P0200F: Other Alarm" and P0200E: "Wander/Elopement Alarm, Step- by-Step

Step-by-Step Coding Guide for Item Set P0200F: "Other Alarm" and P0200E: "Wander/Elopement Alarm"

1. Review of Medical Records

• Objective: Ensure accurate documentation of the use of alarms, including specific types such as wander/elopement alarms and other alarms.
• Actions:
  • Review the resident’s medical records, including nursing notes, physician orders, and care plans, to determine if any alarms were used during the 7-day look-back period.
  • Confirm the types of alarms used, including wander/elopement alarms (P0200E) and other types of alarms (P0200F), and the frequency of their use.
  • Consult with the nursing staff to clarify the purpose and effectiveness of the alarms used.

2. Understanding Definitions

• P0200E: Wander/Elopement Alarm: This item captures the use of any device designed to alert staff when a resident is wandering or attempting to elope from a safe area. These alarms can include bracelets, pins, or buttons worn by the resident, sensors in shoes, or exit door alarms.
• P0200F: Other Alarm: This item captures the use of any other type of alarm not specifically categorized, such as alarms on the resident's bathroom door, bedroom door, toilet seat, or seatbelt alarms.

3. Coding Instructions

• Step-by-Step:
  • Step 1: Determine if a wander/elopement alarm was used during the 7-day look-back period. If used, code the frequency:
    • 0: Not used.
    • 1: Used less than daily.
    • 2: Used daily.
  • Step 2: Determine if any other types of alarms were used (e.g., bathroom door alarms). Code the frequency of use:
    • 0: Not used.
    • 1: Used less than daily.
    • 2: Used daily.
  • Step 3: Document the type of alarm and its purpose in the resident’s care plan, ensuring that any adverse effects or benefits are noted.

4. Coding Tips

• Consistency: Ensure that the alarm types are documented consistently across all relevant sections of the MDS.
• Impact on Resident: Consider whether the alarm affects the resident’s freedom of movement. If it does, it might also need to be coded as a restraint.
• Accuracy: Double-check that the alarm is coded under the correct category (P0200E or P0200F) based on its intended use.

5. Documentation

• Objective: Maintain clear records of alarm use to support resident safety and care planning.
• Actions:
  • Document the specific type of alarm used and its frequency of use.
  • Record any incidents related to the alarm’s use, such as successful prevention of elopement or any negative impacts on the resident (e.g., anxiety or reduced mobility).
  • Include details on the care plan regarding why the alarm is necessary and how its use is monitored and evaluated.

6. Common Errors to Avoid

• Misclassification: Do not confuse other types of alarms with wander/elopement alarms. Each should be coded correctly under their respective items (P0200E for wander/elopement and P0200F for other types).
• Overlooking Alarm Impact: Failing to document the impact of the alarm on the resident can lead to inadequate care planning and potential harm.

7. Practical Application

• Example 1: A resident at risk of elopement wears a bracelet that triggers an alarm when they approach the exit door. This alarm is used daily. P0200E is coded as "2" for daily use.
• Example 2: A resident has an alarm on their bathroom door to alert staff if they attempt to use the bathroom unassisted due to fall risk. The alarm is used less than daily. P0200F is coded as "1" for less than daily use.

Please note that the information provided in this guide for MDS 3.0 Item set P0200F was originally based on the CMS's RAI Version 3.0 Manual, October 2023 edition. 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.