MDS 3.0 Item D0500F2: PHQ Staff Assessment - Frequency of Feeling Bad About Self
MDS 3.0 Item D0500F2: PHQ Staff Assessment - Frequency of Feeling Bad About Self
Introduction
Purpose: Assessing the frequency of negative self-perception or guilt in long-term care residents is crucial for identifying mental health issues, such as depression. MDS Item D0500F2 focuses on how often staff have observed that a resident has been feeling bad about themselves, thinking they are a failure, or feeling they have let themselves or others down over the past two weeks. Accurate coding of this item helps in determining the severity of mood disturbances and guides appropriate care interventions.
What is MDS Item D0500F2?
Explanation: MDS Item D0500F2 is part of the staff assessment for mood under Section D: Mood. This item asks staff to assess the frequency with which they have observed the resident feeling bad about themselves or experiencing guilt during the past two weeks. It is used when the resident cannot or does not complete the mood interview (PHQ-9), and staff observations are recorded instead. Identifying the frequency of these feelings is essential for evaluating the resident’s emotional state and for developing effective care plans.
Guidelines for Coding MDS Item D0500F2
Coding Instructions: To code MDS Item D0500F2, staff members should assess how frequently they have observed the resident feeling bad about themselves, thinking they are a failure, or feeling they have let themselves or others down over the past two weeks. The coding is based on the frequency of these observations:
- 0 - Not at all: The resident has not shown signs of feeling bad about themselves.
- 1 - Several days: The resident has shown signs of feeling bad about themselves on several days.
- 2 - More than half the days: The resident has shown signs of feeling bad about themselves on more than half of the days.
- 3 - Nearly every day: The resident has shown signs of feeling bad about themselves nearly every day.
Example Scenario: If a staff member observes that a resident has expressed feelings of regret, worthlessness, or failure on five out of the last fourteen days, you would code D0500F2 as 1 - Several days. If these feelings are observed almost daily, the appropriate code would be 3 - Nearly every day.
Best Practices for Accurate Coding
Observation: Staff should carefully observe the resident’s behavior and emotional expressions over the two-week period. Pay attention to both verbal statements (e.g., “I can’t do anything right” or “I always fail”) and non-verbal cues (e.g., withdrawal, avoiding social interactions) that may indicate low self-esteem or feelings of guilt.
Documentation: Document specific examples of the resident’s behavior that illustrate these feelings and note the frequency of such behaviors. Recording precise observations will support accurate coding and help guide care interventions.
Communication: Share observations with the interdisciplinary care team to ensure that these signs of emotional distress are addressed comprehensively. This may involve discussing possible interventions such as counseling, medication adjustments, or increased social support.
Training: Provide regular training for staff on recognizing and documenting signs of low self-worth or guilt in residents, especially in understanding how frequently these symptoms occur. Accurate documentation helps ensure that residents receive the appropriate care and support.
Conclusion
Summary: MDS Item D0500F2 is essential for identifying the frequency of feelings of low self-worth or guilt in long-term care residents. Accurate coding of this item based on staff observations ensures that these mood disturbances are detected and addressed promptly, helping to improve the resident’s emotional and mental 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-21.
Disclaimer
Please note that the information provided in this guide for MDS 3.0 Item D0500F2: "PHQ Staff Assessment - 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 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. Additionally, this guide refrains from handling personal patient data and does not provide medical or legal advice.
