as independence.
• Overlooking brief rests or adjustments the resident may need during the walk.
• Failing to document the task accurately, especially regarding assistive devices and the exact nature of assistance needed.

7. Practical Application

• Use assessment results to tailor discharge planning, including home modifications, outpatient therapy needs, and recommendations for continued mobility enhancement.
• Discuss assessment findings with the resident and family to set realistic expectations and plan for safe post-discharge mobility.

The Step-by-Step Coding Guide for item GG0170K3 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.