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MDS 3.0 Item D0150F2: PHQ Response - Frequency of Feeling Bad About Self

MDS 3.0 Item D0150F2: PHQ Response - Frequency of Feeling Bad About Self


Introduction

Purpose: Monitoring the frequency of feelings of low self-worth or guilt is essential in long-term care, as these emotions are often linked to depression and can have a significant impact on a resident's mental and emotional well-being. MDS Item D0150F2 focuses on how often the resident has felt bad about themselves, believed they are a failure, or felt that they have let themselves or others down over the past two weeks. Accurate coding of this item is critical for assessing the severity of these symptoms and ensuring that residents receive the appropriate care and support.


What is MDS Item D0150F2?

Explanation: MDS Item D0150F2 is part of the Patient Health Questionnaire (PHQ-9) interview in Section D: Mood. This item specifically assesses the frequency with which a resident has felt bad about themselves, felt like a failure, or believed they have let themselves or others down in the last two weeks. Understanding how often these feelings occur is crucial for evaluating their impact on the resident’s mental health and guiding necessary interventions.


Guidelines for Coding MDS Item D0150F2

Coding Instructions: To code MDS Item D0150F2, the interviewer asks the resident how often they have felt bad about themselves, felt like a failure, or believed they have let themselves or others down over the past two weeks. The coding is based on the resident’s response and is categorized as follows:

  • 0 - Not at all: The resident has not experienced these feelings.
  • 1 - Several days: The resident has experienced these feelings on several days.
  • 2 - More than half the days: The resident has experienced these feelings on more than half of the days.
  • 3 - Nearly every day: The resident has felt this way nearly every day.

Example Scenario: If a resident reports feeling bad about themselves or like a failure on five out of the last fourteen days, you would code D0150F2 as 1 - Several days. If the resident indicates that these feelings were 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 these feelings, along with any related observations. Detailed documentation ensures that the coding accurately reflects the resident’s experience and informs the care plan.

Communication: Ensure that the results of this assessment are communicated to the interdisciplinary team. Addressing frequent feelings of low self-worth or guilt may require a multidisciplinary approach, including psychological support.

Training: Provide regular training for staff on conducting the PHQ-9 interview and accurately documenting and coding responses. This training should emphasize sensitivity when discussing issues of self-worth and ensuring that residents feel heard and supported.


Conclusion

Summary: MDS Item D0150F2 is critical for assessing the frequency of feelings of low self-worth or guilt in long-term care residents. Accurate coding of this item helps healthcare providers understand the severity of these symptoms and implement appropriate interventions to support the resident's mental 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-9.


Disclaimer

Please note that the information provided in this guide for MDS 3.0 Item D0150F2: "PHQ Response - Frequency of Feeling Bad About Self" 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.

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