MDS 3.0 Item D0150A2: PHQ Response - Frequency of Little Interest or Pleasure in Doing Things

MDS 3.0 Item D0150A2: PHQ Response - Frequency of Little Interest or Pleasure in Doing Things

Introduction

Purpose: Assessing the frequency of mood-related symptoms is crucial for effective mental health care in long-term care settings. MDS Item D0150A2 focuses on the frequency with which a resident has experienced "little interest or pleasure in doing things" over the past two weeks. Accurate coding of this item helps identify the severity of depressive symptoms, enabling healthcare professionals to tailor care plans that better address the resident's mental health needs.

What is MDS Item D0150A2?

Explanation: MDS Item D0150A2 is part of the Patient Health Questionnaire (PHQ-9) interview in Section D: Mood. This item assesses the frequency of the resident's experience of little interest or pleasure in activities, which is a key indicator of anhedonia, a core symptom of depression. The response options quantify how often this symptom has been present, providing essential information for the overall assessment of the resident’s mood.

Guidelines for Coding MDS Item D0150A2

Coding Instructions: To code MDS Item D0150A2, the interviewer records the frequency with which the resident reports having little interest or pleasure in doing things over the past two weeks. The coding is based on the resident’s reported experience and is categorized as follows:

• 0 - Not at all: The resident has not experienced little interest or pleasure in doing things.
• 1 - Several days: The resident has experienced this symptom on several days.
• 2 - More than half the days: The resident has experienced this symptom on more than half of the days.
• 3 - Nearly every day: The resident has experienced this symptom nearly every day.

Example Scenario: If a resident reports that they felt little interest or pleasure in activities on approximately five days in the last two weeks, you would code D0150A2 as 1 - Several days. If the resident indicates that this feeling was present nearly every day, the appropriate code would be 3 - Nearly every day.

Best Practices for Accurate Coding

Documentation: Document the resident's statements regarding the frequency of their symptoms. This documentation should include specific details that support the chosen code, ensuring clarity and accuracy in the resident’s assessment record.

Communication: Effective communication with the interdisciplinary team is essential. Ensure that all relevant team members are informed of the resident’s mood assessment outcomes, as this can impact other aspects of the resident’s care plan.

Training: Regular training sessions for staff conducting PHQ-9 interviews can help improve the accuracy and sensitivity of these assessments. Training should focus on how to ask the questions and interpret the resident’s responses.

Conclusion

Summary: MDS Item D0150A2 is critical in assessing the frequency of a resident’s experience of little interest or pleasure in doing activities, which can indicate the presence and severity of depression. By accurately coding this item, healthcare professionals can ensure that they address the resident’s mental health needs effectively, contributing to better overall care outcomes.

Click here to see a detailed Step-by-Step on how to complete this item set.

Reference

This guide is based on the CMS's Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual, Version 1.19.1, October 2024, Page D-4.

Disclaimer

Please note that the information provided in this guide for MDS 3.0 Item D0150A2: "PHQ Response - Frequency of Little Interest or Pleasure in Doing Things" was originally based on the CMS's Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual, Version 1.19.1, October 2024. Every effort will be made to update it to the most current version. The MDS 3.0 Manual is typically updated every October. If there are no changes to the Item Set, there will be no changes to this guide.

This guidance is intended to assist healthcare professionals, particularly new nurses or MDS coordinators, in understanding and applying the correct coding procedures for this specific item within MDS 3.0. The guide is not a substitute for professional judgment or the facility’s policies. It is crucial to stay updated with any changes or updates in the MDS 3.0 manual or relevant CMS regulations. The guide does not cover all potential scenarios and should not be used as a sole resource for MDS 3.0 coding. Additionally, this guide refrains from handling personal patient data and does not provide medical or legal advice. Users are responsible for ensuring compliance with all applicable laws and regulations in their respective practices.