MDS 3.0 Item D0150B2: PHQ Response - Frequency of Feeling Down or Depressed

MDS 3.0 Item D0150B2: PHQ Response - Frequency of Feeling Down or Depressed

Introduction

Purpose: Assessing the frequency of depressive symptoms in residents of long-term care facilities is crucial for effective mental health care. MDS Item D0150B2 focuses on determining how often a resident has felt down, depressed, or hopeless over the past two weeks. Accurate coding of this item helps to identify the severity of depression and to tailor care plans accordingly, ensuring that residents receive the appropriate level of support.

What is MDS Item D0150B2?

Explanation: MDS Item D0150B2 is part of the Patient Health Questionnaire (PHQ-9) interview in Section D: Mood. This item assesses the frequency with which a resident has experienced feelings of being down, depressed, or hopeless in the last two weeks. This information is essential for gauging the severity of depressive symptoms and plays a critical role in the overall mental health assessment of the resident.

Guidelines for Coding MDS Item D0150B2

Coding Instructions: To code MDS Item D0150B2, the interviewer asks the resident about how often they have felt down, depressed, or hopeless 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 felt down, depressed, or hopeless at all.
• 1 - Several days: The resident has felt down, depressed, or hopeless on several days.
• 2 - More than half the days: The resident has felt this way on more than half of the days.
• 3 - Nearly every day: The resident has felt down, depressed, or hopeless nearly every day.

Example Scenario: If a resident reports that they have felt down or depressed on five out of the last fourteen days, you would code D0150B2 as 1 - Several days. If the resident states that these feelings were present nearly every day, the appropriate code would be 3 - Nearly every day.

Best Practices for Accurate Coding

Documentation: It is essential to document the resident's statements about the frequency of their symptoms, along with any observable behavior that supports their response. This documentation helps ensure accuracy and consistency in the resident's assessment and medical record.

Communication: Share the results of the PHQ-9 interview with the interdisciplinary team to ensure that all aspects of the resident's care plan address their mental health needs. Effective communication is key to providing comprehensive care.

Training: Provide regular training for staff on how to conduct the PHQ-9 interview accurately and sensitively. This training should include guidance on how to discuss potentially distressing topics with residents and how to interpret their responses.

Conclusion

Summary: MDS Item D0150B2 is critical in assessing the frequency of depressive symptoms in long-term care residents. By accurately coding this item, healthcare providers can better understand the severity of the resident's depression and implement appropriate interventions to support their mental health.

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-5.

Disclaimer

Please note that the information provided in this guide for MDS 3.0 Item D0150B2: "PHQ Response - Frequency of Feeling Down or Depressed" 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.