MDS 3.0 Item GG0100D: Functional Cognition - Prior Functioning

Introduction

Purpose: Understanding a resident’s prior cognitive functioning is crucial for assessing their current needs and creating an appropriate care plan. MDS Item GG0100D evaluates the resident’s cognitive abilities before their current illness, injury, or admission to the facility. This assessment provides insight into the resident’s prior ability to complete cognitive tasks such as decision-making, memory, and problem-solving. Accurately assessing prior cognitive function helps care teams develop personalized rehabilitation and care plans that support the resident’s cognitive health.

What is MDS Item GG0100D?

Explanation: MDS Item GG0100D is part of Section GG: Functional Abilities and Goals, which includes an assessment of the resident’s prior cognitive abilities. This item evaluates the resident’s ability to complete cognitive tasks related to daily functioning, such as managing finances, making decisions, and problem-solving, prior to their illness or admission. The information gathered helps create a care plan that supports the resident’s cognitive needs and promotes optimal functioning.

Guidelines for Conducting and Coding MDS Item GG0100D

Conducting the Assessment: Information about the resident’s prior cognitive functioning should be gathered from multiple sources, including:

• Interviews with the resident, family members, or caregivers.
• Reviewing medical records or past health assessments.
• Observations from previous care providers about the resident’s ability to handle cognitive tasks before admission.

The assessment focuses on how well the resident was able to manage their day-to-day cognitive responsibilities, including decision-making and memory tasks.

Coding Instructions: MDS Item GG0100D uses a scale to indicate the resident’s level of cognitive independence prior to their illness or admission. The coding options are:

• 3 - Independent: The resident was able to complete cognitive tasks independently without assistance from others.
• 2 - Needed Some Help: The resident required some help from others for cognitive tasks, such as managing finances or making decisions.
• 1 - Dependent: The resident was completely dependent on others for cognitive tasks or decisions.
• 8 - Unknown: Information about the resident’s prior cognitive function is not available.
• 9 - Not Applicable: Cognitive functioning prior to the illness or admission is irrelevant or not applicable to the resident’s current situation.

Example Scenario: If a resident was fully independent in decision-making, problem-solving, and managing their daily responsibilities before admission, you would code GG0100D as 3 - Independent. If the resident required some help with cognitive tasks, such as remembering appointments or handling finances, you would code GG0100D as 2 - Needed Some Help. If no information is available, you would code GG0100D as 8 - Unknown.

Best Practices for Accurate Coding

Collect Reliable Information: Accurate coding of GG0100D depends on gathering reliable information about the resident’s cognitive abilities before admission. Conduct interviews with family members and review past records to ensure an accurate understanding of the resident’s prior cognitive function.

Thorough Documentation: Proper documentation is essential for supporting the assessment. Record the sources of information used to determine the resident’s prior cognitive functioning, such as interviews, past medical records, and observations.

Collaboration with the Care Team: Share the results of the cognitive assessment with the interdisciplinary care team. Understanding the resident’s prior cognitive abilities helps the team set appropriate goals for cognitive rehabilitation or support, ensuring that the resident’s cognitive needs are addressed.

Conclusion

Summary: MDS Item GG0100D provides important insight into a resident’s prior cognitive functioning. By accurately assessing the resident’s cognitive abilities before their illness or admission, care teams can develop personalized care plans that address the resident’s cognitive needs, supporting their overall well-being and quality of life.

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 GG-4.

Disclaimer

Please note that the information provided in this guide for MDS 3.0 Item GG0100D: "Functional Cognition - Prior Functioning" 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. Additionally, this guide refrains from handling personal patient data and does not provide medical or legal advice.