MDS 3.0 Item D0150E2: PHQ Response - Frequency of Poor Appetite or Overeating

MDS 3.0 Item D0150E2: PHQ Response - Frequency of Poor Appetite or Overeating

Introduction

Purpose: Monitoring changes in appetite, including poor appetite or overeating, is crucial in long-term care settings, as these changes can signal underlying health or emotional issues such as depression. MDS Item D0150E2 focuses on assessing how frequently a resident has experienced poor appetite or overeating over the past two weeks. Accurate coding of this item is essential for understanding the severity of these symptoms and for guiding appropriate care interventions.

What is MDS Item D0150E2?

Explanation: MDS Item D0150E2 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 poor appetite or overeating in the last two weeks. Knowing how often these symptoms occur helps healthcare providers determine their impact on the resident’s overall health and well-being, leading to more targeted and effective care plans.

Guidelines for Coding MDS Item D0150E2

Coding Instructions: To code MDS Item D0150E2, the interviewer asks the resident how often they have experienced poor appetite or overeating over the past two weeks. The response is coded as follows:

• 0 - Not at all: The resident has not experienced poor appetite or overeating.
• 1 - Several days: The resident has experienced poor appetite or overeating on several days.
• 2 - More than half the days: The resident has experienced these symptoms on more than half of the days.
• 3 - Nearly every day: The resident has experienced poor appetite or overeating nearly every day.

Example Scenario: If a resident reports that they have had little interest in eating or have been overeating on four out of the last fourteen days, you would code D0150E2 as 1 - Several days. If the resident indicates that these changes in appetite have occurred nearly every day, the appropriate code would be 3 - Nearly every day.

Best Practices for Accurate Coding

Documentation: Document the resident's statements regarding their appetite, including the frequency of these symptoms, to support the chosen code. This documentation is vital for ensuring the accuracy of the assessment and for informing the care plan.

Communication: Ensure that the results of the appetite assessment are shared with the interdisciplinary team, particularly if the resident is experiencing frequent changes in appetite. This information is crucial for developing a comprehensive care plan that addresses both physical and emotional health.

Training: Provide regular training for staff on how to conduct the PHQ-9 interview and accurately document and code the resident's responses, especially regarding sensitive issues like changes in appetite.

Conclusion

Summary: MDS Item D0150E2 is critical for assessing the frequency of poor appetite or overeating in long-term care residents. By accurately coding this item, healthcare providers can better understand the severity of these symptoms and implement appropriate interventions to support the resident's nutritional and emotional well-being.

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-8.

Disclaimer

Please note that the information provided in this guide for MDS 3.0 Item D0150E2: "PHQ Response - Frequency of Poor Appetite or Overeating" 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.