MDS 3.0 Item D0150H2: PHQ Response - Frequency of Being Slow, Fidgety, or Restless
MDS 3.0 Item D0150H2: PHQ Response - Frequency of Being Slow, Fidgety, or Restless
Introduction
Purpose: Assessing the frequency of motor activity changes, such as feeling slowed down, fidgety, or restless, is essential for understanding the severity of these symptoms in long-term care residents. MDS Item D0150H2 focuses on how often a resident has experienced noticeable changes in their motor activity over the past two weeks. Accurate coding of this item helps healthcare providers determine the extent of these symptoms and tailor care plans to address underlying issues such as depression or anxiety.
What is MDS Item D0150H2?
Explanation: MDS Item D0150H2 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 changes in motor activity, such as moving or speaking more slowly than usual or being unusually fidgety or restless, in the last two weeks. Understanding how often these symptoms occur is crucial for evaluating their impact on the resident’s daily functioning and mental health.
Guidelines for Coding MDS Item D0150H2
Coding Instructions: To code MDS Item D0150H2, the interviewer asks the resident or observes how often they have experienced noticeable changes in their motor activity, such as moving or speaking more slowly than usual, or being unusually fidgety or restless, over the past two weeks. The response is coded as follows:
- 0 - Not at all: The resident has not experienced noticeable changes in motor activity.
- 1 - Several days: The resident has experienced these symptoms on several days.
- 2 - More than half the days: The resident has experienced these symptoms on more than half the days.
- 3 - Nearly every day: The resident has experienced these symptoms nearly every day.
Example Scenario: If a resident reports feeling unusually restless or if staff observe the resident moving much more slowly than normal on five out of the last fourteen days, you would code D0150H2 as 1 - Several days. If these symptoms have been present nearly every day, the appropriate code would be 3 - Nearly every day.
Best Practices for Accurate Coding
Documentation: Document the resident’s responses and any observed changes in their motor activity, including the frequency of these changes. This documentation is essential for ensuring accuracy and for informing the care plan.
Communication: Share findings about the resident’s motor activity with the interdisciplinary team to ensure that any underlying issues, such as depression or anxiety, are addressed in a comprehensive care plan.
Training: Regularly train staff on observing and documenting changes in residents’ motor activity accurately, and on how to discuss these observations with residents during the PHQ-9 interview.
Conclusion
Summary: MDS Item D0150H2 is critical for assessing the frequency of changes in motor activity, such as slowness or restlessness, 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 overall 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-11.
Disclaimer
Please note that the information provided in this guide for MDS 3.0 Item D0150H2: "PHQ Response - Frequency of Being Slow, Fidgety, or Restless" 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.
