H0500. Bowel Toileting Program, Step-by-Step

Step-by-Step Coding Guide for H0500: Bowel Toileting Program

Intent: To identify residents who have or need a bowel toileting program.

Item Rationale:

A bowel toileting program is aimed at decreasing or preventing bowel incontinence, thereby improving the resident's quality of life.

Steps for Coding H0500:

1. Review the Resident's Medical Record:

   • Look for evidence in the resident’s medical record (physician orders, nursing notes) of a current bowel toileting program.

2. Consult with Nursing Staff:

   • Discuss the resident's bowel management with nursing staff to verify if a bowel toileting program is in place or needed.

3. Observe the Resident:

   • If possible, observe the resident’s bowel management practices during the assessment period.

4. Interview the Resident and/or Family:

   • Ask the resident and/or family members about the resident's usual bowel routine and any issues or preferences related to bowel management.

5. Code as Follows:

   • Code 0, Not Used: If the resident does not have and does not need a bowel toileting program.
   • Code 1, Used and Maintained: If the resident has a bowel toileting program that was in place at the time of admission and has been continued.
   • Code 2, Not Used, Offered, and Declined: If the resident does not have a bowel toileting program because it was offered and declined.
   • Code 3, In Place on Admission, Not Maintained: If the resident had a bowel toileting program in place at the time of admission, but it has not been continued.
   • Code 8, Used and Not in Place on Admission: If a bowel toileting program was not in place at the time of admission but has been initiated since then.

Documentation and Care Planning:

• Ensure that the resident's care plan reflects the current bowel management practices, including any bowel toileting program, its goals, and outcomes.

The Step-by-Step Coding Guide for item H0500 in MDS 3.0 Section H is based on the Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual, Version 1.18.11, dated October 2023. Please note that 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.