Step-by-Step Coding Guide for Item Set: GG0170S5. Wheel 150 Feet (OBRA/Interim Performance)

1. Review of Medical Records

   • Begin the process by thoroughly reviewing the resident's medical and therapy records, focusing on mobility assessments related to their use of a wheelchair. Pay particular attention to physical therapy evaluations, occupational therapy notes, nursing assessments, and care plans that detail the resident's ability to self-propel in a wheelchair over a distance of 150 feet since their last assessment.

2. Understanding Definitions

   • Wheel 150 Feet: This measure assesses the resident's capability to self-propel in a wheelchair over a distance of 150 feet. It evaluates physical strength, endurance, maneuverability, and the resident's ability to maintain control over the wheelchair.
   • OBRA/Interim Performance: Reflects the resident's current level of ability to wheel 150 feet as assessed during an OBRA-required or interim performance assessment, capturing any changes in mobility since the last evaluation.

3. Coding Instructions

   • Observe the resident performing the task or gather accurate information from staff familiar with the resident's mobility. Code the resident's ability using the following scale:
     • 06: Independent - Completes the task without any assistance.
     • 05: Setup or clean-up assistance - Requires help only before or after the activity.
     • 04: Supervision or touching assistance - Needs verbal cues or light touch support.
     • 03: Partial/moderate assistance - Staff provides less than half the effort.
     • 02: Substantial/maximal assistance - Staff provides more than half the effort.
     • 01: Dependent - Staff provides all the effort.
     • 88: Not attempted due to medical condition or safety concerns.

4. Coding Tips

   • Accurately assess the resident's independence by considering their need for breaks, verbal encouragement, and any difficulties they may have in maneuvering the wheelchair, especially over longer distances.

5. Documentation

   • Record the selected code in the resident's MDS and medical record. Include detailed notes on the assessment, highlighting the resident's capabilities, any assistance required, and the conditions under which the assessment was performed.

6. Common Errors to Avoid

   • Not considering the full effort required from staff, especially in cases where residents may require significant encouragement or assistance in maneuvering.
   • Failing to document or code the activity when it is not attempted, along with the rationale behind this decision.

7. Practical Application

   • Example: During her interim performance assessment, Mrs. Lee can wheel herself 150 feet in a manual wheelchair without physical assistance but requires periodic verbal reminders to keep her path straight due to mild cognitive impairment. The appropriate code would be 04 (Supervision or touching assistance), noting the type of support provided.

The Step-by-Step Coding Guide for item GG0170S5 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.